Horizon: ‘Should I Eat Meat? – The Big Health Dilemma’

Horizon: ‘Should I Eat Meat? – The Big Health Dilemma’

I don’t really know why I watched this after the abysmal ‘Fat vs Sugar’ in January (a masochistic streak perhaps). I ran out of patience quite early on but managed to last out the hour. Pop over to here to watch it in full. Alternatively have a read of my post and see if it’s worth the bother. The documentary jumped from one issue to another in a confusing and ultimately pointless manner. Repeating the well-worn mantra of ‘all things in moderation’ and leaving the viewer ultimately frustrated at the lack of hard evidence for any of the scare stories, I felt this programme did nothing to seriously address the question.  Let’s hope that the next edition is better than this.

Presented by Dr Michael Mosley the programme questioned whether meat is a nutritious form of protein or an artery clogging danger that causes cause cancer and premature death. ‘What is the truth about meat?’ Dr M asks (in a sort of conspiracy-theory way). He rather guiltily admits to eating meat most days but adds that he is sceptical of the scare headlines about red meat and cancer. Dr M notes that as meat eating has doubled world-wide, we need find out if this is a good thing.  For the purpose of the documentary, he decides to go on a ‘high meat diet’ to see the effects on his body.

The requisite experts then appear (British Nutrition Foundation, Interventional Cardiologist, Senior Heart Health Dietician) and give a series of quite positive opening statements regarding meat. Dr M tells us that ‘as a species we evolved to eat red meat, but not that much and not that often’ (so don’t get too excited).

Dr M advises that we need to look at ‘studies’ (although perhaps we need to turn away from studies, academia and experts and start looking at how we feel on an individual basis, but that’s another argument). We hear that chicken and other white meat are ok (factory-farmed, antibiotic-laden chickens are obviously not a problem) but that it is the effects of eating red meat (beef, pork and lamb) as well as processed meat that needs to be considered.

The average meat consumption in the UK is 70 grams of red and processed meat a day, with a quarter of men eating 130 grams. Therefore Dr M decides that his experiment should consist of eating 130 grams of red and processed meat per day.

Dr M gets a health check (body fat, blood panel etc.) but admits that this is a sample size of 1 and so won’t be representative of everyone. He then hops over the pond to meet some very pleasant vegetarian Seventh Day Adventists who (on average) live for 7 years longer than the (average) American. Not all Seventh Day Adventists are vegetarian though; some eat limited amounts of meat. The community extol the virtues of leading a ‘healthy, wholesome lifestyle’ and so are interesting subjects to study for a comparison between meat eaters and non-meat eaters (the half that do eat meat tend not to smoke or have other unhealthy habits).

Extensive epidemiological studies have been carried out to look at the Seventh Day Adventists and their health in relation to meat-eating. We then skip to an interview in a café where Dr M talks to Dr Gary Frazer leading the research (himself a vegetarian). Dr M tucks into some pulled pork and admits guiltily to the clearly concerned doctor (munching a vegetarian salad) that he has also eaten 4 rashers of bacon the same morning. After reflecting on Dr M’s survival outlook if he carries on like this (bleak), Dr Frazer explains that the vegetarians are doing much better in terms of cardiovascular disease, diabetes and hypertension and tells us: ‘That whole area is fairly well-established.’ Oh…

We are told that men who eat beef 3 times per week, double the risk of heart disease. At this point we see Dr M consuming a huge, deep-fried onion ring. This behaviour translates to 4-5 years reduction in life expectancy (that’s the beef, not the onion ring – keep up with me here…).

Dr M then goes back to Reading University to find out what it is in meat that is doing us harm. We look at the various nutrients in meat as opposed to vegetarian options. The scientist at Reading tells us that red meat is a ‘good, high quality protein’ but that cheese has the same amount of protein. Pork and vegetarian sausage have the same amount of protein. Tofu has a lot less.

We learn that red meat is made up of amino acids which are essential, many of which the body cannot make. Red meat is a complete protein and is also rich in vitamins and minerals. However, cheese has nearly the same amount of B12. It also has more saturated fat, but as people tend to eat less cheese this is ok. The cheese appears to be coming out tops in all this…

We are told that beef, bacon and sausages all have high amounts of saturated fat ‘which are linked to heart disease’. Then there is some talk about the research in the 1950s on heart disease and saturated fat, with the terms ‘red meat’ and ‘processed meat’ being constantly linked. This really is all over the place.

Dr M admits that recent research has suggested saturated fat is not that bad. He goes to talk to Dr Ronald Krause at Berkeley. Dr Krause was a former adherent to a low-fat dogma but found that his patients did not do well on low-fat diets. He set out to examine the studies regarding saturated fat and heart disease but found the evidence lacking. However, just before we get too complacent Dr M warns us that this ‘doesn’t suggest that saturated fat is a health tonic’ and asks if there is something else in red meat ‘that could be clogging our arteries.’

On to the subject of L-Carnotine found in the lean part of the meat and which ‘potentially’ affects the build-up of cholesterol in the arteries by reacting with the bacteria in the gut to produce TMAO (Trimethylamine N-oxide). We are told by an expert that ‘this has not been proven to occur in our bodies but is a potential mechanism for how this might work.’ Dr M then tells us that we now have evidence that saturated fat isn’t that bad but that ‘lean meat could be doing damage.’ The words ‘potential’ ‘could’ and ‘possibly’ crop up an awful lot over the space of an hour.

(Incidentally, pop over to here, and here for some interesting reflections on TMAO. Fish also raises TMAO).

Back to the UK experts and I noticed a hint of mild excitement that although they appear to have been barking up the wrong tree regarding saturated fat, there may be this ‘other thing’ that justifies them telling us to avoid red meat.

There is some dramatic music and then Dr M tells us that ‘the jury is still out regarding what it is in meat that increases risk of cardiac problems and how big this risk is’… Then we watch as he tucks into a burger with huge bun and a load of chips.

There is a brief and totally pointless bit about meat and culture, in which the experts link meat and ‘affluence’, and then Dr M goes to Harvard University to interview Walter Willett. Dr Willett has studied 120, 000 people over 30 years and explains the following findings:

Red meat (unprocessed):

  • Those who ate red meat had a higher risk of mortality, cancer, etc.
  • 85 grams (beef burger) = 13% increase risk of premature death

Processed meat is worse:

  • 35 grams per day (2 rashers of bacon) = 20% increase risk of premature death (because of heart disease and cancer)

Dr M warns us that things are ‘looking grim for meat eaters’. But wait! The EPIC study (European Prospective Investigation into Cancer and Nutrition) followed 0.5 million people over 12 years in 10 countries. This found that moderate amounts of red meat had no effect on mortality rates and that eating meat is ‘better than being vegetarian.’

(Incidentally the study showed that ‘Subjects in the highest fifth of blood vitamin D levels showed a 40% reduced risk [of colorectal cancer compared with those in the lowest fifth.’ See here)

At this point Dr M admits that epidemiological observational studies are ‘not certain’ (funny that he didn’t mention it before now) and that we ‘cannot prove that dietary components are causing specific diseases’.  At this point you wonder why you bothered watching…

Back to the experts and their final recommendations on how often to eat which ranged from ‘meat-less days’ (if you can’t go vegetarian, which is the ideal), ‘once a month’, ‘in moderation’ to Dr M’s advice that ‘a moderate amount a couple of days per week is ok’.

Dr M then considers colonoscopies and their importance in detecting polyps in the bowel (which may lead to bowel cancer). This leads him to look at why processed meat is a possible carcinogenic. Dr M cures some bacon at Reading University using 12 teaspoons of salt which clearly disturbs him (‘salt is obviously not good for us’), 5 teaspoons of sugar (not particularly bothered) and a teaspoon of nitrates. We are informed that Sodium Nitrate stops us getting botulism but reacts with amino acids. However, ‘we have yet to establish a direct link’ between nitrates and colon cancer. The smoking process (producing chemicals called PAH’s) may be another ‘potential mechanism whereby red and process meats increase our chances of gastro-intestinal cancer.’  As with all of this, there seems to be no conclusive proof. As an aside, the possibility of nitrate-free bacon is not mentioned.

On to the best piece of information in the whole documentary and if you have one ‘take-away’ it has to be this. Dr M recruits a statistician and asks him ‘If we were to nail down what we can really, really say  about  how long we live, what sort of things are we reasonably certain will cut years off your life?’. The statistician tells us that eating 2 rashers of bacon a day translates to an hour per day off our life. Dr M looks suitably grave at this announcement and exclaims ‘Wow!’ This is science at its best.

Dr M then returns to the hospital for a check-up and finds out the following:

  • No change in compounds linked to cancer (we are told that this is possibly because he has been consuming a lot of fibre with his meat)
  • LDL cholesterol has increased (no mention of what type here)
  • Body fat and blood pressure have increased

Therefore the suggestion is that eating more meat increases ‘bad’ cholesterol, makes you fat and sends your blood pressure up. No mention of anything else that Dr M may have tucked into on his high meat diet (onion rings, chips, burger buns…)

Dr M advises that we should eat unprocessed, ‘fairly lean’ meat on occasions and that ‘if you are going vegetarian make sure that you get all the vitamins and minerals that you need’. An expert adds that a healthy diet is a ‘predominantly plant-based diet, supplemented with meat.’

Dr M then finishes on a plea for more ‘vegetables, vegetables, vegetables’ and then it ends. Phew! Once again, Horizon comes up with the goods regarding cutting-edge science documentaries.

I feel genuinely sorry for those people looking to find an answer in all of this mess. The lightweight treatment of what is a serious subject (the avoidance of diseases such as heart disease and cancer) is frustrating. The confounding factors in all of the arguments put forward simply serve to confuse things even further. Apart from a fleeting comment (we evolved to eat red meat ‘not that much and not that often’),  our existence as hunter-gatherers for the majority of our time on earth eating meat, fish, fat, roots and tubers, a variety of other vegetables, with some limited fruit is not discussed or considered relevant. It as if we have all been beamed down from another planet. We need to look at the consumption of meat in the context of a real food diet; quality meat produce eaten alongside healthy fats and vegetables. The lumping together of meat-eating with a high carbohydrate diet for the purpose of ‘scientific’ observational studies such as this will always obscure the benefits of eating meat.

If people are encouraged to cut back their consumption of meat, many will probably increase carbs (as I did), as most people have been scared to death of fat. This has all sorts of implications for health – especially in terms of gluten and excess carbohydrates. The satiating effects of meat, and especially fat, are so important in the context of a healthy diet, particularly if people are struggling to lose weight and come from a background of low-fat, low-calorie eating that the ‘experts’ have pushed on us for many decades. When eaten with sufficient fat, meat portions do not have to be huge to be satisfying (particularly if you are looking to move into ketosis, in which case protein should be limited).

Meat quality was not addressed, although that may be a subject for next week’s edition (but what if you don’t watch that?). I also noticed that the benefits of offal was not discussed which was a shame as it provides some of the best nutrition by far.

I will watch next week’s edition but I wonder how many years of my life I have wasted – and will probably continue to waste – by watching rubbish documentaries such as this.  So a bacon sandwich a day takes an hour off your life? In that case I’m sticking to my bacon (without the bread) and if I could just give up watching these hour-long pointless documentaries, things will even themselves out…



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Noble Ancestors and Modern Selves

Noble Ancestors and Modern Selves


Bruce Parry: BBC Documentary Film Maker and Author
Daniel Everett: Anthropologist and Author
Sarah Chan: Bioethicist
Janet Radcliffe-Richards: Oxford Professor of Practical Philosophy, Author
Chair: Sean Curran: BBC Editor


The debate took place earlier this year at How the Light Gets In, a philosophy festival in Hay on Wye that ran from 22nd May to 1st June. I have been meaning to write it up, but have been so busy these last months that it was delayed. We happened upon the talk by chance and were delighted to see that Explorer and Author Bruce Parry had joined the panel.

‘Thomas Hobbes believed life before civilisation was ‘nasty, brutish and short’ but from diets to lifestyles, some anthropologists think otherwise.’

The debate asked whether we should look to modern hunter-gatherers for lessons on how to live our own lives. Do they have a better grasp on life?  Is this a romantic delusion? What has ‘civilisation’ done for our societies?

The debate was one of the most thought-provoking and interesting discussions I have heard in a long time. There was a definite tension between the views of both Bruce and Daniel and those of the philosopher Janet Radcliffe-Richards as is clear from the transcript below (although that tension was clearly projected from one direction). Both Bruce and Daniel spoke eloquently and movingly about their experiences and the audience was clearly transfixed. I had heard neither speak before and I have to say that I could have listened to them for hours. Their views were neither romantic nor simplistic and both stressed the need to remember that tribes differ greatly. Both men felt there were definite lessons to be learnt from their time spent with modern hunter-gatherers and both had changed profoundly from their experiences. A fascinating and very moving debate; it made a big impact on me. I hope you enjoy it too.


Each of the panellists gave a brief statement about their position on the subject before starting the debate. At the end of the debate there was time for a few questions from the audience.

Daniel Everett

Daniel has spent over 35 years living and working amongst modern hunter-gatherer tribes, including 8 years with the Pirahã tribe in the Amazonian Basin. His life has been ‘transformed’ by these people but he stressed that it was important not to think of them as ‘original humans’ as we can never fully know the conditions that our prehistoric ancestors faced. They are instead modern societies. However, in his search for options on how to live life, the hunter-gatherers that he had worked with were happier, smiled more and held an outlook on life that he had not seen elsewhere. He described the tribe as ‘happy societies of intimates’ that know each other (as opposed to modern ‘societies of strangers’) and this affects how people relate and talk to each other that has lessons for us all. Although Daniel did not believe that they are ‘noble savages’, these people do help us to understand our place within the world and how we should live as human beings in complex societies.

Sarah Chan

Sarah noted that philosophers all through the ages have studied the issue of wellbeing and asked the questions ‘What is the Good Life and how can we obtain it?’ Is technology conducive to a good life? Although not all technology makes our life better, much of it can and does.  We shouldn’t presume that rejecting technology will necessarily make our lives better. Sarah stressed that there is a ‘fetishisation’ of the natural which is irrational but agreed that not all products of human invention are necessarily good for us – even if they started out that way. Technological inventions often come with their own concerns such as pollution, sustainability etc. but just imagine a life without modern medicine, transport, electricity, clean water etc. This doesn’t mean that there are not useful lessons to be learnt from societies that are very different from our own but these need to be evaluated critically with our eyes open, rather than assume they are better for us as a movement away from the idea of technological progress.

Bruce Parry

Bruce has spent time with many different hunter-gatherer tribes around the world and as Daniel stated, this had changed his life profoundly and very much for the better. He is especially interested in studying pre-agricultural societies and believes the dawn of agriculture is a fascinating time in human history.

Bruce then talked about the specific issues that interest him. He is concerned with issues of identity and how they have transitioned from the group and the family to the individual, technological (avatars) and media identities and the loss that this has brought about. Also issues of ownership and the transition from a ‘loose’, group, shared ownership towards a much more individualised notion of ownership. A shared, gift economy has also moved towards one in which those who do the least are rewarded the most.  There is usually communal child-rearing (paternal and maternal) and a strong family unit in comparison to much of our society. There is also very little addiction or addictive traits in hunter-gatherer groups. Emotions are shared and expressed with no repression (and the behaviour patterns this induces). Although not able to access the medical care that we enjoy, such societies use plant-based drugs to cure aspects of their being and Bruce’s experience with these have had profound positive effects upon his life. Regarding gender, Bruce stated that we currently live in a patriarchal society and felt this needed to be questioned. Finally Bruce added that he was brought up to look at Animism as a backward way of looking at the world, when in fact it is now cutting-edge. He believed that looking at the world as anima and full of meaning should be reintroduced to our thought patterns. Hunter-gatherers live in the present (obviously in order to hunt) but perhaps they have a very different way of using their minds, in ways that bring them a perspective of reality that is hard for us to understand. Bruce thinks that these different ways of seeing the world may be very valuable to us.

Janet Radciffe-Richards

Janet argued that humans always look back at ‘better state of things’ before something came along and ruined it, with a sentimental view of the countryside and the past which is echoed in stories such as the ‘myth’ of the fall. There is an idea that things that come later – the civilizing, intellectual things – must automatically be at fault, The idea of the noble savage comes from the idea that all our advances have corrupted things. Janet stressed that she is interested in what we can do now. We cannot go and live in groups of 250 in the jungle as there are too many of us. She added that even if there are some advantages, she wouldn’t want to go and live in a hut in Borneo without dentistry.

SC: This ‘romanticisation’ of the ‘noble savage’ is certainly not a new idea.

Bruce agreed that there is a tendency to romanticise tribal societies i.e. Rousseau, and acknowledged the many different theories of why this is so. For instance, this is echoed in a longing to return to childhood.

‘The rise of agriculture is in fact a relatively recent phenomenon as we have lived as hunter gatherers for the vast majority of our time on earth. Although we think of hunter gatherers as looking back they are in fact rather modern.’

Before agriculture, we experienced our world and our place in nature in a completely different way. It is this connection to nature and to something greater than ourselves that makes us feel as if we have lost something.


SC: Jared Diamond’s new book ‘The World Before Yesterday’ looks at this issue. Is there anything new about the way we view hunter gatherers?

Daniel stressed that although it is new research, it makes essentially the same points that we have forgotten the good life and replaced it with our neuroses. However, this point cannot be completely discounted. Some tribes have no concept of suicide or depression and although they worry about a few things, but certainly not as much as we do. However, this may not apply to a group living 5 miles away with very different values as they may have other concerns etc. The biggest lesson is diversity. The bigger the difference in people, the more we learn. This is why we can learn much from these people.

Sarah added that diversity is good and it is important to realise how big the world is through inventions such as the internet but that it relies on us being able to travel and experience different cultures. If we all lived in these communities we would lose that diversity.


SC: Is this longing was for a real past, or a romanticised version of the past?

Janet stated that it was a worry that people made too much of an inference between where we are now and primitive societies. She stressed the reliance on a romanticised version of events and that the idea that there is an ideal way of living is false. In fact whatever situation one is living in, there will always be the dream of better things. Janet asked Daniel and Bruce if they found this with the tribes they had encountered.

Daniel replied that the Pirahã showed no desire for technology but where other tribes have, this has caused unhappiness. Not because the technology in itself brings unhappiness but because they have learned to rely on something that they do not have the economics to support. So the Pirahã’s rejection of technology has made them happier because in their minds, the adoption of technology has not resulted in them becoming ‘poor’. They do not have a concept of ‘poverty’.

Bruce agreed that exposure to technology promoted insecurity. They initially rush to it – especially the children – but within one generation things change. They realise afterwards that they haven’t got the means to support themselves and have to go to the city to work. On a Polynesian island that he visited, there was one boat a year to the mainland and when members of the tribe did leave the island, they realised that what they had was special. That is very telling – when these groups experience our society they appreciate what they have at home.


SC: What can we realistically learn from these people?

Daniel replied that firstly, personal self-sufficiency and confidence in their own ability is very important. They regularly undergo fasting in order to keep their bodies ‘hard’ and this discipline made them more efficient hunters. The main thing is openness to emotions as Bruce said; the ability to express themselves without inhibitions and to talk about things without euphemisms. Also, to know how everyone else is doing and to take a responsibility not just for one’s self but for neighbours and fellow people.

SC: How we can actually achieve this – it sounds as if we need to remake ourselves?

Daniel replied that it is not just about living simply. Look at our friends – what responsibility do we take for them? Our lifestyles today allow us more time to care for others but how much of this do we take? How do we interact socially?

Daniel stressed that the only reason the panel was able to sit talking was that farmers have produced food so that we have freedom from farming and hunting and gathering. Although he enjoyed his time spent with hunter gatherers, he still enjoyed coming out of the society and going home. However, this does not negate the lessons that he learned and how he can apply them in his life. The experience of this is transformative even if the time spent with them is short. It was important to experience the world in a completely different way, including the hardships. The lessons do not depend on us becoming hunter gatherers.

Bruce added that he has chosen to change the way he lives as a response to his experience with hunter-gatherers. There is a realisation that choices made in this complex society have a detrimental effect on these people, on the environment, the air, the water. As he has made these changes – foregoing many ‘luxuries’ and reducing his footprint – Bruce noticed he became happier and that was a shock.

Sarah noted that the issue is quite complex. Our freedom to pursue our own version of the good life is what is important.

Social interaction

Janet warned against looking for some sort of ‘design’ in the world to make people ‘happy’. This is a problem. She asked about the tensions in hunter-gatherer societies i.e. psychological. Daniel talked about a tribe in Brazil where there are problems with suicide (using poison). Daniel told a story to the Pirahã about his step-mother who committed suicide. He thought that it would be a very meaningful story for them but when he finished, they burst out laughing. They thought that he was making it up as they could not believe that people killed themselves – it was the silliest thing they had heard. Although they all kill very effectively, they could not understand why people would kill each other (after watching a clip from a movie). Ostracism is a form of punishment for those who break tribal rules.

Daniel added that it is not just about the way these people live, but how they organise their knowledge and their personal values. They have a have a completely different philosophy. The Pirahã learned how to predict his behaviour even before he was able to. They ask questions all the time.

Sarah mentioned the idea that we are designed for a different age and the current tendency to explain our choices in terms of our evolutionary history. For instance, she stressed this in relation to the Paleo diet or the idea that we evolved to live in societies no bigger than around 30-50 individuals and so our moral compass has difficulty in making decisions based on larger numbers than this. She warned about the danger in making decisions based on scientific interpretations about why we lived the way we lived, as opposed to how we should live.


Bruce then talked about groups that had been on the verge of changing and that had employed people to destroy the forest around them (a tribe in Brazil). However, suddenly they had a ‘wake-up call’ and stopped. It’s not to say that they do not want comfort and luxury in their lives, but they realised that in order to change the price was not worth it and that there would be no security for their children’s future. That is a trend that he sees again and again.

Daniel added that such transitions are too abrupt – any transition needs to be slow and evolve naturally. When societies change very quickly, it rarely works out.


Janet argued that we should not presume we are designed for happiness. Can we really have Animism alongside modern scientific education? If you are having to choose between them, it presents a dilemma. Bruce argued that there is a convergence. The subjectivity of us actually being a part of what we are observing is an accepted idea and this happens on both a small and large level. He does not see animism as mutually exclusive to scientific explanation. Janet argued that this is an ‘expressionistic view.’

Bruce asked whether happiness is not something that one pursues but that occurs as a result of other choices.

Sarah noted that happiness was tied to consumerism in our society. The promotion of unhappinesss if we do not buy ‘stuff’ is used as a marketing trick. However, our society would be unwilling to give up the luxuries that it now takes for granted.

Sean asked about consumer culture, technology and media networks and their effect on our happiness. An audience member asked if we should not instead look at things like vulnerability, isolation and feelings of powerlessness that make us unhappy and go from there. It would seem that tribal societies can address these concerns.


Another audience member talked about the concept of alienation and commented that hunter-gatherer tribes seemed not to experience this alienation – from their fellow people and from the world around them. In contrast, many people in our society have become alienated.

Daniel warned against generalisation and added that alienation is an issue in some tribes. However in the tribes that he has encountered this has not been the case and people took care of others. Daniel then told a story of a tribe he was staying with. The people were sitting around the fire and they had all taken it in turns to bring firewood. Daniel spotted a very old, stooped man who was struggling to bring a few small sticks of firewood to the group. When he did this, one of the men gave him a large piece of meat to eat in return for the wood. When Daniel enquired of the man why he gave him the meat as the pieces of firewood were so small, he replied: ‘When I was a little boy he put meat in my mouth and now he is an old man, I put meat in his mouth.’ It is not that these lessons are unique to these people, but that Daniel has seen them more with these particular groups than elsewhere.


An audience member then asked if we should look for ‘meaning’ rather than happiness. Bruce replied that he came to the realisation that he had previously taken his scientific, Western mind-set into these societies and when they had talked about the spirit world and similar concepts, he had slightly looked down upon such ideas.

‘I was challenged to look at the world through their eyes and when I did, I suddenly saw and felt in my being a whole new set of values and way of interacting with the world. My actions and my thoughts had a reciprocal effect with everything that was going on around me and this was a level of meaning that brought a whole new sense of being to myself. I am still exploring this and some psychologists may say that is delusional and psychotic but if that takes place within a whole culture that thinks the same, then maybe not. Perhaps that is another level of having ‘meaning’. It is not just about believing that you are part of something bigger i.e. nature but taking it to the next level in which everything including our thoughts are part of a bigger whole which has meaning. That may have been the case for earlier people and playing with this idea myself has had a profound effect.’



Janet then returned to the point that we cannot believe in witchcraft and science simultaneously. Bruce argued that science as we know it is a method of investigation that currently uses the material realm, but there may be other methods of investigation that could be equally interesting and valid even though they don’t fit into our material system of measurement. Janet asked: ‘So the question is not whether something is true but whether it feels good?’. Bruce replied that he could only comment in the context of his own experiences. He has benefitted from alternative ways of seeing reality that and has found meaning that has changed his life in a very beautiful way. He has seen parallels to this in the lives of some of the indigenous peoples he has met.

Daniel added that we live in a society which has managed to produce science while often holding religious views that are seemingly contradictory. He stated that most people hold inconsistent beliefs all the time and talked about an Amazonian tribe that predict meteorological events based on the perceived movement of constellations. Although the constellations do not move in that sense, but only appear at points in the sky that are then correlated with events on earth, they have a very well developed science that is based on false presupposition. There has been a lot of science that ‘works’ for the wrong reasons but we do not call it any less science because of that. He then agreed with Bruce:

‘There are a number of points of animism that offer satisfying personal choices in life, but can I justify them all scientifically? No. Do I try to reconcile them with science? No. And do I care if they are reconciled? No. If we are going to hold mutually inconsistent beliefs, just admit that they are mutually inconsistent.’










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The Savory Institute Conference 2014: Putting Grasslands to Work

The Savory Institute Conference 2014: Putting Grasslands to Work

Six months ago I had no idea who Allan Savory was. Fast forward to a week ago and I was sitting at the Savory Institute World Conference in London, knowing that I had found something very, very special…

That’s life I guess – full of twists and turns – but more importantly that’s Paleo. Starting my Paleo journey had led me to learning about pasture-raised meat, to avidly listening to Joel Salatin videos on Youtube and to a chance exchange of a few words with Robb Wolf at Paleo f(x) in Austin. It was Robb that told me about the conference so yet again in my life, thank you Robb…

I have worked within various environmental organisations and campaign groups over the years, including the National Parks in London and Wales and volunteering to work with the Campaign to Protect Rural England on their Local Foods project and other campaign issues. I have always been interested in our connection to the environment from a practical as well as a philosophical viewpoint and love the work of Roger Scruton, who writes so eloquently about our relationship with this land we call ‘home’.

From a small child growing up in East London I was fascinated by farms and all things ‘countryside’.  My toys consisted of plastic farm animals rather than dolls and I would read avidly on wildlife and dream of living on a farm.  Later as I grew up I did my best to get out of London as soon as I could, but it took me a while – too long in fact. Living here in the Brecon Beacons, surrounded by some of the most beautiful scenery in the UK and in prime beef and lamb country, I have taken one step closer to the source of my food, but that is not enough. Truly connecting with our food choices means not only knowing who produced it, but how they produced it and whether that system is sustainable and beneficial for our environment and for our health.

My interest in Paleo made sense in terms of conscious food choices and supporting localism, but it wasn’t until I attended the Savory Institute Conference that I felt as though the circle had truly been completed.

For those of you unfamiliar with the work of Allan Savory, his 20 minute Ted talk in 2013 caused quite a stir and put the work of the Savory Institute firmly at the forefront of the environmental news. The philosophy behind his work is one of holistic management and of mimicking the large-scale movement of stock over land to regenerate growth and to heal the soil – movements that we would have seen thousands of years ago when ruminants crossed the land in vast numbers.

Allan Savory’s ideas have come in for criticism in some quarters. However, embracing Paleo has made me question many aspects of mainstream opinion related to health and in the same way, I question the received wisdom on how best to manage the land and provide our food. Challenges to the status quo are not kindly received, be they in health or environmental issues and there is no doubt that the Savory Institute (just as Paleo) has some formidable enemies waiting in the wings. But this should not deter us. All great ideas have their critics.

The conference brought together land managers from across the globe – Africa, Mexico, Argentina, America, the Netherlands, the UK to name just a few – together with representatives from various environmental and health organisations and movements (Paleo included). It was amazing to see such a diverse group of people uniting around an idea (and practice) and as the conference progressed, it became clear that the work of the Savory Institute signals a shift in the way we think about agriculture, our relationship to the land and the food we eat. Things are at a tipping point and we do not have much time to begin to reverse some of the devastating damage that we have wrought on the environment in the pursuit of food over the last 10,000 years since the agricultural revolution.  This movement feels powerful and the people that talked over the course of two days were nothing short of inspirational.

The importance of pasture-raised meat to the Paleo movement cannot be understated. The range of beneficial health benefits are of course extremely important, but added to that is the way in which responsibly farmed, grass-fed livestock has the potential to heal the land and regenerate not only the flora and fauna within it, but the soil itself. The health of the soil mirrors the health of our gut – indeed this was discussed many times during the conference – and we ignore both at our peril. This subject gets talked about a lot within Paleo! As we cannot heal the body without feeding the gut microbiome with good bacteria through responsible food choices, so we cannot heal the land from the devastation of desertification without returning nutrients to the soil through the practice of responsible livestock management.

The people that I met were concerned about the health of their families, of their animals, of their communities and of the environment. They ranged from young environmental studies students to farmers in their 80s, from people who made their living on the land to people who wrote about the land, from butchers to shepherdesses, from vets to publicans, from Weston A Price to Paleo, from people who tended small vegetable plots to land managers overseeing thousands of heads of cattle over thousands of hectares.  This was a conference that brought them all together and united them under one movement.

The producers of pasture-raised livestock have a unique opportunity to join forces with Paleo and to bring the benefits to a wider audience here in the UK. I for one will do everything in my power to help that happen and to make the work of the Savory Institute better known. I don’t have a farm, I don’t have the money to set up a business, but I can write and I can talk and maybe that can help. The conference was the next step on a journey that started for me with a love of the environment, and then a complete passion for Paleo. It joined together the dots and now I can see the bigger picture for the first time.  All of the elements have suddenly slotted into place and the work that needs to be done is now clear. What an amazing experience…


Go to the Savory Institute pages for more on the conference.

See my notes – links below – for summaries of the various talks that I attended and check out the Savory Institute website for more information about their work. I have written my notes as I took them. I am afraid that they do not convey the atmosphere and the passion of the speakers but I hope they go some way towards encouraging people to find out more about the work of the Savory Institute.



© Past Present Paleo 2014. All Rights Reserved.

The Wahls Protocol by Terry Wahls, M.D.

The Wahls Protocol by Terry Wahls, M.D.

I first heard of Dr Terry Wahls from the excellent Ted talk* she gave in 2011 called Minding Your Mitochondria. The talk caused quite a stir as Dr Wahls, who was diagnosed with Multiple Sclerosis in 2000, explained how nutrition and lifestyle changes helped her to radically transform her life. Her return to walking and even biking after being confined to a tilt-recline wheelchair is at once inspirational and fascinating. I had stumbled across the video shortly after starting Paleo in April 2012 as I was looking for every available resource on the lifestyle. Dr Wahls’ story was particularly relevant to me as I had suffered with ongoing gut issues for over 20 years, followed by neurological symptoms such as Trigeminal Neuralgia and Facial Palsy. My consultant had warned about keeping a look-out for symptoms of MS, so I was intrigued by Dr Wahls’ story. I had also read the brilliant Grain Brain by Dr Perlmutter and the link between the gut, neurological problems and auto-immune disease is a topic that I find fascinating. When I learned of Dr Wahls new book The Wahls Protocol, I ordered it immediately.

The book begins with Dr Wahls’ story of diagnosis and decline. A clinical professor of medicine and a previously active marathon runner, mountain climber and tae kwon do black belt, Dr Wahls was seemingly fit and healthy individual with a full (although at times stressful) career and loving family. She writes very movingly of her diagnosis and the realisation in hindsight that something was wrong many years ago; the clues that appeared but were not investigated, the warning signs, the niggling problems… Post-diagnosis, and as her condition declined, Dr Wahls discovered the work of Ashton Embry and Loren Cordain. She began to adopt a nutritional strategy based around the Paleo diet but sadly her decline continued. Undaunted and with a thirst to find out everything that she could about her disease, Dr Wahls went on to study MS in more detail – in particular the relevance of healthy mitochondrial function – and eventually devised a treatment plan that incorporates food as the core component, along with electrical-stimulation, targeted supplements, exercise and stress management. The Wahls Protocol outlines this plan in an easy to read, incredibly practical way.

‘When chronic disease is the result of a deficiency, drugs aren’t going to solve the problem.’

The importance of food and other lifestyle factors in the treatment and prevention of disease lies at the heart of this wonderful book. However, Dr Wahls’ message is bigger than this. There is a power that lies within each of us to overcome symptoms and to improve our condition, if we adopt the right methods. The Wahls Protocol is about reinstating that power to individuals. It is about giving control back. It is not about throwing away medication, or ignoring your doctor. It is about working gradually to reclaim health; seeing how things improve, how you feel, monitoring symptoms. It is about ensuring that your illness no longer controls your life. A reduction in medication may be part of this – or it may be not – and Dr Wahls makes it very clear to discuss this carefully with your doctor. Testimonies from ‘Wahls Warriors’ – people who have adopted the Protocol with excellent results – are placed throughout the book. These moving accounts stand as a reminder that things can improve, even when hope has been lost.

‘A genetic propensity may never come to anything if the body stays healthy and fully  nourished nourished.’

Dr Wahls stresses that tackling MS or any other major disease starts with the realisation that ‘Genes are not your destiny’ p.25. The importance of environmental factors in switching on genes for disease is huge. Although Dr Wahls discovered that she had a genetic vulnerability for MS, she reminds us that ‘scientists believe that environment determines 70-95% of the risk of developing autoimmune problems’ p.24. In the same way that environmental factors can ‘switch on’ these genes, so they can influence whether they remain ‘switched off’.  The lifestyle choices we make can mitigate our genetic propensity for disease and merely possessing the gene for a particular illness is not an automatic route to that disease.

‘Cellular nutrition is everything’

So how do we ensure that we make the correct choices that enhance our genetic make-up? Dr Wahls argues that healthy cellular activity should be at the root of all such choices. ‘Cellular nutrition is everything. It is the very basis of all health.’ p.26. Healthy cellular function is dependent upon the correct workings of our mitochondria, the energy power-houses within cells that also regulate cell signalling, cell death and cell growth. Their optimal function is of critical importance to cell health and mitochondrial breakdown leads to chronic disease. I was fascinated to read that the ‘the cells that do not die when their time is up will continually grow at the expense of all other cells, becoming cancerous tumours.’ p.29. Making sure that we do everything we can to look after our mitochondria – particularly when it comes to neurological conditions – will ensure that cells function properly. One of the most important ways we can achieve this is through our diet and Dr Wahls urges us to remember this vitally important piece of information: Our cells are ultimately fuelled by what we eat.

‘The highest bioconcentration of toxins are in your fat, and remember that your brain is 60-70% fat’

Recognising that we can target our nutrition for brain health is one of the first steps in successfully applying the Protocol. Dr Wahls goes on to describe how MS is caused by a faulty immune system which attacks the myelin sheath (the fatty insulation that surrounds the nerve cells), resulting in damage to the nervous system. Dr Wahls looks at micronutrients that are essential for making myelin and for healthy neurotransmitter function, both of which contribute to brain health. Her exhaustive work in compiling this range of nutrients and her years of research, first upon herself and her own condition, then followed by her patients and Wahls Warriors, are brought together in an extremely detailed and easy-to-follow plan.

‘In a very real sense, we all have the same disease’

One of the most memorable passages of this book is when Dr Wahls explains the problem with naming and treating diseases based on symptoms. In reality, we are experiencing the same disease with different symptoms. Auto-immune diseases, along with the major diseases of Western societies are the result of ‘mitochondrial dysfunction, excessive inflammation, high cortisol levels and other markers of broken biochemistry. In a very real sense, we all have the same disease…’ p.47. I found this way of thinking about disease very interesting. By treating the various symptoms, conventional medicine names and classifies the disease yet fails to address the underlying cause. It treats auto-immune diseases by prescribing drugs which – in many cases – undermine the natural functioning of the body, and as a consequence inhibits the very immune system that needs help. An alternative, functional medicine approach which treats the whole person rather than the symptom, involves ‘optimizing the body’s environment to minimize immune hyperactivity’ p.55.

Just as we cannot separate ourselves from the world we live in, so we cannot isolate a disease from the functioning state of the whole person. If the environment we live in is polluted and sick, we cannot survive. If our bodies are sick, then disease takes hold. Our bodies are a microcosm of the world. We talk about environmental pollution and yet we find it so hard to look after our own bodies and give them what they need. If we cannot help ourselves, is it any wonder that we cannot help the world we live in? Symptom-based management will never solve the problem of our major Western diseases. At best it prevents a bad situation getting worse. Only through the optimization of health for the person as a whole can we begin to prevent some of these diseases taking hold in the first place. As you read The Wahls Protocol, there is a realisation that our whole medical system is based upon treating disease from completely the wrong angle – damage limitation rather than prevention. It’s depressing to think about, but maybe we can begin to turn things around.

‘Medications for autoimmune disease do not cure the disease. Their only purpose is to make you feel a little better, which might work, and possibly slow the progression, which also might work. Or not.’

The Wahls Protocol gives an excellent breakdown of the causes and characteristics of autoimmune disease, as well as explaining the conventional vs functional medicine approach. I found this to be an extremely fascinating part of the book. Dr Wahls explains the different types of MS and very interestingly looks at the CCSVI theory of Dr Paolo Zamboni, which suggests that MS is caused by a narrowing of the veins supplying blood to the brain. As Dr Wahls argues, if this is true then surely we need to examine the root cause of this narrowing. The inflammation that narrows the veins (don’t forget that inflammation is the body’s natural response to a problem) is triggered by things such as toxins, chronic infections, insufficient nutrients, food allergies/sensitivities, hormonal imbalance and sleep disruption. Dealing with these inflammatory triggers rather than operating to correct the narrowed veins (angioplasty or bypass) makes much more sense. The link between inflammation and disease is explored and we learn that ‘excessive inflammation is a factor in many if not all psychiatric disorders.’ P.65. Dealing with inflammation is at the heart of the Wahls Protocol and addressing this important issue is a must if we are to tackle diseases such as MS.

‘The root of optimal health begins with taking away the things that harm and confuse our cells while providing the body with the right environment in which to thrive.’

There are three levels of diet to the Wahls Protocol, increasing in strictness: the Wahls Diet, Wahls Paleo and Wahls Paleo Plus. Paleo diet principles underlie all of these and Dr Wahls gives an excellent background to Paleo nutrition with thorough explanations of issues such as leaky gut: a potential disaster for health.  However, the Wahls Protocol is specifically tailored to address chronic disease and to maximise nutrients for mitochondrial function – taking Paleo principles to a whole new level. At all 3 stages, the diet centres around a diverse range of vegetables, together with pasture-raised meat, and wild-caught fish and eliminates gluten, dairy and eggs.  I could write that the Protocol increases in strictness, but instead I like to think of it as becoming increasingly liberating. Depending on which stage you choose to follow, additional foods (such as all forms of grains) are eliminated and others increased (coconut fats).  I was happy to see that those who experience difficulty digesting large amounts of raw vegetables can also scale the quantities down to suit and as the gut heals, reintroduce them.

At the Paleo Plus level, smaller quantities of vegetables are desirable. The highest stage of the Protocol takes the basics of a ketogenic diet but modifies it to include a slightly higher carbohydrate content from non-starchy vegetables. Staying in mild ketosis is possible due to the liberal use of ketone-producing MCTs from coconut products which are essential at the Paleo Plus stage. Some measurement of blood ketones may be desirable to track progress. At this stage of the Protocol, meals are also reduced to two per day (something that many Paleo followers find happens naturally), fat is increased, carbohydrates are decreased and protein limited.

As a Paleo devotee, I naturally slotted in to the Wahls Protocol. I had already eliminated all grains and dairy. After reading the book I cut eggs out too and I have got to say that I feel so much better for doing that. Eggs always made me feel slightly sickly – I can’t quite describe it – and I had read that they can provoke an immune reaction in some people. I hesitated for ages about eliminating them from my diet but when I read Dr Wahls’ book, I did it immediately and didn’t flinch. Likewise with dairy. We learn that ‘gluten and casein molecules have a similar amino acid sequence, and so to our immune cells they are often equivalent.’ P.129. I had cut dairy out completely before reading the book but the difference is that where I once found it hard to have it in the house or felt like I was missing it (definite opioid receptor response for me!), after reading The Wahls Protocol I am so completely resolved never to touch it again.

‘It provides more structure and guidance to help you maximise your nutrition, which is critical for those with any chronic disease.’

I have never found that following a Paleo eating template is hard, restrictive or unenjoyable. It is the complete opposite. However, sometimes I feel like I need help with structuring my food choices in a more systematic way to ensure I receive the full benefits of a wide range of foods. I have to say that this is one of the many things I found invaluable when reading The Wahls Protocol. Dr Wahls gives a very detailed explanation of the importance of foods such as seaweed, bone broth, organ meats and fermented foods and gives practical steps for integrating them into your diet on a regular basis. There are fantastically comprehensive lists of nutrients too. There are also full lists of the three vegetable groups that form an essential part of the Protocol (greens, sulphur-rich, colour), making it easy to plan shopping lists etc. as well as lists of foods permitted for each stage of the Protocol. There is even a handy recipe section. In addition, the book is filled with tips and advice for ensuring you get the full range and correct amounts of various foods. I have found this so helpful as I begin to implement changes. The Wahls Protocol is bursting at the seams with helpful information and the whole book is geared towards making your transition as easy as possible.

‘Brains depend on exercise for growth and maintenance.’

Of course the Wahls Protocol is about more than food. We are encouraged to keep a Wahls Diary in order to monitor progress, feelings, symptoms, etc. and to help us focus on the changes that we need to make. Dr Wahls also urges us to look at the toxins that surround us – in our home, even in our mouth – and look at ways to eliminate them. Natural detoxification through sweating and skin brushing is also encouraged. Exercise is a major part of the Protocol, in particular stretching, strength training (interestingly Dr Wahls explains that ‘strength training generates the largest gains in nerve growth factors’ p.234) and gentle cardiovascular. There are also many helpful illustrations of stretching exercises to supplement the text. Electrical stimulation is advised for MS sufferers to improve mobility and Dr Wahls also discusses when – and if – to reduce medication.

‘Vitamins and minerals act together to facilitate the chemistry of cells and must be kept in balance, but it is far better (if not easier) to achieve this balance through food.’

The Protocol provides extensive information on supplements but Dr Wahls always maintains that the majority of nutrients should come from food first and foremost, listing the various food sources to increase. If supplementation other than the basics (Vitamin D, Magnesium etc.) is desirable, there is a wealth of information here regarding the research and recommended doses, but Dr Wahls stresses  that supplementation should be carefully individualised.

I found the section on alternative therapies extremely interesting and as someone who was previously rather sceptical of such things; Dr Wahls takes a measured and considered viewpoint on some of the treatments available. She provides a helpful list of questions to ask before embarking on such therapies but always stresses the underlying importance of healthy cellular function; maximise this first through food choices and lifestyle changes and then consider some alternative therapies as a helpful addition.

There are some great tips on stress management and the connection between stress and insulin resistance is explored. Reading this section made me realise how I was caught in a cycle of carbohydrate dependence that was inextricably linked to stress, with each feeding off the other and leading to all sorts of health problems over the years.  Quality sleep is also a vital component of the Protocol and Dr Wahls explains the effect of sleep deprivation on stress levels and general health.

‘I believe the public will soon be far ahead of the medical community when it comes to understanding the power of food to reclaim and maintain health.’

The depth of detail and the sheer amount of information contained in this book is fantastic. It really is a bible for brain health. I read it once and then went back and read it again. Everything is so clearly and comprehensively explained and you will find yourself referencing it time after time. In my opinion it is not only a ‘must read’ for anyone who suffers from MS or other auto-immune conditions, this book is for anyone who wants to do as much as they possibly can to avoid these conditions and live a healthy life  (that’s everyone right?).

The Wahls Protocol is also a testament to one woman’s determination to fight and transcend her disease and to help others do the same. Dr Wahls’ story, along with the story of her many Wahls Warriors, is inspirational and gives hope not only to those with MS, but to all of us. Taking control over our health and recovery begins with the Protocol set out in this book. Let’s pray that Dr Wahls gets the funding that she needs to expand her research even further and I look forward to reading more about her work in the future.

*This Ted talk now contains a warning: ‘This talk, which features health advice based on a personal narrative, has been flagged as potentially outside of TED’s curatorial guidelines. Viewer discretion advised.’ Hear Dr Wahls talk about this in this excellent inetrview with Robb Wolf here.


Grain Brain

Grain Brain

There are many great books that I have recommended – see over in the Resources section for further information – but I wanted to dedicate some time talking about Grain Brain as it is a relatively new and generated much debate in the ancestral health scene upon its release.

I first heard of Dr Perlmutter after listening to this fantastic discussion with Robb Wolf. I was very interested in what he had to say and like many others, I was intrigued to hear his advice to limit carbohydrates to around 60g per day for optimum brain health. Since eating a more traditional foods diet, I am always interested to read about the food/brain/gut connection as I have seen such fantastic improvements and want to find out more.

Of course in addition to this – and like many others – I am concerned about the rising number of people suffering with dementia. This is something that I not only find sad and worrying, but I am interested in the theory that dietary elements are significant in the sudden rise of this illness and that dietary intervention could at least improve the condition, and possibly help to prevent it.

‘The origin of brain disease is in many cases predominantly dietary.’

After listening to the podcast, I ordered Grain Brain immediately (not something I do often) and read it cover to cover. I have just finished a second reading and I would like to share some information on the book. As expected, Grain Brain did not get any publicity here in the UK, even as we struggle with soaring rates of diabetes, Alzheimers and obesity. Though some may disagree with Dr Perlmutter regarding the role of diet in causing these diseases or the amount of carbohydrates Dr Perlmutter recommends for brain health, Grain Brain remains an important book that is essential reading for anyone who has suffered from neurological disorders or indeed anyone that is concerned about protecting the health of their brain.


Dr Perlmutter is a practising Neurologist and also a fellow at the American College of Nutrition. His credentials are impressive – see his C.V. here – and he has devoted his career to working with patients who have neurodegenerative disorders. He has a particular interest in the role of nutrition in brain health and has written and presented widely on the subject.  Dr Perlmutter’s father also practised in the field of Neurology. A former Neurosurgeon and 96 at the time of the book’s release, he now suffers from dementia and Dr Perlmutter touchingly describes how he still dresses to see his patients every day. In both interviews and writing, Dr Perlmutter is passionate and persuasive.

Brain disfunction is not normal

Grain Brain argues that the obesity and Alzheimers epidemic is predominantly due to a diet that is high in carbohydrates but low in essential fat and cholesterol. This diet has starved the brain of its necessary nutrients and overdosed it with sugar which, together with the ever-increasing use of statins to lower cholesterol even further, is causing a brain health disaster. This is not meant to happen. Something is seriously amiss and Dr Perlmutter states that ‘We are designed to be smart people our entire lives. The brain is supposed to work well until our last breath.’ So what has gone wrong?

Gluten – a ‘silent germ’

Dr Perlmutter argues that the presence of gluten in our foods has had an insidious effect on brain health, causing inflammation and infiltration of the blood-brain barrier. He describes it as a nervous system ‘irritant’ and gluten sensitivity as the ‘most under-recognised health threat to humanity’ .

‘one of the largest and most wide-reaching events in the ultimate decline of brain health in modern society has been the introduction of wheat grain into the human diet’.

Gluten is linked to a range of illnesses including dementia, diabetes, depression, inflammatory diseases, schizophrenia and ADHD (the list is much longer). Dr Perlmutter uses examples of patients such as Kurt, whose distressing symptoms (in the case of Kurt, convulsive tremors) were greatly improved – if not cured – by the elimination of gluten from their diet. There is a wealth of information on the internet regarding the possible link between gluten and brain disorders and I am surprised at the lack of attention this receives outside of research/medical/dietary circles.

One of the most important things that Dr Perlmutter stresses is that gluten damage is not necessarily experienced through stomach problems but can often be undetected for many years as it silently affects the brain: ‘99% of people whose immune systems react negatively to gluten don’t even know it’.

Blood sugar chaos

Along with the problem of gluten, Dr Perlmutter stresses that high blood sugar levels and the ensuing insulin resistence cause mayhem within the body over time. High blood sugar should be avoided as much as possible to limit the deleterious inflammatory effect on the brain.

Dr Perlmutter tells us how vascular dementia, which occurs with the hardening and subsequent narrowing of arteries in the brain cause ‘blockages and strokes which kill brain tissue’. The oxidation and inflammation which leads to this state of atherosclerosis is a direct result from high blood sugar levels and it is essential to do everything we can to prevent this occurring. In order to achieve this we need to cut carbohydrates.

‘the link between sugar and oxidative stress cannot be overstated.’

Grain Brain explores the links between diabetes and dementia and quotes research that suggests diabetes doubles the risk for Alzheimers. It is the production of Advanced Glycation Endproducts (AGEs) that links the two diseases and we read an excellent description of how these ‘deformed proteins’ are able to wreak havoc on the body. Dr Perlmutter argues that a high sugar diet ‘speeds up’ the glycation process (itself a natural part of aging) and that the best way to reduce AGEs is to reduce the amount of sugar in the diet.

Cholesterol is critical

We learn that cholesterol is essential for brain health and low levels of cholesterol are potentially dangerous for the brain. Dr Perlmutter explains the myriad ways in which cholesterol is used by the body and argues that people with low cholesterol levels are at much greater risk from diseases such as dementia and other neurological problems as the brain is unable to function properly. He quotes studies that point to high levels of cholesterol being associated with better memory function and increased longevity, while other studies show that low levels of LDL are linked to an increased risk of Parkinsons disease. Dr Perlmutter stresses that cholesterol – in particular the so-called ‘bad’ LDL – should not be feared. It is only when this becomes oxidised (as a direct result of a high carbohydrate diet) that problems occur.

Fat: ‘our brain’s secret love’

Fat is extremely important for brain health and Dr Perlmutter discusses the massive error that our governments have made by advocating low-fat diets. The hysteria surrounding fat and heart health is examined, as well as the history of our fat phobia and the erroneous lipid hypothesis that spurned decades of low-fat diets. Dr Perlmutter quotes a study ‘involving more than 340,000 subjects followed from periods of five to 23 years’ which failed to show that saturated fat intake was associated with ‘an increased risk of coronary heart disease, stroke or cardiovascular disease’.  Good fats that are high in Omega-3s reduce inflammation, boost the immune system and transport essential vitamins. There is an excellent overview of the importance of fat in just about every area of the human body. However, it is the brain where the consequences of our lack of dietary fat is felt so acutely.

Statin madness

Dr Perlmutter discusses the rise in the use of statins to lower cholesterol. It is this phenomenon, combined with a typical low-fat, high carbohydrate diet comprised chiefly of gluten-containing grains that has, according to Dr Perlmutter, created the ‘perfect storm’ for brain health and contributed to the dementia and diabetes epidemic (diseases that he argues are inextricably linked). We read about the deleterious effects that statins have on brain function and Dr Perlmutter states that statins ‘may cause or exacerbate brain disorders or diseases’. For instance, by inhibiting the production of cholesterol, statins affect the release of neurotransmitters which are directly linked to memory function. Statins also inhibit the production of Enzyme Q-10, deficiency of which is linked to a host of problems, especially fatigue and muscular pain (common complaints of statin-users) and even heart failure and Parkinson’s disease. These are just some of the many problems brought about by statin use that Grain Brain highlights.

Anyone who has watched ‘Statin Nation’ will agree that the proposed mass-medication with these drugs is downright scary – see recent UK headlines here. Any favourable outcome they do show with people that have already suffered heart attacks is down to the fact that they are anti-inflammatory, a preventative effect that could be replicated through diet – and without drugs with the ensuing harmful side-effects – if there existed the impetus from the medical profession (and without the pressure from pharmaceutical giants).

The argument that people are not able to follow dietary advice and so need to be pumped full of drugs instead crumbles when we know that the dietary advice churned out for decades has been not only been downright wrong (low-fat, high carbohydrates, margarines instead of butter, trans-fats…) but has led to even further deterioration in our nations’ health. As Dr Perlmutter argues, because cholesterol is essential for so many processes within the human body and especially the brain, using statins to reduce cholesterol is not only madness, it is downright dangerous.

Inflammation: silent and devastating

As we know, inflammation is a symptom of many of the major diseases of mankind. Rather than the underlying cause of disease, inflammation is a natural response by the body when something is wrong but itself acts as a trigger for further damage. Irritants to the nervous system such as gluten and high sugar diets turn on the inflammation response and this is constantly maintained throughout a lifetime, leading to a reduction of cellular function.

We read how oxidative stress and the ensuing creation of free radicals which generate further inflammation leaves us open to a wide range of diseases. Remember that it is the oxidized LDL that causes the problems in our arteries. Inflammation is the body trying desperately to cope with a problem and can be triggered by the body’s immune system trying to deal with a foreign ‘invader’ such as gluten.

 ‘No organ is more susceptible to the deleterious effects of inflammation than the brain.

The problem that Dr Perlmutter stresses throughout the book is that unless we experience neurological problems or headaches, it is difficult to find out what is wrong until late into the condition. Inflammation cannot be ‘felt’ by the brain and so by the time we experience symptoms, the damage may already be well advanced – a worrying thought.

The gut: ‘our second brain’

The chapter on the role of gluten in mood disorders and neurological problems such as persistent headaches is particularly fascinating. I do believe that what we eat has a profound effect on our mental state both in the short and long-term and I have read about the links between schizophrenia and gluten/leaky gut (I first read about this in Dr Loren Cordain’s Paleo Diet book), so I was very interested in hearing Dr Perlmutter talk about this in detail.

The increasing rates of depression and the prescription of anti-depressants in both the US and UK is a worrying trend, along with the increased use of drugs to treat disorders such as ADHD. Recent headlines such as this in the UK suggest that in the case of depression, targeting potential sufferers with drugs at an earlier age will become increasingly common. Dr Perlmutter argues that often, these problems can be alleviated by the removal of gluten from the diet.

I was surprised to read that autism has also been linked to gluten sensitivity and Dr Perlmutter states that ‘As much as celiac is an inflammatory disorder of the gut, autism is an inflammatory disorder of the brain.’ I was also surprised at the link between depression, low cholesterol and celiac disease. As the gut lining is damaged by gluten, the absorption of nutrients essential for brain health is inhibited, setting off a chain-reaction of adverse effects. Dr Perlmutter also tells us that the nerve cells in the gut manufacture ‘an estimated 80 to 90% of our body’s seratonin’ (our ‘feel-good’ neurotransmitter). I had no idea about this. The role of the gut in our brain health (and happiness) cannot be over-estimated and I felt that this was one of the strongest chapters in the book.

Additional brain boosters

Dr Perlmutter also covers calorie restriction and the benefits of a ketogenic diet for patients with cognitive decline. He also talks about the importance of exercise and intellectual stimulation for brain health.

I was also interested in his discussion of anti-oxidants. Dr Perlmutter stresses that we need to stimulate the body’s production of anti-oxidants such as Glutathione (which fight oxidative damage and free radicals) rather than consume anti-oxidants through diet. This boosting of anti-oxidants is possible via the Nrf2 pathway which triggers cells into anti-oxidant production. Dr Perlmutter highlights the importance of foods such as oily fish (high in DHA or Docosahexaenoic acid which is essential for brain health), turmeric, green tea extract, broccoli and coffee which can all activate the Nrf2 pathway. Dr Perlmutter also gives us lots of advice on supplements, recipes, and sleep to ensure optimum brain health.

Final thoughts

I found this book absolutely fascinating and I have to say that I couldn’t put it down. I do understand the issue that some have with Dr Perlmutter’s recommendations for only 60g of carbs a day, particularly for those who are healthy, with no signs of metabolic syndrome and who exercise vigorously, although Dr Perlmutter states that in the case of athletes, ‘pushing your daily allowance to 90 or 100 grams of carbs/day is certainly acceptable.

Along with others, I am reluctant to think that consuming 100g of carbs a day – we are talking vegetables, sweet potatoes, limited fruit – when seen in the context of a traditional diet would be dangerous in terms of brain health but of course this depends on the individual.  For someone coming from a standard UK/USA diet, following Dr Perlmutters recommendations but eating 100g of ‘good’ carbs may indeed produce dramatic improvements, but is it too much? As Dr Perlmutter states throughout Grain Brain, the problem is that when it comes to the brain, how can we know before it’s too late?

I do feel that people have to find what carb level works for them. The lower end of the scale is definitely the place to start for those with neurological disorders such as those discussed in the book but it is important to remember that Dr Perlmutter makes it clear that he believes all people should err on the side of caution and cut carbohydrates to the 60g level (apart from athletes as mentioned). However, if this level really doesn’t work for the individual and they feel like they cannot function, then perhaps it needs to be revised.

The elegant simplicity of traditional diets appeals to people on an instinctual level and the personal experimentation needed to tweak the diet is central to its success. What works for someone in their 60s who has spent a lifetime consuming carbs with all the signs of metabolic syndrome compared to someone in their 20s who works out and is super-fit may be different. But in the scheme of things – and in comparison to the average UK or US diet – these tweaks (40-odd grams of carbohydrates?) are ‘small-fry’. The similarities of two such approaches outweigh any differences by miles. Many of us have a history of problems or with a background of family illness so we have to weigh up the pros and cons of Dr Perlmutters advice on carbs and tailor our diets to our profiles.

I do think it is a shame that for many people, the ‘take-away’ from this book is centred around the carbohydrates issue, when really most people would agree with Dr Perlmutter on many things – the need to keep blood sugar in check, the importance of fat, the unfounded fear of cholesterol etc. The book is full of excellent explanations of what are – to many people – fairly complicated topics and the research papers that Dr Perlmutter references are fascinating. Of course, some of the issues have been covered elsewhere but they are necessary to explain and support the central thesis of the book regarding brain health. It is when Dr Perlmutter explores the complex and fascinating relationship between diet, gut health and brain disease that this book really shines and where it becomes so thought-provoking. I do think that the link between these will become ever-more apparent and perhaps Grain Brain is one of many steps towards bringing the issues to the public. Because of that – and despite the heated debate over carbohydrate levels – for many people this is a must-read book.

For further discussion see the following blog posts and comments:
Robb Wolf, Low Carb and Paleo: My Thoughts Part 1
Robb Wolf, My Thoughts on Low Carb and Paleo, Part Deux
Robb Wolf, My thoughts on Low Carb and Paleo Episode 3: A New Hope
Chris Kresser, Do Carbs Kill Your Brain?