Protein as bad as smoking – a ‘steak through the heart’?

Protein as bad as smoking – a ‘steak through the heart’?

by | Mar 11, 2014 | News articles

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‘High protein diet as bad for health as smoking’ – 348 news articles UK/ 15,400 news articles worldwide

‘Saturated fat is not bad for health’, says heart expert’ – 67 news articles UK/ 2,640 news articles worldwide

Two very different headlines and both in the news last week. You can guess which of the two dominated conversations in the workplace, on radio and tv, at the supermarket checkout, even between random strangers on the street…. Yes, the ‘eating meat kills you’ line rears its ugly head again.

My first reaction to this headline was to take a look at the original paper, ‘Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population’. You can find it here.

The study combined data from 6,381 US men and women over 50 with ‘mouse and cellular studies’. Data collected from people was based on a 24 hour recollection of what they had eaten. This data showed an average consumption of 1,823 calories, the majority of which came from carbohydrates (51%), then fat (33%) and protein (16%), with most of it (11%) derived from animal protein. That is by any description a high-carbohydrate diet although 1,823 calories seems very low, so I wonder how accurately people reported their eating.

The people were followed up for 18 years and results showed 40% overall mortality (2553 people), 19% cardiovascular disease (CVD) mortality (485 people), 10% cancer mortality (255 people), and about 1% diabetes mortality (26 people). So, data from one day’s eating was extrapolated over an 18 year period to help us understand why people died. One day of eating sure gives us an awful of information, but on we go…

The results of this experiment are written here as follows:

‘Using Cox Proportional Hazard models we found no association between protein consumption and either all cause, CVD, or cancer mortality (Table S2). However, high and moderate protein consumption were positively associated with diabetes – related mortality. One explanation is that diabetes may be more prevalent in these groups, possibly because of a switch to a higher protein, lower fat, and lower carbohydrate intake following a diabetes diagnosis. Finally, high versus low protein consumption was found to be associated with an over ten-fold increase in the risk of diabetes mortality for subjects age 66 and over.

However, the much higher prevalence of subjects with a history of diabetes in the high protein group and the small number of subjects dying of diabetes in the low protein group may account for this, thus emphasizing the need for additional studies to determine the role of protein intake on diabetes incidence and mortality.’

From that, I take that there is NO association between high to moderate protein diets and death by cancer, CVD or all cause. Also, that any rise in diabetes deaths was so small and inconclusive that further studies are needed.

However, finding no overall link between protein consumption and these diseases, the study then goes on to isolate the findings according to age. They are broken down into two groups: 50–65 and those aged 66 or over. The people in the former group had ‘a 74% increase in their relative risk of all-cause mortality’ and were ‘more than four times as likely to die of cancer’ during the following 18 years. How this conclusively proves that moderate to high protein consumption causes cancer and death is a mystery. There could be a myriad of confounding factors and as we know so well, correlation is not causation. Nevertheless, the study finds that ‘high levels of animal proteins promote mortality and that plant-based proteins have a protective effect.’

The study then looked at IGF-1 (insulin-like growth factor), which is a hormone that regulates the effects of the growth hormone (GH) in the body. When we are young, we need this hormone to generate growth in our bones and organs but as we age, cell proliferation also carries with it the risk of genetic mutations that may lead to cancer, so there is an argument that high circulating IGF-1 levels pose a risk. Obviously we want the right amount of IGF-1 at the right time and not levels that are abnormally high. Dairy products have been linked to high IGF-1 levels and calorie restricted diets have been found to lower IGF-1 levels.

Levels of IGF-1 were only available for 2,253 people. Although the study states that for those in the 50-65 bracket on a moderate to high protein diet, the risks of all-cause and cancer mortality were increased further with high levels of IGF-1, it also confusingly states that ‘IGF-1 did not account for the association between protein consumption and mortality’. Next they ran ‘predicted hazard ratios’ on the IGF-1 and protein groups to calculate risks.

The data was then combined with ‘mouse and cellular studies’ to look at the effect of IGF-1 levels.

The mice in the high protein group were fed on Harlan AIN-93G (see contents here – just scroll down the page to find the AIN-93G pdf). The diet was 60% carbohydrates, 7% fat and 18% protein (from casein – a milk protein) and contained corn starch, Maltodextrin, Sucrose, Soybean Oil and Cellulose. The study states that ‘additional diets with contents ranging from 4%-18% kcal from protein were created using either the AIN-93G purified diet or the Soy protein diet (93G, G) as reference standards’.

How can we derive data regarding nutrition when mice are fed food filled with such as corn starch, Maltodextrin, Sucrose, Soybean Oil and Cellulose? How can we isolate protein as the culprit against the background of such a combination of other foodstuffs? What does this tell us about meat consumption when the protein used is casein? How can this tell us that consumption of beef in the context of a healthy, real food diet such as Paleo will give us cancer? I just don’t understand the giant leaps that this research makes. But once all of the confusing data, tenuous links, projections, risk analysis and hazard ratios are combined, we end up with a headline that equates high protein with cancer and ultimately that is what makes the news.

The study was funded by NIH/NIA grants to V.D.L. V.D.L has equity interest in a company called L-Nutra. The company make plant-based ‘anti-aging’ replacement meals that mimic the effect of a calorie restricted/fasting diet for chemotherapy patients or for anyone that wishes to ‘increase healthspan’. It makes sense that the research findings are clearly in favour of a predominantly plant-based diet, with the study stating that ‘… associations were either abolished or attenuated if the proteins were plant derived.’

The possibility of using calorie restriction as a way to treat cancer is certainly interesting. There is some very exciting research taking place by Professor Seyfried at Boston College using ketogenic diets (extremely high fat, moderate protein and very low carbohydrate) in conjunction with calorie restriction to treat cancer – see the Resources page. Calorie restriction may be easier in the context of a ketogenic diet as the body is satisfied with very high levels of fat and low levels of carbohydrates, removing the need to eat frequently. However, calorie restriction is not the crux of the argument put forward by this research. This study was clearly intended to promote a plant-based diet while vilifying protein-based diets. Sadly, those hysterical headlines are what people remember.

In the same week as the above story appeared, I was so pleased to see this article about a paper written for the BMJ journal Open Heart by Dr DiNicolantonio, of Ithica College, New York. Dr DiNicolantonio discusses the vilification of saturated fat and the dangers of high carbohydrates. Read the original paper here. It is an excellent summary of the misleading dietary advice adhered to over the last few decades. Many of the issues that Dr DiNicolantonio discusses are touched upon elsewhere on this site (and on other sites that I have recommended over in Resources) – the unfounded fears over saturated fat, the dangers of a high refined carbohydrate diet, the misinformation regarding cholesterol… So refreshing to see this reaching the news but as I said at the beginning of this post, you can guess which of the two stories generated the most publicity.

© Past Present Paleo 2013. All Rights Reserved.

 

 

 

 

 

Grain Brain

Grain Brain

by | Mar 1, 2014 | Reviews

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.

Background

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?

Surviving and thriving

by | Feb 15, 2014 | General

During my search for a dehydrator (see last post), quite by chance I discovered the website of Arctic explorer Gary Rolfe. You can watch a short film about Gary, who lives in Greenland, directed by Tom Whitworth below. Dehydration of nutrient-dense food is a necessity on his expeditions in the beautiful but harsh Arctic environment, (hence me stumbling upon his review of a dehydrator). Gary also has an amazing blog here. The videos and pictures that Gary posts are spectacular and his blog is a testament to one man’s determination to fulfill his dream – read this post.

The relationship he has with his beloved Greenland Dogs is truly wonderful to see. They work as a team, with the dogs doing the job that they were born to do, and which they clearly love. Gary writes: “Everything about them is vast and strong. They despise physical and mental cowardice and have boundless positive confidence in themselves and everything they do. They are aggressive in their appetite to do what they’ve been bred to do and that’s pull massive payloads in brutal cold. For over two thousand years the selection process remains, if you pull hard, you live. What remains are incredible canine athletes with unique traits; powerful dominant dogs that are incredibly strong-willed. With huge chests and fur over twenty centimetres thick they are the Panzer tanks of the dog world, stop at nothing and I love them dearly” (from an article at Snowpawstore).

These dogs have adapted perfectly to the extreme Greenland climate and thrive on the tough work of traversing – what seems to us – incredibly inhospitable terrain. Originally from Siberia, they are one of the oldest breeds in the world. Their diet is mainly comprised of seal and includes a mixture of skin, blubber and meat. Presumably this is identical or similar to that of their ancestors, and also to the Siberian wolves they so closely resemble (and from which they have evolved). To introduce an alien diet to these dogs would no doubt result in both short and long-term problems with their health and performance. It would also go against all common sense. The dogs, their diet and their environment are inextricably linked.

On reading Gary’s blog, I am reminded that sharing our lives with these wonderful creatures that have evolved in unison with us is a blessing. But I am also reminded that in order to thrive – not merely function – we are not so different from Gary’s dogs. To reject the diet that has sustained us for hundreds of thousands of years is a massive mistake. Yes we have evolved, just as the Greenland dogs have evolved in unison with man to pull sledges and work tirelessly but scratch the surface and underneath we are ultimately still hunter-gatherers and wolves.

“Rolfe” (2009) – GREENLAND from Tom Whitworth on Vimeo.

For an amazing read, I throughly recommend Hugh Brody’s ‘The Other Side of Eden – Hunter-gatherers, Farmers and the Shaping of the World’ set amongst the Inuktitut of the Arctic. This beautifully written book explores the triumph of farming over the hunter-gatherer. Reading this changed my perspective on our relationship with agriculture, food and the land we live in – a truly wonderful book. With thanks to Professor Scruton for recommending it in his excellent article:
Tally ho! Let the hunt remind us who we are by Roger Scruton

 

© Past Present Paleo 2013. All Rights Reserved.
Meaty muffins and dehydrators

Meaty muffins and dehydrators

by | Feb 4, 2014 | Recipes

These delicious muffins over on the Recipes page are adapted from a recipe in Everyday Paleo by Sarah Fragoso – thank you Sarah.

We change the ingredients according to whatever is in fridge or freezer and they make a perfect breakfast, lunch or snack. Forget those bird food cereal bars and eat one of these instead. They are seriously delicious. We make extra and freeze them so that Richard can take them out the freezer before he leaves for work and have them for breakfast when he gets there. Just pop them in the microwave to warm them up but they are just as nice cold. We often use frozen peppers in quick recipes as they are more economical. Frozen spinach is really handy too as it cooks so quickly. Morrisons is definitely better than the Co-op brand – it retains its shape and doesn’t turn into a soggy mess. We use minced beef, minced lamb, minced pork, bacon – whatever you have to hand.

It is hard to find sun-dried tomatoes in olive oil rather than sunflower oil. Waitrose sell them (Cook’s Ingredients range) but I’ve been having a look at making our own sun-dried tomatoes as they are expensive to buy. Apparently you can dry them in the oven, but a dehydrator looks more efficient and easier on the energy consumption. We did look at getting a dehydrator last year so that we can make snacks like jerky. Trying to find jerky without a host of additives and sugars is hard, and when you do it is really expensive so it makes sense to prepare your own. Dehydrators range in price from around £100 to the latest super-duper model at around £399. Excalibur seems to be the preferred model but the Sedona digital (£399) is also quite impressive. You would have to dehydrate quite a lot of food to make it worthwhile, but if you have a glut of vegetables in the garden or get a good deal on your meat it would work out well. You could also dehydrate herbs. The world of dehydrating is new to me, but it looks like a valuable addition to the paleo diet.

© Past Present Paleo 2013. All Rights Reserved.

Horizon Fat vs. Sugar BBC2

by | Jan 31, 2014 | Reviews

I was so excited as I read the headlines on Tuesday’s Daily Mail website (not something that I say too often). ‘One twin gave up sugar, the other gave up fat. Their experiment could change YOUR life’.  “This is it!” I thought “This is the turning point!” and I enthusiastically began reading with my heart in my mouth (yes I really do get that excited about these sorts of things). However, the article (a preview of the BBC Horizon programme) was a complete let-down and so I watched the programme last night with a heavy heart knowing what was in store.

Before I start I just want to make a quick comment about the quality of documentary programmes on the BBC – or lack of it. To say that they resemble documentaries better suited to an early secondary school audience is rather demeaning to the children. Everything is filmed to show exactly what the presenter is talking about – just in case we can’t quite understand. Talking about eating fat and sugar? Let’s set up a camera in his kitchen to show him shovelling sugar and cream in his mouth. People like a particular flavour of doughnut? Let’s waste several minutes showing the presenters offering doughnuts to random people in the street. Craving for carbohydrates? Let’s show a close-up of him almost putting a chip in his mouth and then stopping. It’s as if we can’t understand things without them being literally demonstrated by the presenter/’actor’ on the screen. I remember Horizon as being a serious science programme. What has happened? Anyway, rant over…

Right, let’s get to it. The programme (watch here while still available) was presented by two chirpy and camera-friendly twin doctors, Alexander and Chris van Tulleken, one a specialist in infectious disease and the other a specialist in Tropical medicine. They did admit that despite being doctors, they knew nothing of ‘eating healthily’ and that nutrition ‘fell between the cracks’ at medical school. I thought it was quite refreshing to hear doctors admit that.

The battle lines were drawn. The experiment would find out ‘which is worse’ with the anti-fat brigade amassing on UK shores and the ‘sugar is toxic’ brigade over the pond. The doctors agreed to go on ‘extreme diets’ in order to settle the debate once and for all and prevent all-out war. They could eat as much as they want and the idea was to look at the effect of these diets on weight and ‘lifestyle diseases.’ It was quite interesting that they set up the ‘battle’ as American vs. UK opinion.

The high-fat diet consisted of cheese, meat, steak and burgers. There was confusion here because in both the article and the programme, they mention ‘no carbohydrates’ and then go on to talk about low-carbohydrates. Nutritionist Amanda Ursell (more about Amanda’s advice later) talks about minimal carbohydrates but the proportions are never made clear. I would have liked to see the fat/protein/carbohydrate ratio explained just for the sake of clarity. It looks like Alex was on a ketogenic diet (rather than a Paleo-ish high fat diet) but even with a ketogenic diet we would possibly go as high as 50g of carbs a day, so I can’t quite figure if they cut ALL carbs out or whether they just didn’t film him eating the minimal amount of carbs permitted while still remaining in ketosis. Alex worries that he is going to be ‘craving fresh greens’ so I assume that no veg was allowed at all. In addition to this, there was no mention of a period of ‘keto-adaptation’ before the body transitions fully to a fat-burning state. Alex also bemoaned the fact that he would suffer from bad breath and constipation, subjects that were brushed under the carpet for the rest of the programme.

The twins then hop over to Richard Mackenzie at University of Westminster for some tests before embarking on the diets. Dr Mackenzie informs us that ‘High amounts of cholesterol blocks our arteries’ and annoyingly does not differentiate between types. He measures the twins’ body fat percentage which is at 26.7% for Alex and 22% for Chris.

Two weeks into the diet, there is an inane experiment to test their mental agility, in which the twins are given $100,000 to trade with on the stock exchange in the hope of making more cash (with a wonderful cameo by ‘JJ’ who berates Alex for his negativity before the task begins). This test was intercut with Professor of Psychology Robin Kanarek’s grave comments about glucose being ‘the primary and best fuel for the brain’ without which it ‘doesn’t function properly’. I would have liked to see their performance pre-diets and then a comparison made, but never mind. I would also have liked to see any other factors that may have influenced either of the twins, such as caffeine intake, sleep, time difference (as they were on opposite sides of the Atlantic). We were assured that ‘ketones aren’t as efficient as sugars’ and Professor Kanarek very carefully worded the following statement: ‘At least on a short-term basis (my italics), a high carbohydrate diet will facilitate memory.’

Anyway, back to the trading floor with shots of high-fat Chris sighing and burying his head in his hands as his finances went into meltdown. Triumphant, sugary Alex announces that ‘I’ve absolutely thrashed him’ and we are told that Alex has made only $300 while Chris a whopping $800. Chris announces that ‘a big carb breakfast helped me do that.’ Really?! I make that 0.5% difference of the starting value, not really enough to sell me one fuel over another, but let’s not be picky…

We then have an interview with Robert Lustig, Professor of Clinical Pediatrics at the University of California, San Francisco and presenter of Sugar:the bitter truth. Professor Lustig explains about how the liver turns excess fructose into fat and how glucose activates insulin. This is followed by Alex stating that reports on high sugar diets use ‘unrealistic amounts of sugar to prove their point’ and he announces his scepticism. Move along please, nothing to see here…

The twins then pop in to see nutritionist Amanda Ursell to see if eating fat and sugar have different effects on how hungry we get. As we expect, the high fat diet leaves Alex feeling fuller for longer while Chris eats around an extra 30% of food and admits that ‘calories do not necessarily make you feel full and I was hungrier quicker.’ Does this signal a move away from the calories are calories are calories thesis? No, not quite as the twins explain that ‘as sugar is an easy source of calories, you get fatter quicker.’ Back to calories then…

Then we moved on to fats. We are told that the recommended saturated fat intake is no more than 30g while quickly slipping in a fleeting comment about this being ‘currently contested’. Things are moved very swiftly on to trans-fats and how bad they are. There is no attempt to examine the argument in favour of saturated fats, although they can spend precious minutes of the documentary handing out doughnuts to people in the street. We are just told that fat has twice as many calories as sugar (back to calories again) and we are informed that our body ‘turns dietary fat into body fat easier than it turns sugar into body fat.’ That’s fat sorted then…

We then saw the twins taking a gruelling test riding a bike up a mountain, alongside a ‘commercial’ for porridge from the helpful Tour de France man. He also tells us that Alex is in ‘the last state that we want our athletes to be in.’ Alex announces that he ‘hasn’t eaten carbs for weeks.’ I remind myself that this is all about extremes…

A return visit to a worried looking Dr Mackenzie confirms that sugary Chris has lost 1kg – 0.5kg of fat and 0.5kg of muscle. Alex has lost 4kg – 1.5kg of fat and 2kg of muscle (where did the other 0.5 kg go?!). Proportionally, they have lost the same amount of muscle (50% of the total loss). The doctor informs us that people who lose muscle mass are ‘more likely to visit the hospital and be ill.’ However, presumably people who are very overweight are even more likely to visit the hospital and be ill, so it makes sense to get the fat off with a very effective high fat, low-carb diet and later exercise to build muscle if they can. I don’t remember seeing headlines about the amount of people turning up at the hospital with diseases due to lost muscle mass, but there is an awful lot about the effects of diseases due to obesity. Maybe I’m missing something.

There is also a quick examination of their cholesterol which has stayed normal in both twins (no mention about what type of cholesterol here, or any measurements of tryglycerides). On to announce that Alex has a raised blood glucose from 5.1 to 5.9 which is apparently ‘pre-diabetic’ although I keep turning up results on the internet that suggest this is at the top of the ‘normal’ range. Again, I would have liked to see what their levels were pre-diet as Alex was quite overweight and carrying a lot of extra body fat around the midriff. Chris, who worryingly is becoming ‘better at producing insulin’ in response to all that sugar (oh that’s ok then…), appears to be relieved and oblivious to the fact that another few months on this diet will surely make him insulin resistant and diabetic.

We then go over to Professor Susan Jebb at Oxford University who confidently informs us that a diet ‘which has extreme composition is not the answer’ and that ‘cutting out sugar does not have a big effect.’

We are now into the home run and while Richard (my other half) is losing the will to live I encourage us to battle on to the end. The conclusion is in sight and with the help of some rats and cheesecake we finally get to the advice we have been waiting for all along – avoid processed food. Yes it’s the magic combination of 50/50 fat and sugar in processed food that is making the nation obese. All faddish diets are worrying and misguided, and the enemy is neither fat nor sugar but both together. It’s not the fat that’s the problem (although remember that warning about saturated fats) and it’s not the sugar (as one of the twins explained earlier, we don’t binge on sugar cubes). A final suggestion to cut calories was slipped in for the last time and that was that. Phew!

This programme set out to exonerate a high carbohydrate diet from any blame in the nation’s obesity crisis. It did this by deliberately choosing extreme diets with which to make its point and to hell with any sense of proportion or fairness. Important topics were skimmed over quickly (the debate about saturated fats, the different types of cholesterol, what causes heart disease, the effects of a low-fat, high carbohydrate diet). Subtle (and not so subtle) remarks were made throughout the programme that made it clear that the evidence had been carefully chosen to trash a high-fat, low-carb diet and to ‘protect’ high-carb diets. We are all aware that the hedonic impact of food is mighty important, but there are many people who have spent decades on high-carb, low-fat diets (while simultaneously avoiding hyper-palatable junk food) that have experienced a myriad of problems.

The consensus was a return to the same advice that governments and nutritionists have been trotting out for decades – a ‘healthy’ wholegrain diet, low in saturated fat and processed foods. Don’t worry too much about the sugar as long as its low fat, so stock up on those low-fat, sugary yoghurts because they are fine.

I wanted to have a look at the work of some of the experts that appeared in the programme. This turned up some rather interesting information. Professor Susan Jebb ‘works closely with the Department of Health, Public Health England and National Institute for Clinical Excellence’ and is also the Chair of The Department of Health Public Health Responsibility Deal – see here. They had something to do with that strange swimming pool/saturated fat pledge that I wrote about last year. Professor Jebb works with industry and retailers on such ‘Responsibility Pledges’ and is on a ‘high-level steering group that encompasses health professionals, food industry representatives and civil servants’ – see here. She has also been vocal in warning of ‘fad diets.’ Professor Jebb has previously come under fire for her work with Weight Watchers.  Also, check out this article from the excellent Dr Briffa here.

Amanda Ursell is a nutritionist and also a member of the British Dietetic Association. I wrote about the BDA take on ‘fad diets’ here. I was interested in the sort of diet that Amanda recommends and so I hopped over to her website and had a look. For breakfast, Amanda recommends amongst other things apple muesli, French toast, blueberry porridge, fruity toast, peanut butter toast, fresh fruit bowl and bacon sandwiches – and skinny cappuccinos. Plenty of sugar then… I was also interested in her take on the ‘French paradox’, which I always thought was to do with the fact that French people ate lots of saturated fat and yet had lower incidences of heart disease. Saturated fat is mysteriously missing from Amanda’s tips on French eating.

Professor Kanarek has served as ‘a member of the National Academy of Sciences, Committee on Military Nutrition Research, and on review committees for the National Institutes of Health, United States Department of Agriculture, and National Science Foundation’. Professor Kanarek contributed to a similar study on low-carb diets and cognitive function in this paper in 2008 with the USDA Human Nutrition research Centre on Ageing (unfortunately tracking dieters for only 3 weeks). A very low-carbohydrate diet (maximum of 10-16g per day) was compared to the ‘healthy’ diet as recommended by the American Dietetic Association.

All interesting stuff but it did leave me feeling that the scales were heavily weighted towards finding a favourable outcome for conventional wisdom on dietary matters. We were left with many unanswered questions, for instance what is the effect on weight and lifestyle diseases (the original question posed in the documentary) of a long-term high sugar, low-fat diet. I did not feel that this was addressed in any comprehensive way, in fact hardly at all other than Robert Lustig’s brief appearance followed by a sceptical comment from one of the twins.

Listening to people talk the day after the documentary was aired, the consensus seemed to be that all things in moderation and an avoidance of those ‘fad diets’ was the most sensible option. It’s a sad state of affairs.

Ending on a more positive note, my talk on Paleo to the ladies (and gentleman!) at the social club went down extremely well and their enthusiasm and interest cheered me no end. Perhaps things are not that bad after all…

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