Paleo Diet Q & A: Blood Type and Diet

Q: Professor, I pulled my information from thepaleodiet.com and attributed the statement, "Paleo is truly is the world’s healthiest diet," to you, which I doubt is a stretch.

Have you gotten into any of the information about the blood-type-related nutrition info? I've only heard snippets, but I'm curious what an expert thinks of it.

Seth

A: Hi Seth,

Thanks for your support. I am currently completing a paper on nightshades, and when it is done the very next topic in the queue is my critique of the Blood Type Diet, which I have been researching and reading about for the past couple of weeks. Although I don’t want to give away the story line, I can say that the concept of four specific types of diet for the four ABO blood groups (A, B, O & AB) is not supported by the available data. However, having said that, susceptibility to disease, and the robustness of the immune response to pathogens throughout the entire GI tract, is very much related to ABO blood groups. Our group has published at least one paper on the dietary lectin/disease concept and we believe that common dietary lectins may promote certain diseases (allergies, autoimmune disease) while simultaneously promoting chronic low level inflammation. However, little evidence in either humans, animals or tissues point in the direction that dietary lectins elicit disease symptoms exclusively via interaction with ABO antigens. Additionally, of the hundreds of plant lectins that have been identified, only a very select few have been demonstrated to bind gut tissue. Hence, most dietary lectins are benign, simply because they cannot penetrate the gut barrier.

Cordially,
Loren Cordain, Ph.D., Professor

Paleo Diet Q & A - Sprouted Legumes

Q: Hi, the Paleo Diet makes a lot of sense to me and I very much appreciate the research that's gone into it. However, am I right in thinking that any diet we are adapted to may nevertheless not be an ideal diet? We adapted to a diet that enabled us to be healthy enough to live long enough to reproduce healthy enough offspring.

If I understand correctly, couldn't certain foods could make that basic diet even healthier? For example, I have The Paleo Diet for Atheletes out from the library right now and I see that you believe that the life of an athlete requires departure from a strict paleolithic diet. Couldn't properly treated grains and legumes be beneficial additions to the diet? (i.e. soaked/sprouted to reduce/eliminate anti-nutrients?)

I am waiting to receive The Paleo Diet from the library (I'm on a long waiting list, which is good news I guess!) so maybe you address this issue in the book, in which case, I apologize. But if not, I would appreciate knowing your views on soaking/sprouting grains and legumes, and the reasons behind those views.

Thanks so much,
Zena

A: Dear Zena, first of all - thanks for supporting our work.

Lectins, one of the known antinutrients in cereal grains and legumes1, have been demonstrated to exert several deleterious effects upon human physiology1, (especially for those with autoimmune diseases) by increasing intestinal permeability2. Their function is to protect the plant against attacks by plant-eating animals by using several toxic substances, such as lectins3. There is a growing body of evidence showing that both the root and the sprout of wheat kernels have significant amounts of wheat germ agglutinin (WGA), one of the most studied lectins. Indeed, WGA originates in the wheat kernel, especially during germination and growth4, and the highest concentrations are found in young plant roots, seeds, and sprouts.

Lectins are resistant to digestive enzymes, and are found intact in peripheral circulation, as shown by Wang et al (1998)5. Furthermore, they are deposited in the internal organs6.

As stated by Pusztai et al7, lectins are heat stable, and normal cooking does not completely eliminate these toxic compounds unless they are pressure cooked8-11. The best way to reduce lectins' adverse health effects is to limit their intake.

In addition, saponins - another type of toxic/antinutritive compound - exist in legume sprouts. Saponins have been shown to affect the gut barrier and by extension immune system function12. They may also increase the risk of autoimmune diseases in genetically susceptible individuals13. Soaking, sprouting or cooking legumes, does not reduce their saponin content14, 15.

In addition, a peptide fraction from gluten proteins called gliadin is found in wheat. Gliadin is resistant to digestive enzyme degradation16, arrives intact when it comes into contact with intestinal epithelial cells17, and increases intestinal permeability. Increased intestinal permeability may be at the root of autoimmune diseases such as Celiac Disease and Type 1 Diabetes13.

Phytate, the main form of phosphorus storage in many plants (especially bran and seeds) is classified as an antinutrient because is a chelator of iron, magnesium, calcium and zinc1. Phytate ingestion inhibits the intestinal absorption of those minerals. Phosphorus from phytate is unavailable to humans, as we do not produce the phytase enzyme necessary to break down phytate - unlike ruminants, who do produce phytase, and are able to digest phytate18. Yeast fermentation in bread reduces phytate content19. Furthermore, addition of ascorbic acid counteracts the inhibitory effects of phytate upon iron absorption20. Soaking and fermentation reduces the phytate content of grains and legumes as indicated in several studies21, 22, 23, 24.

Having said that, Dr. Cordain in his first book talks about the 85:15 rule, where he explains that 85% of caloric intake from modern paleolithic-like foods is still more healthy than the typical western diet, where more than 70% of caloric intake comes from foods introduced in the human food chain after the agricultural revolution25.

The bottom line is that our metabolism is perfectly adapted to the nutrition that shaped our genome during million of years of evolution. Therefore, any nutrient introduced after the agricultural revolution may not be compatible with our ancient genome. We believe that anyone engaged in athletic activities could do very well on a diet based on 85% paleolithic nutrients, which are preferable to the nutrients found in the typical western diet.

I hope this is helpful.
Maelán Fontes

References:

Cordain L. Cereal Grains: Humanity’s Double-Edged Sword. World Rev Nutr Diet. Basel, Karger,
1999, vol 84, pp 19–73.Cordain L. et al. Modulation of immune function by dietary lectins in rheumatoid arthritis. British
Journal of Nutrition (2000), 83, 207–217.Chrispeels, M.J. & Raikel, N.V. (1991) Lectins, lectin genes, and their role in plant defense. Plant Cell 3, 1-9.Miller, R., & Bowles, D. (1982). A comparative study of the localization of wheat-germ agglutinin
and its potential receptors in wheat grains. Biochem. J., 206, 571-576.Wang Q, Yu LG, Campbell BJ, Milton JD, Rhodes, JM. Identification of intact peanut lectin in peripheral
venous blood. Lancet 1998;352:1831-32.Caron, M. & Steve, A.P. (2000) Lectins and Pathology, Taylor & Francis, London. Pusztai A and Grant G. Assessment of lectin inactivation by heat and digestion. From Methods
in Molecular Medicine. Vol 9 Lectin methods and protocols. Edited by J M Rhodes and J D Milton Humana
Press Inc. Totowa, NJ.Grant G, More LJ, McKenzie NH, Pusztai A. The effect of heating on the haemagglutinating activity
and nutritional properties of bean (Phaseolus vulgaris) seeds. J Sci Food Agric 1982;33: 1324-1326.Boufassa C, Lafont J, Rouanet J M, Besancon P 1986 Thermal inactivation of lectins (PHA)isolated
from Phaseolus vulgaris. Food Chem 20 295-304.Buera M P, Pilosof A M R, Bartholomai G B 1984 Kinetics of trypsin inhibitory activity loss in
heated flour from bean Phaseolus vulgaris. J Food Sci 49 124-126.Collins J L, Beaty B F 1980 Heat inactivation of trypsin inhibitor in fresh green soybeans and
physiological responses of rats fed the beans. J Food Sci 45 542-546.Patel B, Rober S, Sporns P, et al. potato glycoalkaloid adversely affect intestinal permeability
and aggravate inflammatory bowel disease.Visser J, Rozing J, Sapone A et al. Tight junctions, Intestinal permeability and Autoimmunity.
Ann. N. Y. Acad. Sci. 1165: 195-205 (2009).Ruiz RG, Price K, Rose M, Rhodes M, Fenwick R. A preliminary study on the effect of germination
on saponin content and composition of lentils and chickpeas. Z Lebensm Unters Forsch 1996;203:366-369.Ruiz RG, Price KR, Arthur AE, Rose ME, Rhodes MJ, Fenwick RG. Effect of soaking and cooking on
the saponin content and composition of chickpeas (Cicer arietinum) and lentils (Lens culinaris).
J Agric Food Chem 1996;44:1526-1530.Shan L, Qiao SW, Arentz-Hansen H, et al. Identification and Analysis of Multivalent Proteolytically
Resistant Peptides from Gluten: Implications for Celiac Sprue. J Proteome Res. 2005 ; 4(5): 1732–1741.Drago S, Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac
intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology,
2006; 41:408/419.Klopfenstein, TJ et al. "Animal Diet Modification to Decrease the Potential for Nitrogen and
Phosphorus Pollution". Council for Agricultural Science and Technology 21.Reinhold JG. Phytate destruction by yeast fermentation in whole wheat meals. J Am Diet Assoc 1975;66:38-41.Hallberg L, Brune M, Rossander L. Iron absorption in man: ascorbic acid and dose-dependent inhibition
by phytate. Am J Clin Nutr 1989;49:140-4.Chen LH, Pan SH. Decrease of phytates during germination of pea seeds (Pisium Sativa). Nutr Rept Int.
1977;16: 125-131.Walker KA. Changes in phytic acid and phytase during early development of phaseoleus vulgaris beans.
Planta 1974;116:91-98Bain, J. M., Murcer, F. V.: Changes in phytic acid and acid-soluble phosphorus in maturing pinto beans.
J. Sci. Fd. Agric. 20, 82–84 (1966).Jennings, A. C., Morton, R. K.: Changes in nucleic acids and other phosphorus-containing compounds of
developing wheat grain. Aust. J. Biol Sci. 16, 332–341 (1963b).Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the western diet: health implications
for the 21st century. Am J Clin Nutr 2005;81:341–54.

Paleo Diet Special Report: Chia Seeds

Dear Readers,

The following is an excerpt from a special report authored by Dr. Cordain on Chia seeds. The full report is available in our newsletter, The Paleo Diet Update, Volume 6 Issue 7.

Q: Are there any negative effects associated with chia seeds which would make them inappropriate in The Paleo Diet?

Thank you.

A: Good question. I would imagine that many of our readers have never even heard of chia seeds much less eaten them. Chia seeds (Salvia hispanica L.) are a member of the Labiatae plant family and are native to southern Mexico and northern Guatemala. The seeds are small, oval shaped; either black or white colored and resemble sesame seeds. These seeds were cultivated as a food crop for thousands of years in this region by the Aztecs and other native cultures. Chia seeds can be consumed in a variety of ways including roasting and grinding the seeds into a flour known as Chianpinolli which can then become incorporated into tortillas, tamales, and various beverages. The roasted ground seeds were traditionally consumed as a semi-fluid mucilaginous gruel (Pinole) when water is added to the flour. In post-Columbian times the most popular use of chia flour was to make a refreshing beverage in which the ratio of seeds to water is decreased, thereby resulting in a less gelatinous consistency to which lemon, sugar or fruit juice are added. The sticky consistency of chia seed Pinole or chia beverages comes from a clear mucilaginous, polysaccharide gel that remains tightly bound to the seeds. This sticky gel forms a physical barrier which may impair digestion and absorption of fat from the seed4 while also causing a low protein digestibility.

In the past 20 years a revival of interest in chia seeds has occurred primarily because of their high fat content of about 25-39% by weight, of which 50-57% is the therapeutic omega 3 fatty acid and alpha linolenic acid (ALA). In the past 10 years chia seeds have been used as a foodstuff for animals to enrich their eggs and meat with omega 3 fatty acids. So I wholeheartedly approve of feeding chia seeds to animals and then eating the omega 3 fatty acid enriched meat or eggs of these animals.

How about feeding chia seeds to humans – should we consume chia seeds because of their high omega 3 fatty acid (ALA) content? The Table below shows the entire nutrient profile of chia seeds. At least on paper, it would appear that chia seeds are a nutritious food that is not only high in ALA, but also is a good source of protein, fiber, certain B vitamins, calcium, iron and manganese.

Unfortunately, the devil is always in the details...

Welcome to The Paleo Diet Blog!

The Paleo Diet--the world’s healthiest diet--is based on the simple understanding that the best human diet is the one to which we are best genetically adapted. It is supported by documented scientific evidence and by real-life improvements, even triumphs, of people winning their personal health battles.

The Paleo Diet is based upon the life work of Dr. Loren Cordain. Dr. Cordain is widely acknowledged as a leading expert on the diet of our Paleolithic ancestors. In numerous publications in the world's best scientific journals, he has documented the dramatic health benefits of eating a diet consistent with human genetic evolution and our ancestral, Paleolithic diet. Learn how a diet based on lean meats, seafood, fresh fruits, and fresh vegetables can lead to ideal body weight, optimum health, and peak athletic performance.

This concept represents the "unified field theory" of nutrition that has until now been lacking. The discipline of human nutrition previously had no orienting paradigm to guide research and inquiry, and as such was an immature science. In contrast, cosmology has the big bang theory, which orients all thought regarding the origins of the universe, and geology has continental drift and plate tectonics, which universally guide research into the origins of earth's land mass. In biology, the fundamental, guiding principle is Darwin's theory of evolution through natural selection, which provides a template for the creation of life on earth.

It has only been in the last two decades that a few enlightened scientists have realized that this principle also represents the basic biological principle which determines the nutritional requirements of any organism - including humans. Our genes were shaped by our ancestors' environment, including our nutrtional requirements. Because what we eat today is so far removed from the diet of our hunter-gatherer ancestors, a discordance exists between our genes and our diet, and this factor represents the underlying reason why we are so sick and overweight as a society.

Dr. Cordain has authored three pioneering books that provide specific applications of The Paleo Diet for general health and nutrition, specifically for athletes, and for curing acne.

The Paleo Diet provides the background and basis for the optimally healthful diet. It has been highly praised by researchers, scientists, and readers from all over the world.

The Paleo Diet for Athletes, written by Dr. Loren Cordain and world-class fitness trainer Joe Friel, provides detailed information on how endurance athletes can improve performance, recovery, and health by eating a slightly modified version of the Paleo Diet.

The Dietary Cure for Acne represents the first real cure--not a treatment--a real solution to this pervasive skin disease. It is a natural acne diet program, based on recent research.

We also offer numerous programs designed to help people address particular nutritional and health needs. These programs can enable you to achieve your health goals whether you seek to:
permanently free yourself from acneimprove your athletic performanceenjoy a longer, healthier, more active lifelose weight without dieting and exercise,reduce or eliminate your risk of diseases, including cancer, heart disease, diabetes, and the vast majority of all chronic degenerative diseases that affect humanityFor more information about our team and our products please visit our Paleo Diet web site as well as our Dietary Cure for Acne web site.

You may post comments and questions at the end of most blog posts. Scroll down to the end of a post, type your comments in the text area under the title Post a Comment, and click the Post Comment button.

Paleo Diet Q & A - Epigenetics, Flaxseed Oil

Epigenetics

Q: What do you think about epigenetics? Many scientists (in Germany) believe that the concept of the Paleo Diet is no longer tenable.

Thanks a lot, Michael

A: Dear Michael,

Epigenetics is defined as the science studying changes in phenotype or gene expression by mechanisms other than changes in DNA nucleotide sequence1. The phenotype is someone's appearance which it's determined by the genotype (stable and heritable) and the environment (nutrition and other lifestyle factors) which give place to the epigenotype (heritable, labile and rapid)1. Epigenetic changes are controlled, among other mechanisms, by methylation and histone modification. Altered methylation pattern and histone modification may lead to increased susceptibility to disease. E.G. cancer is associated to generalized hypomethylation and localized promoters hypermethylation1. Histone manipulation may also increase or decrease disease susceptibility2.

Both, methylation and histone manipulation are under the control of dietary substances. For example, methylation depends on SAMe availability, which in turn is influenced by vitamin B6, vitamin B12 and folate intake3, and long chain polyunsaturated fatty acids such as DHA4. On the other hand, certain substances such as garlic, horseradish, fiber, blueberries, apple, onion, nuts, berries, red grapes, broccoli, etc. are known nutrients involved in histone modification2.

The Paleo Diet is rich is all of these nutrients5, hence it may exert positive effects upon epigenetics machinery leading to decreased disease susceptibility. Decreased availability of micronutrients is associated to disease severity, probably, through complex epigenetic mechanisms, and supplementation could improve those symptoms3. Improved epigenetic is influenced by metabolic programming during foetal and early life. These two periods are crucial for the developing newborn and future adult's health. Hence, The Paleo Diet may confer protection against several diseases improving the epigenetic programming.

We hope this is helpful.

Maelán Fontes Villalba
Pedro Carrera Bastos

References:

van Vliet J, Oates NA, Whitelaw E. Epigenetic mechanisms in the context of complex diseases. Cell Mol Life Sci. 2007 Jun;64(12):1531-8.Delage B, Dashwood RH. Dietary manipulation of histone structure and function. Annu Rev Nutr. 2008;28:347-66.Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.Muskiet FA, Kemperman RF. Folate and long-chain polyunsaturated fatty acids in psychiatric disease. J Nutr Biochem. 2006 Nov;17(11):717-27.Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.

Flaxseed Oil

Q: I recently visited family and my brother is a new advocate of the paleo diet. For breakfast he made us "fakecakes" which had about 1-2 tablespoons of flaxseed in them that he ground in a coffee grinder. I had few a questions regarding the use of flaxseed in the Paleo Diet.

First, why are flaxseeds ok in the Paleo Diet but other grains (seeds) are not? My understanding for eliminating grains from the diet is the toxins that they contain, but flaxseed contains large amounts of cyanogenic glycosides, producing up to 139 mg/kg of hydrogen cyanide in raw human-grade flaxseed. I am sure flaxseeds are processed somehow before selling them but I don't know what process that is or what effect it has on the HCN concentration.

So, secondly...do you know of any studies on the amount of HCN in meals containing ground flasxseed and the chronic oral exposure of those amounts on humans? My understanding here is the HCN that isn't hydrolysed to formic acid in the stomach and doesn't bind to hemoglobin is converted to thiocyanate which hinders thyroid function.

Thank you for your time and any information you can supply.

Sincerely,
Tim

A: Hi Tim,

We think your thoughts are on the right track.

When Dr. Cordain wrote The Paleo Diet book, the advice to consume flaxseed oil was an attempt to balance the increased omega-6/omega-3 fatty acid ratio due to the exaggerated intake of omega-6 vegetable oils, especially linoleic acid, in the typical western diet.

Nevertheless, animal foods (fish, muscle meat and organs from wild animals) are good sources of w3 fatty acids. Therefore, when people eat these foods regularly along with vegetables and nuts, and avoid vegetable oils (especially oils rich in Linoleic Acid – Omega 6), they get a balanced intake of omega 3, omega 6, monounsaturated and saturated fatty acids. In this situation, there is no need for flax seeds to provide Omega 3 fatty acids and balance the Omega 3/Omega 6 ratio.

Here are some facts that support the notion that animal foods, vegetables and nuts provide the necessary Omega 6 and Omega 3 fatty acids in the right proportion:

Hunter-gatherers do not eat ALA from seeds or vegetable oils.Nuts, green leafy vegetables and animal foods contain ALA.The conversion of ALA to EPA+DHA is limited, due to low delta-6 and delta-5 activity, although ALA is highly oxidized (twice that of LA) (see paper by Freemantle et al). This means that at some point in history we included preformed sources of EPA and DHA and still need to do so. Animal foods (especially brain from wild ruminants and fish) are very good sources of these fatty acids.The essentiality of LA & ALA in human metabolism has been questioned (see paper by Le et al.), as we relied almost on LCPUFA (Arachidonic Acid, EPA and DHA) during the Palaeolithic era (see Dr. Cordain’s papers on that here and here). Moreover, there is already some evidence showing that human metabolism could re-convert AA and DHA into LA and ALA respectively, hence AA and DHA would be the true essential fatty acids.The possible toxicity from seeds and vegetable oils (HCN, saponins, lectins).They are not used by current HG societies, and these populations show no signs of western disease, so this means that flax seeds are not necessary.The well known positive health effects of fish oil supplementation (among other factors to improve omega-6/omega-3 ratio) in contrast with some possible adverse effects of flaxseed oil (like the epidemiological evidence that points towards increased risk of prostate cancer with flax oil consumption – see paper by Brouwer et al).

The bottom line from an evolutionary perspective is that flax seeds and/or flaxseed oil would not have been consumed by pre-agricultural humans. However, having said that, hunter gatherers always would have preferentially sought high oil plant foods as per optimal foraging theory. But, most high fat plant foods contain high MUFA (with the exception of coconut and palm oils).

Hope this helps,
Maelán Fontes Villalba

Additional reading: Effectiveness of different processing methods in reducing hydrogen cyanide content of flaxseed, Feng, et al.

Paleo Diet Q & A - Whey Protein

Q: Could you please provide some details on the benefits/detriments of whey protein supplementation? I am a weight trainer/powerlifter and supplement with whey protein, which is currently touted as the best/most health-conscious choice there is. I have read in your newsletter about the inflammatory aspects of dairy products - is whey protein included in this? Is it better or worse than other dairy products?

Many people interested in the Paleo Diet who are also into strength training and fitness would be interested in your thoughts on this. Any pointers re: inflammation and supplementation of protein would be very well received. Thank you, in advance.

Best regards,
Karl

A: Dear Karl,

Unfortunately, at this point, most of the research has focused on the beneficial effects of whey. It basically revolves around whey's high BCAA content, its use as a post-workout recovery drink ingredient, and its capacity – due to cysteine – to increase Glutathione, a powerful endogenous antioxidant enzyme.

Nevertheless, we believe that whey protein can have some potential adverse effects, because it greatly elevates insulinemia - although it can be therapeutic for diabetics in the short term. We suspect that whey protein could be detrimental long term, as hyperinsulinemia can down-regulate the insulin receptor and lead to insulin resistance. Insulin resistance underlies the Metabolic Syndrome, and is implicated in various other diseases, such as Acne, Alzheimer, various cancers, Coronary Heart Disease, Myopia, PCOS, etc.).

But to be completely sure, we would need intervention studies with whey protein with a relatively long duration in people genetically prone to insulin resistance, or who are in fact insulin resistant.



Also, there is the matter of hormones in milk: estrogens, DHT precursors, Insulin, IGF-1 and the hormone Betacellulin (BTC), which Dr. Cordain has discussed in a previous edition of this newsletter. These are some of the possible mechanisms for which there is repeated epidemiological evidence associating milk consumption with some cancers - especially Prostate Cancer.

We know that these hormones are present in milk and - in the case of BTC - it is present in whey too. Nevertheless, the real content of all these hormones in commercial milk-derived products is an open question that deserves proper and urgent study. So while we don’t know for sure, and since and we have alternatives, I would follow the old saying: do no harm!

Finally, if you have an auto-immune disease or allergy to Beta Lacto Globulin (protein that exists in bovine milk, but nonexistent in human milk) I would stay away from whey. Whey contains not only Beta Lacto Globulin, but also Bovine Serum Albumin. Some peptides from this protein have structural homology with peptides from our own tissues, and BSA has been implicated in Multiple Sclerosis, Rheumatoid Arthritis and Type 1 Diabetes.

In conclusion, I would follow the evolutionary template until all these issues are resolved. which states that recently introduced foods may have potential adverse effects to humans, especially long term. Non-human milk was only introduced in the human diet ~10,000 years ago. Therefore, given the potential health hazards of milk that science is revealing, I would use another protein source. Lean meat and seafood are very good sources of BCAA. If you want a protein drink immediately after strength training to speed recovery and increase muscle mass, I would suggest ~9 grams of essential amino acids, along with a banana.

I hope this helps.

Cordially,
Pedro Bastos

Editor's note: the following blog posts also discuss whey protein:
Q: I started the program and I was wondering if Whey Protein or protein powder in general is against the diet?
Q: I like drinking protein shakes in the morning, but I noticed some of the protein sources in my protein shake are made from milk or dairy products. Is there an alternative that is available in the market place?
Q: I am just trying to figure out your feelings and thoughts on protein powders.
Additional reading: Hyperinsulinemic diseases: more than just Syndrome X.

The Paleo Diet in the News

Dear Readers,

The Paleo Diet and Dr. Cordain's work have been cited in recent articles in the following media:
Mail Tribune, Medford, Oregon
Daily News, Redbluff, California
The Ledger, Lakeland, Florida
The Press of Atlantic City
A Sweet Life: An interview with a Type 1 Diabetic
Netstrife News - Rapid Weight Loss on the Paleolithic Diet (click on the article to make the pop-up go away).
Medscape - Does Diet Really Affect Acne?
Total Health Breakthroughs - Beating Obesity, The Old-Fashioned Way
Robb Wolf discusses The Paleo Diet in his podcast The Paleolithic Solution. Robb is a former student of Dr. Cordain's, and an advocate of Cordain's work in paleolithic nutrition.
Psychology Today - features an article on The Paleo Diet in their June edition (print), and their own paleolithic nutrition Q &A referencing Dr. Cordain's work on their blog. PT first wrote about Dr. Cordain's work in paleolithic nutrition in 1997!
WBUR.org (Boston NPR affiliate)
Westword
San Jose Mercury News
ArgusLeader.com
AnnArbor.com
ESPN - main article, expanded articleThe Colbert Report - interview with John Durant
The Denver Post
National Post
Voice of AmericaMacleans
Politics DailySun-SentinelAFPSpiegel OnlineIndependent OnlineThe Times OnlineThe New York TimesThe Washington PostAOL's thatsfit.comBook publishing news site GalleycatThe ExaminerMedscapeHuffington Post

The Paleo Diet and Crohn's Disease

Q: Can you comment on any reported results in curbing the symptoms of Crohn's Disease with the Paleo Diet. As I am a sufferer, I would love to know.

Thank you,
Shannon

A: Dear Shannon,

Indeed, inflammatory bowel disease (Ulcerative Colitis & Crohn's Disease) patients usually do very well with The Paleo Diet, as nutrients are one of the main environmental triggers of this condition. Crohn's disease is an autoimmune disease where the immune system mounts an attack against its own tissues - in this case the cells lining the intestine.

For an autoimmune disease to occur we need a genetic predisposition and an environmental trigger. The genetic predisposition depends on genes coding for the Human Leukocyte Antigen (HLA) system. One of the environmental triggers may be nutrition, besides infections, geography (vitamin D deficiency), physical trauma or vaccination.

One of the key points in this process is increased intestinal permeability. This means that the gut barrier allows increased passage of bacterial or food proteins (antigens) into peripheral circulation, skipping a process known as oral tolerance. Once antigens come in contact with the immune system located in the gut associated lymphoid tissue, they may elicit a T-cell mediated immune response against those antigens.

If the molecular structure of the dietary or bacterial antigens is similar to that of the HLA system (part of the immune system representing cellular mechanisms), chances are that a cross reaction between foreign antigens and self antigens (produced by T-cells) occur. This is termed molecular mimicry, and leads to self injury by the adaptive immune system.

Hence, decreasing intestinal permeability is one of the treatment targets. There are several nutrients known to increase intestinal permeability that you may want to avoid, at least until symptoms subside. Here is a list, with the noxious substances in parentheses:

Cereal grains (lectins and gliadin)Legumes, including soya and peanuts (lectins and saponins)Tomato (tomato lectin and alpha-tomatin)Potato (lectins and saponins)Chili (capsaicin)Quillaja (foaming substance)Quinoa (saponins)Egg white (lysozyme)Alfalfa sprouts (saponins)Amaranth (saponins)Alcohol

Moreover, some nutrients exert an adjuvant-like activity (they stimulate the immune system), which is something you don't want to if you are suffering from an autoimmune disease. Nutrients containing adjuvants:

Quillaja extract, found in root beerTomato alpha-tomatine

Dairy products and vegetable oils also have deleterious effects upon your immune system.

I hope this helps.
Maelán

Paleo Links

Dear Readers,

In addition to our paleo nutrition links on the right-hand side of the blog (scroll down if not visible), here are useful links for fitness, Paleo Diet, and paleo nutrition-related web sites and blogs.

Paleo Diet Q & A - Lichen Sclerosis, Stevia

Lichen Sclerosis

Q: Hi there - I have been following a Paleo Diet for a few weeks now and there is no doubt that I feel much better for it. I did not need to lose weight and I always regarded myself as pretty fit and healthy. However, a little while back I developed a troublesome skin condition called Lichen Sclerosis. Have you ever been asked about this condition and suggested dietary changes? I think part of the problem is that the etiology is not fully understood but many doctors seem to think it has an autoimmune component though I have read recent research that suggests oxidative damage plays a part and that antioxidant therapy may be useful in treatment. This condition is supposedly incurable (though manageable with potent steroids) but I'm sure it would give a great many people some comfort if simple dietary changes could help. Would be really great to hear your thoughts.

Simon

A: Dear Simon,

The available evidence indicates that an autoimmune component likely occurs with Lichen Sclerosis (LS). With all autoimmune diseases, an autoantigen (self protein) exists and represents the target protein being attacked by the immune system. About 75 % of LS patients maintain an IgG autoantibody to Extra Cellular Matrix Protein 1 (ECM1)1. Acceleration of ECM1 deposition in dermal (skin) blood vessels may underlie the disease symptoms 2, 3. So the question now arises, what causes an accelerated deposition of ECMI in dermal blood vessels in LS patients? The available evidence indicates that increased concentrations of a ubiquitous enzyme in the body called tissue transglutaminase (TG2) is primarily responsible for excessive ECM1 accumulation3. In medical terms, an increase in a concentration of a substance in the bloodstream by another substance is called "upregulation".

So, in LS patients, an upregulation of TG2 causes an upregulation and increased deposition of ECMI in the skin blood vessels in the affected area of the body. The next question to be posed is, what event or events trigger an upregulation of TG2? When we answer this question, then dietary recommendations advocated by the Paleo Diet will make sense. A storage protein called gliadin which is fournd in wheat, rye, barley and oats is known to upregulate TG2 4-7. Hence grain free diets may prove to be therapeutic for LS patients, although no current randomized controlled trials of this intervention strategy have yet been conducted.

Cordially,
Loren Cordain, Ph.D., Professor

References:

Chan I, Oyama N, Neill SM, Wojnarowska F, Black MM, McGrath JA. Characterization of IgG autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Clin Exp Dermatol. 2004 Sep;29(5):499-504. Kowalewski C, Kozlowska A, Chan I, Górska M, Wozniak K, Jablonska S, McGrath JA.Three-dimensional imaging reveals major changes in skin microvasculature in lipoid proteinosis and lichen sclerosus. J Dermatol Sci. 2005 Jun;38(3):215-24. Epub 2005 Mar 3. Fisher M, Jones RA, Huang L, Haylor JL, El Nahas M, Griffin M, Johnson TS. Modulation of tissue transglutaminase in tubular epithelial cells alters extracellular matrix levels: a potential mechanism of tissue scarring. Matrix Biol. 2009 Jan;28(1):20-31. Epub 2008 Nov 5. Michaelsson, G., Ahs, S., Hammarstrom, I., Lundin, I. P., & Hagforsen, E. Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer ki67+ cells in the dermis. Acta Dermato-Venereologica, 2003; 83(6):425-429. Biagi F, Campanella J, Laforenza U, Gastaldi G, Tritto S, Grazioli M, Villanacci V, Corazza GR. Transglutaminase 2 in the enterocytes is celiac specific and gluten dependent. Dig Liver Dis. 2006 Sep;38(9):652-8. Gorgun J, Portyanko A, Marakhouski Y, Cherstvoy E. Tissue transglutaminase expression in celiac mucosa: an immunohistochemical study. Virchows Arch. 2009 Oct;455(4):363-73. Villanacci V, Not T, Sblattero D, Gaiotto T, Chirdo F, Galletti A, Bassotti G. Mucosal tissue transglutaminase expression in celiac disease. J Cell Mol Med. 2009 Feb;13(2):334-40.

Stevia

Q: Is Stevia Paleo? I have attempted to find an answer for this and the information I've found is conflicting at best. Please advise!!
Jeff

A: Dear Jeff,

There's some scientific evidence to support the notion that Stevia is safe, even in type 2 diabetes patients1, 2. Furthermore, it has been demonstrated to have antihypertensive properties, as shown by Chan et al.3 and a long-term study4. Having said this, I am not aware of any study examining the potential antinutrient (lectins or saponins) content of the plant, hence we do not know the possible adverse effect of consuming this plant on a daily basis. Hunterh-gatherers used to consume a wide range of plants, thereby minimizing the amount of a single bioactive compound ingested and its toxicity. It is known that rotating the kind of plants is a good strategy in order to decrease food allergy and intolerance.

From an evolutionary standpoint we should look at nutrition as "whole food" rather than nutrients per se. The bottom line is that Stevia seems to be safe, but we need more research to rule out possible side effects.

I hope this is helpful,
Maelán

References

Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism. 2004 Jan;53(1):73-6. Barriocanal LA, Palacios M, Benitez G, Benitez S, Jimenez JT, Jimenez N, Rojas V. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul Toxicol Pharmacol. 2008 Jun;51(1):37-41. Epub 2008 Mar 5. Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20. Hsieh MH, Chan P, Sue YM, Liu JC, Liang TH, Huang TY, Tomlinson B, Chow MS, Kao PF, Chen YJ. Clin Ther. 2003 Nov;25(11):2797-808. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study.

Announcing: The Paleo Diet Cookbook

Editor's note: Dr. Cordain's latest publishing projects include The Paleo Diet Cookbook, available for purchase on December 13, 2010. This article includes a brief interview with Dr. Cordain.

Patrick Baker (PB): What did you hope to achieve by publishing your own cookbook?

Dr. Loren Cordain (LC): The Paleo Diet Cookbook will be published by John Wiley & Sons, the publisher of my first book, The Paleo Diet. Because of the enormous success of The Paleo Diet, my publisher wanted us (me, my wife Lorrie Cordain, and Nell Stephenson) to write a follow-up cookbook that would provide my readers with a "how to, hands on" easy approach to preparing and making delicious Paleo meals and snacks. The book contains more than 150 recipes arranged into the following chapters and topics:
IntroductionCHAPTER 1: The Paleo Diet BasicsCHAPTER 2: Paleo Kitchen BasicsCHAPTER 3: Paleo Breakfasts DishesCHAPTER 4: Paleo Snacks and AppetizersCHAPTER 5: Paleo PoultryCHAPTER 6: Paleo Beef, Pork, and LambCHAPTER 7: Grass- Fed Meat, Game Meat and JerkyCHAPTER 8: Paleo Fish and SeafoodCHAPTER 9: Paleo SaladsCHAPTER 10: Paleo Vegetable DishesCHAPTER 11: Condiments, Salad Dressings, Sauces and Fruit PureesCHAPTER 12: Paleo Beverages and DessertsCHAPTER 13: The Paleo Diet Two Week Meal PlanCHAPTER 14: Treats and Meals for Crossfitters and AthletesPB: Given the proliferation of other paleo cookbooks, what makes yours stand out?

LC: I am aware of two other cookbooks that have taken the Paleo approach, however it turns out that many of the recipes are not pure Paleo, and use salt, honey and other non-Paleo ingredients. This book comes straight from the originator of The Paleo Diet, and I can assure my readers that all of the recipes in the book are not only pure Paleo, but also appetizing and nutritious. Nell and Lorrie have done a wonderful job creating some brand new incredibly delicious recipes and snacks.

PB: In general, how does the cookbook reflect the principles outlined in your book The Paleo Diet?

LC: In the first chapter of the book, I outline the basics of Paleo dieting - all the do's and dont's that experienced Paleo Dieters may be aware of, but also great background material for newbies to Paleo Dieting. Actually, as most of our veteran readers realize, The Paleo Diet is not a diet at all, but rather a lifetime plan of eating to optimize health and well being. I've also devoted a large section of Chapter I to autoimmune diseases, and how Paleo Diets can ameliorate symptoms of these illnesses. This is brand new information which has never been published.

PB: Do you cross-reference any of your other published work in the cookbook?

LC: The Paleo Diet Cookbook is consistent with most of the work from my prior three books. However, I have completely updated it based upon the most recent scientific evidence. A couple of key points are different from my first book, The Paleo Diet, which was published in 2002. First, I no longer advocate the use of canola oil, for reasons explained in the book, and I have also taken a softer stand on saturated fats based upon my own article on the topic, published in 2006, and available as a free PDF download from my website. Further, I now advocate coconut and coconut oil consumption.

PB: When will your cookbook be available for purchase?

LC: The Paleo Diet Cookbook can be pre-ordered right now at Amazon, but it will not ship until December 13, 2010.

PB: Where can your readers purchase a copy of your cookbook when it becomes available?

LC: The Paleo Diet Cookbook, as well as my upcoming 2010 Revision to The Paleo Diet, can be purchased at my website, at Amazon, or almost any local bookstore.

Paleo Diet Q & A - Saturated Fat

Dear Readers,

This question has come up several times in recent weeks. Maelán's response warrants breaking this out from among the other questions answered in the original post. Included in this post is a link to Dr. Cordain's paper on the subject.

Q: I wanted to ask you why it is that you discourage saturated fats in the paleo diet? From what I have read their are healthy saturated fats from coconuts that are used for around 17% of the Kitavan diet. Also, what about tubers such as sweet potato and yam, do you think that consuming these in moderate portions (small enough to keep a low glycemic load) could be detrimental?

A: Regarding saturated fats:

Saturated fatty acids intake and the risk of developing cardiovascular disease (CVD) is a topic with a lot of controversy. In recent years a wide body of research has suggested that increased consumption of certain saturated fatty acids (Lauric acid, myristic acid and palmitic acid)
down-regulate LDL receptor and thereby increase LDL plasma levels, and this has been associated to increased risk of CVD. On the other hand, stearic acid (a 18 carbon saturated fatty acid) has been shown to decrease LDL plasma levels. However, this view is too simplistic as they are several other factors contributing to CVD, such as smoking, exercise, trans-fatty acids, increased omega-6/omega-3 ratio, free-radicals, nutrient deficiency, homocysteine, alcohol intake and low-grade chronic inflammation among others.

Moreover, some studies have suggested that there’s not enough scientific data to support the view that increased total or LDL cholesterol is an independent risk factor for CVD, but rather oxidized LDL. Plaque production is mediated by oxidized LDL but not LDL. Oxidized LDL can produce shedding of the inner layer of the artery namely glycocalix. Then oxidized LDL infiltrates in the intima of the artery. Oxidized LDL is eaten by macrophagues, a process known as phagocytosis, and therefore macrophagues are transformed into foam cells which produce the fibrous cap.

Once the fibrous cap has been produced we need to break it down in order to produce an ischemic event. Lectins and low-grade chronic inflammation are involved in the activation of matrix metalloproteinases which break down the fibrous cap.

In summary, high total cholesterol or LDL levels do not increase CVD risk but rather oxidized LDL. To produce oxidized LDL we need the factors mentioned above. Hence, consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned before.

Dr. Cordain wrote a book chapter where he shows that saturated fat consumption in ancient hunter-gatherer populations were usually above recommended 10% (American Heart Association) of energy from saturated fats yet non atherogenic.

The bottom line is that we do not recommend cutting down saturated fatty acid intake but rather decrease high-glycemic load foods, vegetable oils, refined sugars, grains, legumes and dairy.

I hope this helps.
Maelán

Link to supporting paper.