Re-Indigenizing Our Diets I

I was nineteen when I was diagnosed with my first ulcer. The doctor looked at my family’s medical history with dismay, noting both my parent’s struggles with chronic stomach problems and suggested I start taking medicine to counteract the acidity of my stomach and the cramping in my lower intestine. The following year was a battle between myself and my rebellious stomach. Despite subsisting on what the doctor’s claimed was the safest diet, a blame regime of bananas, yogurt, and bread, nothing seemed to get better. On a desperate visit to the college acute care clinic, the middle-aged doctor told me that his entire family had the same problems, and like him, I should expect to be on my medication for the rest of my life. Food became my enemy and the thought of dinner was one of dread.

I was no stranger to medical disorder. Like my mother, I had also suffered from severe asthma and like my father I had a congenitally misaligned jaw. I accepted these inheritances as my lot in life and thanked my lucky stars that I had been born in modern times.

The first inkling I got that I might not be so lucky was my sophomore year of college, when I was assigned an essay called The Worst Mistake by Jared Diamond. I had read several of his books, but I had never encountered such an infuriating idea. He dared to imply that agriculture, the foundation of all modern society, was a mistake. To me, agriculture was the mother of all I loved. It had allowed us to break free of our state of nature, which Hobbes famously called “nasty, brutish, and short.” Because of agriculture, Chopin had played his etudes, Michelangelo had painted the sublime Sistine chapel, Homer had written his epics…and I had my very thick glasses that allowed me to read them. I set out to prove him wrong.

A dramatic and unintentional experiment on the effects of modern agriculture is being played out right now. The subjects are the native peoples of America and while the results may be more exaggerated than what happens to the average person, they may hold the key to the disorders that plague modern society.

The most prevalent disease that accompanies civilization is sometimes simply called “Syndrome X,” a deadly cocktail of high blood pressure, high triglycerides, high cholesterol and obesity that is linked with heart disease and diabetes . In indigenous populations, this Syndrome X has reached epidemic levels. While it has also increased in the general population, the increase in indigenous populations has been much larger. Native Americans have two times the heart disease and seven times the rates of diabetes . It affects nearly every Native American population, from the Ojibwa-Cree in Northern Canada with the third highest rate of type II diabetes in the world to the Pima in the American Southwest who are the second most obese people in the world to Native Hawaiians who have twice the national level of heart disease .

The end result of Syndrome X is type II diabetes, a disease of chronically high blood sugar . In a healthy person, sugar stimulates the pancreas to produce insulin, which leads to sugar being absorbed by the cell, but in a diabetic, but the process has stopped working because so much sugar has been consumed that the receptors malfunction. The sugar remains in the blood stream and in high levels it can become toxic. Even with treatment, diabetics can suffer from high rates of vision problems, kidney failure, cardiovascular disease, and in the worst cases, gangrene. On a visit to a Pima reservation, reporter Malcolm Gladwell described the carnage: 300-pound pre-diabetic teenagers, young women confined to wheelchairs, and middle-aged men dependent on kidney dialysis. In most towns in America the same scene of carnage is repeated, but typically only in homes and hospitals catering to the elderly.

The stark fact is that when Native Americans first made contact with Europeans, no such illnesses existed. They emerged only as their societies adopted western foods such as white flour and sugar.

Foods like white flour and sugar have been connected with disease in every society on earth. However, for Native Americans and other indigenous populations, it seems these foods are more toxic than normal. These foods were a product of thousands of years of agriculture in Europe, whereas as Louis LaRose, a member of the Winnebago Tribe of Nebraska, describes it: “we’re only two or three generations removed from picking berries, we were not designed to do all our hunting in aisles A, B, and C. ”

In reality, no human was designed for the modern diet. Humans have not changed much since the Paleolithic, when all humans lived as hunter-gatherers . It is commonly believed that hunter-gatherers live short, harsh lives, but science come to different conclusions. As I researched the effects of agriculture, I learned that studies of modern hunter-gatherers show that they not only obtain an average of 2116 calories a day, but they only have to work 4-5 hours a day for their food . While they are unable to accumulate possessions like shiny cars or ipods, disease is rare. Modern hunter-gatherers have usually been pushed to marginal land, so it’s possible that ancient hunter-gatherers lived in even greater abundance. In a seminal essay on the subject, Anthropologist Marshall Sahlins called it “the original affluent society,” challenging the notion that wealth is about possessions, instead connecting it to health.

Through bones and other human remains, anthropologists have been able to paint a picture of the diet humans evolved to eat and the effects of agriculture on human diet and health. It’s impossible to perfectly reconstruct the original human diet, but a few tenets have emerged. Scientists have concluded that the Paleolithic diet was low in sugar, high in “good” fats, high in micronutrients, low in acid, high in potassium, and high in fiber . Very few grains and tubers were consumed, and milk, eggs, beans, alcohol, and refined sugar were entirely absent.
Modern diet gurus often vilify certain macronutrients like fat or carbohydrates as “bad,” but hunter-gatherer diets were healthy no matter the composition. That composition varies from the Eskimos, who ate an astonishing 185 grams of fat a day, to the Yanomamo, who primarily subsisted on high-carbohydrate plant foods .

The food itself was the difference. Meat from a wild animal is not the same as the ground beef from a fast-food burger. Wild game is typical lower in total fat, especially saturated fat, which has been linked to heart disease . However, wild game is higher in the “good” fats such as omega-3 fatty acids. Recent science has shown that omega-3 fatty acids are vital in heart and brain health . Unfortunately, in the western diet, omega-3 fatty acids have literally been literally out-competed by their cousins, omega-6 fatty acids, which are present in high levels in seeds, a staple of western diets in the form of grains and oils. The receptors that process these fats work best when the ratio of omega-6 to omega-3 is 2.3:1, but in the western diet the average ratio is 15:1. This explains why Eskimos, who still consume large amounts of seafood rich in omega-3 fatty acids now suffer from symptoms of omega-3 deficiency -- the fats in the new foods cancel them out .

Even the plant foods were different. Overall, more leaves were consumed than seeds. Some peoples consumed staple foods, but overall they relied on hundreds of diverse plants . The plants they consumed were rich in complex secondary compounds, which are known to affect genetic expression and metabolism Little is known about the effects of having a diet less rich in these secondary compounds we evolved to consume, but scientists suspect their absence is connected to diseases such as cancer.

Most sugar consumed by early humans was in the form of fruits, but fruits were also different. Wild fruits contain more fructose and glucose, whereas cultivated varieties contain more sucrose. They are also higher in fiber and those secondary compounds.

The dawn of agriculture 12,000 years ago left its mark on human skeletons. Agriculture developed independently in as many as seven places and archeologists who survey skeletons find that as civilizations increased their reliance on agriculture, their bone-health deteriorated. This does not exempt American civilizations. The Mayans heavy reliance on corn, a food that lacks important nutrients and impedes absorption of others, led to shrunken skeletons deformed from pellagra. At Dickson Mounds in Illinois, studies show that first farmers in the area had lived an average of 19 years compared to the 26 years their hunter-gather predecessors enjoyed.

One of the more dramatic illustrations of the effect of agriculture came from a paper by an intrepid dentist named Weston A. Price, who traveled the world in search of the cause of poor dental health. In his work, he juxtaposed pictures of traditional hunter-gatherers, smiling with straight white teeth, with those who had adopted “modern foods” like sugar and boiled potatoes, who had crooked jaws and blackened teeth. The changes happened in as little as one generation, squarely laying the cause on food, not genes. I started wondering if my crooked teeth were really all my father’s fault.

Some links, a full bibliography at the end

Price, Weston. 1945. Nutrition and physical degeneration a comparison of primitive and modern diets and their effects

Slimy slow release

Hi Melissa,
I'm visiting your blog from Fanatic Cook. I like what you write about! Nice blog! Re what you said on Bix's blod, just wondering what sorts of foods are included in the "mucilaginous carb" category (hope it's not okra--ick!). Thanks!

I mentioned this with respect to native diets and Why Some Like It Hot, Nabhan's excellent book. In that book he mentions that many native foods, when ingested, do not spike blood sugar...at all. From a botanical standpoint, many of these are desert plants that have evolved in a way to defend themselves against moisture loss. Most of them are considered mucilaginous, an appetizing (or not) word meaning "Having the nature or properties of mucilage; of a soft, moist, and viscous quality or appearance, slimy."

Slimy? While that might not sound delicious, it keeps these foods slow in your digestive system. This is a boon if you have blood sugar issues, but also for a host of other health problems like IBS. These foods also keep you satiated for longer than average.

Some of the foods he mentions include Southwestern prickly pear and other cacti, Australian bush potato, and mesquite. More common foods that are considered mucilaginous include, yes, okra, but also purslane, seaweed, flax, oats, and cucumbers.

Paleo Rules

Michael Pollan's rules about eating from In Defense of Food are a good framework, but ultimately don't take a stand for what humans evolved to eat.

The article by Cordain in Implications of Plio-Pleistocene Hominin Diets for Modern Humans in the anthology Evolution of the Human Diet: The Known, the Unknown, and the Unknowable is academic, but also provides a good "rules" framework.

According to Cordain, the diet we are most evolved to eat is:

1. Omnivorous (typically, high vegetable content by weight, and high meat content by caloric contribution)
   
2. Low in sugar
3. Proper omega-3: omega-6 ratio... 1:3 is optimal
4. High in protein
5. High in micronutrients, mostly from diverse plant foods
   
6. Low net acid load...most hunter-gatherer diets are net-base yielding
7. High potassium to sodium ratio
8. High in fiber

Unfortunately, this is a diet that is difficult to follow these days. Feedlot meat has an unfavorable fatty acid composition, fish stocks are poisoned, and domestic varieties of plant crops are higher in sugar and lower in fiber. Thankfully, if the need arises, these basic rules allow me some flexibility to adjust my diet with the inclusion of some agrarian foods without sacrificing the major benefits.

Scots Wha Hae

Why Some Like it Hot by Gary Nabhan is an interesting book focusing on human microevolutionary adaptations to diet and how eating traditional foods is healthier. Unfortunately, as some reviewers on Amazon point out, he gives Northern Europe the short shift. Undeniably, Northern Europe has churned out some pretty horrifying foods from semla to shortbread.

So does this whole "eat your heritage" thing just not apply to people from Northern Europe? Well, I think people just aren't going back far enough in history. Scottish Food in Season's Larder Page lists all sorts of foods that are really delicious and healthy. Venison, edible seaweed, shallots, kale, plums, tayberries, barley...doesn't sound bad to me. Actually, it sounds very close to the diet that I've found is best for me. Just avoid the prepared foods, which are a relatively recent invention, and the Scottish diet is just as admirable as the traditional Pima diet that Nabhan praises.

Now that offal is trendy, maybe I'll even start eating haggis.

Addendum to Eskimo Post

Addendum to this previous post:

The typical Western diet yields a net acid load estimated to be 50 mEq/d (148). As a result, healthy adults consuming the standard US diet sustain a chronic, low-grade pathogenic metabolic acidosis that worsens with age as kidney function declines (146, 149). Virtually all preagricultural diets were net base yielding because of the absence of cereals and energy-dense, nutrient-poor foods—foods that were introduced during the Neolithic and Industrial Eras and that displaced base-yielding fruit and vegetables (147). Consequently, a net base-producing diet was the norm throughout most of hominin evolution (147). The known health benefits of a net base-yielding diet include preventing and treating osteoporosis (150, 151), age-related muscle wasting (152), calcium kidney stones (153, 154), hypertension (155, 156), and exercise-induced asthma (157) and slow the progression of age- and disease-related chronic renal insufficiency (158).

Cordain, Loren, Eaton, S Boyd, Sebastian, Anthony, Mann, Neil, Lindeberg, Staffan, Watkins, Bruce A, O'Keefe, James H, Brand-Miller, Janette
Origins and evolution of the Western diet: health implications for the 21st century
Am J Clin Nutr 2005 81: 341-354

So, perhaps while many high-protein foods have a high acid load, the net acid load, which can be brought lower by eating fruits and vegetables, is ultimately what matters.

Eskimos and protein

Fanatic Cook: High Prevalence of Osteoporosis Among Alaskan Eskimos

I have the anthology Hunter-Gatherers: An Interdisciplinary Perspective on my desk because I'm doing a project on native diets.

Peoples of the far north, while interesting, aren't terribly relevant to debates about humanity's evolution because, in the scale of human evolutionary history, they haven't been there very long. They prove it's possible to survive on a diet of 90-98% meat, but that doesn't mean it's optimal. Unlike most hunter-gatherers, Eskimos have a high incidence of Osteoporosis.

However, Eskimos who are still following their traditional diet are still a lot healthier than most Americans. Unfortunately, most have now adopted a Westernized diet, which has led to high rates of obesity and diabetes.

It's theorized that the high rates of osteoporosis are caused by eating excessive amount of protein. Most illnesses in Eskimo populations, like diabetes, seem to be the result of civilization, but in this case, even pre-contact skeletons seem to be marred.

That said, skeletons from other societies that ate a diet high in both plant and animal foods are often remarkably healthy. This leads me to wonder if the real problem is the lack of plant foods, rather than the amount of protein.

From Kiple's A Moveable Feast:

...the healthiest ancient skeletal population turned up so far in a study of health and nutrition in the western hemisphere represents individuals living on Brazil’s south coast from about 1000 BCE to 1000 AD. Like so many of their North American counterparts, they enjoyed this good health because they remained hunter-gatherers –actually fishermen and shell fishers – who produced highly visible mounds while consuming a varied and protein-rich diet.

Another good example are the Ache of Paraguay. They eat an impressive amount of animal foods, but also rely on hundreds of plants.

My Diet I

Looking back at my health problems, it's easy to see the domino effect. My senior year of high school was incredibly stressful and I suffered from intense headaches. Unfortunately, I discovered Excedrin Migraine, which had the added bonus of caffeine, so I could stay up late studying headache-free! I continued taking it regularly through my freshman year in college, which is when I discovered another stress-salve: cake and ice cream, which the dormitory provided in abundance.

I still can't believe what I ate back then. Sugary cereal in the morning, dessert with both lunch and dinner, and "late night," an a la cart well-stocked with Haagan Daaz, giant muffins, Little Debbies, and soda. Besides gaining twenty pounds, I noticed a gnawing sensation on my side.

Given my daily use of ibuprofen, my doctor suspected an ulcer and just handed me some Prilosec, a proton pump inhibitor (PPI). PPIs inhibit acid secretion in the stomach and are used to treat disorders of gastric acid production, such as chronic heartburn, as well as ulcers, since the decreased acidity allows for faster healing.

I didn't follow my doctor's advice and instead stopped taking ibuprofen and tried to improve my diet. I became an almost-vegan and learned to love industrial foods like soy milk and Boca burgers. Unfortunately, I didn't get better and the gnawing sensation turning to searing heartburn and a diagnosis of gastroesophageal reflux disease (GERD). Eventually I had to go on Prilosec.

It worked, but not perfectly. I could feel the creeping acidity in my stomach and I looked and felt bloated all the time. My middle-aged paunchy doctor confided to me that I shouldn't worry, that PPIs were safe and that he himself expected to be on them for the rest of his life. This just depressed me...I was only twenty, I didn't want to be dependent on these drugs for the rest of my life.

A few months later I started having more sinister symptoms, which my doctor ascribed to IBS, which I had been diagnosed with as a freshman. It wasn't until I collapsed and ended up in the ER that I got a real diagnosis: chronic salmonella. I wonder if the PPI use was related. A study connected PPI use with pneumonia, the authors noting "reduction of gastric acid secretion by acid-suppressive therapy allows pathogen colonization from the upper gastrointestinal tract." PPI use is at an all-time high in America, so is food poisoning. Humans evolved an acidic stomach for a very good reason.

Recovering took a long time and I did a lot of research on diets and health. I found this study about low-carb being good for GERD. At the same time I read Jared Diamond's essay The Worst Mistake In The History Of The Human Race for a class and was struck by the idea that while agriculture has led to some progress, it certainly hasn't made us healthier. I started researching the Paleo diet and adopted a modified version of it for the summer.

My basic premise was to eat mostly paleo foods, with a few "agrarian foods" (a la Weston A. Price), and almost no "industrial foods." I'll write more later about my exact diet, but at the end of the summer almost all my symptoms, from headaches to bloating, were gone. Despite increased consumption of fat, I lost a lot of weight. I'm no longer on any medication and while my diet sometimes includes beer and candy, I always operate on the basic premise of eating primarily foods humans evolved to eat.

It's sad that the standard line on GERD is to avoid fat even though there seems to be little documented connection. I was told my low-fat diet of soy milk and rice was the right one. Macronutrients put food into shallow categories, placing radically different foods like coconut and fried chicken into the "evil" high fat label. If only doctors would stop preaching about macronutrients and instead suggest that patients eat real food.

Eating polycultural

Dianne of the Migraineur embarks on "Omnivory Month," with the goal of eating a diverse diet

I love this project because most Americans get 72.1 of their calories primarily from dairy products, cereals, refined sugars, refined vegetable oils, and alcohol. Humans evolved to eat a diverse diet, mainly because a diverse diet is far more likely the cover all the nutritional bases than one reliant on standard American staples. I also have to wonder if food allergies have something to do with our excessive reliance on a few staple crops.

Also, I must say that farmer's market and CSAs are a great way to diversify your diet. At the market you can find all kinds of varieties of food that might not fit into the industrial food system well and most farmers will gladly give you tips on how to use each one. Last summer I wrote down all the new things I consumed. The list included red currants, kohlrabi, Japanese pumpkin, hubbard squash, Lebanese zucchini, perpetual spinach, misato radishes, parsnips, and thai eggplant. A CSA is probably even better because you end up with things that might not stand out at the market, such as the plain brown candy-roaster squash which opens up into bright-orange sweet flesh.