Chris Kresser How to Win an Argument With a Paleo Critic

Wow we have a packed room here I don't guess y'all know who's coming up next anyway I would like to introduce our next person to the stage who actually does not need an introduction Chris presser he's a practitioner of integrative and functional medicine the creator of one of the world's most respected natural health sites Chris Kresser calm and the author of The New York Times bestseller your personal Paleo code please welcome to the stage John all right so as you can see I'm going to talk about how to win an argument with a paleo critic and I'm gonna give you two versions there's a short version and there's a long version so here's the short version all right so welcome to leave the room if that if that satisfies it for you if you're interested in the longer version you can stick around for a little while longer okay so I was a little unexpected wasn't it so paleo has exploded in popularity you all know this I mean the number of people in this room is a testament to that and the fantastic growth in these conferences and discussion of it in the popular media but as it's growing in popularity so of the critiques right I'm sure everyone in this room has seen any number of the critiques that we're going to discuss today and every time a critique gets published I'll typically wake up open my email and see you like 192 messages from people that want me to address this latest critique doesn't mean that the diet you know we've all been talking about following is is bunk and should we go back to being macrobiotic vegans or vegetarians or whatever so I'm a little out of breath because we went to a barbecue place for lunch and there was a lot of traffic on the way back so I need to kind of settle down here a little bit so I wanted to take the opportunity to answer a bunch of these critiques in one place so that you're all armed with all the ammo that you need in these discussions that you have with your friends family member doctor etc so I'm going to talk about first some general tips for debating discussing I would definitely recommend not doing what I started the presentation with if you want to make progress but I'll share some other tips and then we're going to talk about seven specific critiques that I find are the most common and then if we have time I'm gonna open it up to you to tell me some critiques that you've heard in case I can address those and hopefully we'll have some time for Q&A so here's the first tip don't be a jerk I say this you know half seriously because there's this old saying he who speaks softly carries a big stick and I don't think that's really about volume of speech or the tone of voice necessarily although those play a role to me this means that we get a lot further with respect you've probably noticed this in your own life the harder you push typically the harder someone's gonna push back and it's also true that none of us like to be made to feel like an idiot and I know that's true for me and I imagine it's true for you raise your hand if you were born into a family that was following a paleo diet and you follow paleo your entire life all right that's so I thought not a single person raise your hand if you used to think saturated fat was bad for you raise your hand if you used to think red meat was bad for you maybe you didn't eat it or you kind of felt guilty when you were having that big juicy steak all right so I think it's pretty clear that all of us were in the position where we thought this paleo diet was bunk at some point and so for me it helps to remember that I was once you know a paleo critic per se you know maybe I wasn't actively a paleo critic but I had the same beliefs as the paleo critics so tip number two is to acknowledge what's true about the critique and it's it's usually the case not always but usually the case that there is a shred of truth in the Paleo critics and I think if you acknowledge that you gain credibility and you also establish some common ground in the discussion and that's going to take you a lot further than you know just denying everything about the critique so the third tip is to admit the things we've been wrong about now I you know some of you know that I like to say this but the history of science is essentially the history of most scientists being wrong about most things most of the time if you look back any period of history of scientists all thought they knew the answers the world was flat Sun revolved around the earth more recently everybody was convinced that ulcers were caused only by stress until some very brave researchers introduced the idea that they're actually caused by a bacterium called H pylori and I don't know how much you know about this story but these researchers were essentially ridiculed for years for thinking this and it wasn't accepted widely until they swallowed a vial of h pylori and infected themselves and gave themselves an ulcer and then treated it with an antibiotic before people even began to take them seriously after that it was still many years before this new concept was adopted in mainstream medicine more recently if you went to your doctor 10 years ago even today in many places and you said doc I think I have leaky gut this is what they're gonna do you got to stop reading the internet you know like you're spending way too much on the Internet the time on the Internet this is you you probably been to see some naturopath or acupuncture if you know but when you look in the scientific literature and intestinal permeability and I had to give it kind of a more legit name is one of the hottest topics in scientific research it's been correlated with conditions as diverse as autoimmune disease - autism spectrum disorders - Parkinson's - rosacea and eczema - inflammatory bowel disease and irritable bowel syndrome so the message here is that things change and they should in science science depends on us questioning our hypotheses even our most cherished hypotheses somewhat ruthlessly and this is this this progress of science requires that kind of honesty and I think we need to apply that to even our most cherished paleo concepts as well if we want this to be credible movement if we want to really influence a big number people instead of just talking to ourselves continuously so legumes I think are maybe one of the best examples of this of course the the the paleo Dogma holds that we should avoid legumes because our ancestors didn't eat them and because they contain compounds called lectins and phytic acid which can be harmful but it turns out that there's a growing amount of evidence that suggests that our ancestors did actually consume legumes and in some cases quite a bit of them so that's a little iffy that argument and then lectins can be harmful but the lectins that we typically find in most beans within the goom's with the exception maybe peanuts and soy are quite easily broken down by heat aka cooking so if you cook legumes the lectins that otherwise might be a problem get into the bloodstream and cause harm aren't really a problem there's another issue which is that 53 other plant foods fruits vegetables herbs and spices have discernible significant amounts of lectin sometimes more lectins and are found in legumes and many of these are paleo friendly foods like zucchini or melons or strawberries etc so if we stop if we require a complete avoidance of lectins to be paid oh we're going to be avoiding a lot more than the goom's and then you have the phytic acid arguments so phytic acid is a compound that inhibits mineral absorption and certainly we want to reduce our exposure to this as much as possible but there are a lot of other again paleo foods that are higher in phytic acid than legumes for example spinach Swiss chard almonds that beloved paleo nut and walnuts are all much higher in phytic acid then legumes are typically especially lentils so if we again apply the same rigorous standards and critical thinking to our paleo concepts as we do to mainstream critiques and concepts we might find that we have to change our views occasionally even on some sort of untouchable subjects so now I'll discuss seven of the most common critiques number one is some version of this why should we follow the Paleo diet I mean those people all died when they were 30 years old right so you've heard something like this before so it's it is true that the average lifespan of our ancestors was short and shorter than our average lifespan today but that doesn't take into account important considerations challenges that they face that most of us living in the industrialized world don't face today so they had very high rates of infant mortality 130 times higher rates in fact of infant mortality than we have today 100 times higher rates of early childhood mortality they had absolutely no emergency medical care they were subject to exposure to the elements so they could very easily die from freezing if it got really cold out and they couldn't find shelter they had extremely high rates of trauma and injury due to violence and warfare it may seem sometimes like we live in a violent society but it's an absolute utopia compared to what a hunter-gatherer society is like in terms of violence so these these are challenges that reduced average lifespan and wasn't about their diet and lifestyle if you take a hypothetical group of ten people living in the Paleolithic era let's say two of them died in a childbirth another three died during early childhood maybe another two died from tribal warfare and violence and adolescents and the remaining three live long healthy vibrant lives and die you know peacefully in their sleep which is all we can really ask for the average lifespan of that group is gonna be very short right because most of the people are dying young and in childhood but that the average lifespan does not tell the full full story and that's why it's not a good metric in terms of gauging the health of a particular population so today our life expectancy in the u.s. is 78 years and these this increase in life expectancy has not happened because of changes in diet and lifestyle it's actually happened in spite of those changes because of things like antibiotics sanitation modern hygiene emergency medical care less violence and increased social stability so an interesting question might be how long would contemporary hunter-gatherers who maintain their traditional diet and lifestyle live if they had access to these advances in modern medicine and hygiene and in fact researchers have asked this question and answered it it turns out that contemporary hunter-gatherers with even the most rudimentary access to modern medical care which means in some cases they have to walk for a half a day you know to get to the most basic medical clinic where they can have you know an infected wound taken care of or deal with any other kind of trauma or injury from violence these people live an average of 68 to 78 years which is not very different than our life expectancy as I just said and more importantly when they reach age 45 which means they've escaped the most risky periods of infancy and early childhood they can expect live another 25 to 27 years after that so into their into their 70s again very much like life except expectancy in the you but here's the really good news we don't have to choose we don't have to choose between hunter-gatherer lifestyle and life expectancy and the standard American diet and lifestyle and life expectancy we can take the best of both so we can use the traditional diet and lifestyle of hunter-gatherers which by the way enable them to reach these ages that are similar to our age the ages that we reach without any of the chronic inflammatory diseases that plague us today no diabetes no obesity no heart disease not even any allergies or asthma no autoimmune disease which now affects 50 million people one in almost one in six Americans so they lived through these ages without getting any of those diseases whereas now in the u.s. many of us are acquiring these diseases even during childhood and we may live a couple to three years longer in some cases but what's the quality of our life during those years compared to the quality of their life so we can we can take the best learn from the best of their diet and lifestyle practices which kept them free of those chronic inflammatory diseases and also remarkably lean and fit and then we can take the best of what modern medicine has to offer emergency medical care trauma care and even drugs in certain cases when they're appropriate and combine them to live even longer lifestyle than what the typical standard American life expectancy is so critique number two goes something like this well you know we don't live in the Paleolithic era anymore we're not caveman so why should we follow a caveman diet after all human beings are still evolving so it is true that human beings are still evolving and that's something I think that the early paleo movement got wrong our genetics are largely the same as they were in the Paleolithic era but recent evidence suggests that evolution is occurring at a rate a hundred times faster than the average over six million years of hominin evolution and that in fact as much as ten percent of our genetic code shows evidence of recent selection so this means that even in the past ten to twelve thousand years since agriculture came onto the scene we 10% our genes have changed so that's you know it's not all of them or even most of them but it's a significant change and these genetic changes do affect our tolerance to some agricultural foods and dairy is perhaps the best example of this so throughout most of our history humans only produce lactase which is the enzyme required to break down lactose the sugar and milk during infancy and early childhood why because Mother's Milk was the only lactase containing food so after we were weaned there was no reason for the body to continue producing lactase evolution is nothing if not efficient so if there's no reason to continue doing something the body is not going to waste resources and energy doing it but this all changed with the Agricultural Revolution and the beginning of domesticating cattle because then cow's milk all of a sudden became a readily available food source and this was important because early farmers relied heavily on grains as a staple and this made them prone to mineral deficiencies because grains as we're gonna find out later are not particularly high in nutrients and they're lacking in several crucial nutrients our farming ancestors were shorter than our hunter-gatherer ancestors they actually shrank which suggests a deficiency of calcium and vitamin D which are notoriously absent in grains and milk of course is I'm sure most of you know is is rich in calcium it contains some vitamin D from if it's from pasture raised cows it's a complete protein and it promotes growth and perhaps most importantly it provided a source of hydration and sustenance during periods of drought and famine which became increasingly common during the right around the advent of Agriculture we went from being relatively well nourished in the Paleolithic era to dealing with a lot of food scarcity in the agricultural period so people with a genetic mutation that would have allowed them to digest milk in adulthood would have been favored by natural selection and this seems to be exactly what happened about 8,000 years ago we know from gene mapping studies a genetic mutation spontaneously arose actually in several different parts of the world this implies there was just one that enabled us to produce lactase into adulthood and then it's rapidly around the world thereafter but here's the important thing these changes are relatively simple and crude genetically they're typically changes in single genes rather than changes that affect the coordinated action of multiple genes which would be required to fully adopt us to a new food source and keep in mind that these genetic changes only affect a subset of the population so yes it's true that some people have the ability to produce lactase in adulthood but that's actually only 1/3 of the global population the remaining two-thirds of people cannot digest lactose into adulthood and then we have gluten according the most recent statistics one in ten people are gluten intolerant and this number continually seems to be going up each time it's studied and I think personally it has something to do with changes in the gut microbiome that are making us even more sensitive to gluten but that means a substantial portion people can't tolerate gluten and what this tells us or it should tell us is that yes it's true we've evolved yes it's true there are some genetic mutations which affect our tolerance of agricultural foods which is why I think dairy products and the goom's might be in an acceptable addition to the diet after you've taken those foods out for a period of time and then added them back in but it's still absolutely true that agricultural foods are far more likely to cause either allergic reaction or an intolerance reaction than paleo foods it's simple we've eaten paleo foods for two million years and we've eaten agricultural foods for ten thousand years which do you think we're going to be more adapted to and this is why you don't often hear about blueberry intolerance or broccoli intolerance the only intolerant somebody has in broccoli is they don't like eating it typically I mean there is a possibility of being allergic to it but it's pretty rare so number three is this argument and this was one of my favorite little gems from the US News and World Report that ranked paleo diet the last diet that you should follow in the world way below the slimfast diet which is basically a bunch of powdered shakes and bars that are full of sugar high fructose corn syrup being like the second ingredient and most of them all right what genius wrote that article but one of their criticisms was there's no evidence behind the Paleo diet and so again you know we try to find the grain of truth and in all of these critiques so there is a grain of truth which is that there isn't as much you know there haven't been as many randomized clinical trials on the Paleo diet as there have been for the Mediterranean diet for example which is a diet that's been very popular for a long time and and all the cardiologists got really excited about however there are four very distinct lines of evidence that even on their own are quite convincing but when you combine them together create a extremely compelling evidence based story for the Paleo approach the Paleo template so number one is that is archaeological studies so we look at fossil remains and how fossil remains changed from you know hunter-gatherer period to agricultural period and one of the biggest changes that we see in fossil remains was that as our ancestors moved from primarily a hunter-gatherer lifestyle to primarily an agricultural lifestyle they shrank the average height of men decreased by six inches during that transition and for women it decreased by five inches so that's not an insignificant change and while within a population the variance in height from person to person is not necessarily an indicator of health status I'd like to believe it is personally but it's not but from one population to the next it is and it typically is a reflection of the nutritional status of that population because of course we need nutrients like calcium like vitamin D for our skeleton to develop properly plenty of protein for for our to produce enzymes and all the tissues that we need to function well so the second line of evidence is anthropological so this is where we study contemporary hunter-gatherer populations which unfortunately there are few of now that haven't had a lot of contact with the Western world that have maintained their traditional diet and lifestyle and we compare their health to the health of people living in industrialized populations and what those studies almost universally show is contemporary hunter-gatherers are lean they're fit obesity is essentially unheard of and even being overweight is is extremely rare there's no diabetes there's no heart disease there's no autoimmune disease there's no allergies there's no asthma so there's superior in all of those ways and they also are superior in almost every measure of health and fitness from insulin sensitivity to body mass index to oxygen consumption which is one way of measuring physical fitness to vision to bone density so then we have biochemical studies so these are studies that look at for example the nutrient density of foods and also the canoe treant completeness of a particular diet and as we'll see in more detail in the next two slides paleo turn comes out very well in those biochemical studies and then finally we have the much-lauded gold standard RCTs randomized clinical trials and we do in fact have eight or nine now RCTs randomized clinical trials that have all been extremely encouraging some of them have been relatively small studies so we definitely want to see bigger studies and we want to see these studies replicated but some of the results were quite phenomenal in in a couple of the studies paleo was superior to the Mediterranean diet in terms of weight loss and improvements in metabolic markers and perhaps more importantly it was found to be more satiating per calorie than the Mediterranean diet which means essentially it's easier to stick with because people who follow paleo feel more satisfied they're not as hungry and so they're there they're more able to stick with it over the long term so critique number four is paleo is not nutritionally complete this is a this is a favorite of mainstream registered dietitians you often hear this from them I don't know where they get it because it's when you look at this slide what you find is that paleo a typical Paleo diet meets or exceeds often by many fold the RDA for several important nutrients for all important nutrients except for calcium so I mean just look at vitamin A percent of the RDA vitamin C twelve hundred and fifty percent of the RDA vitamin b6 515 percent b12 730 percent so calcium is 69 percent but there are a couple of things to be aware of here number one you can get calcium very easily if you eat bone-in fish so can salmon from a place like vital choice that has still has the bones in it you eat that a couple times a week you're gonna be doing very well with calcium there are also things like bone broth that can be rich in calcium and of course if dairy works for you as I argued before and you've tried a period of time without it and you have the ability digested into adulthood you could incorporate some dairy into your diet and easily meet your needs for calcium so I don't think that's a big shortcoming and the last thing is that studies suggest that cal are calcium needs are lower when our magnesium intakes are sufficient and we get 200% of our requirement for magnesium with paleo and also probably when our vitamin k2 intakes are sufficient because vitamin k2 regulates calcium metabolism so it helps deposit calcium in the bones and the hard tissues where it's needed and keeps it out of the soft tissues where we don't want it paleo is extremely nutrient dense as I mentioned before sorry I want to mention this this chart here and the data comes from the infamous Rob wolf calm so I want to thank him for that and this is from Matt lalonde another incredible researcher in the paleo community and Matt presented this data originally at the ancestral health symposium a couple years back and you did it because there's there's a big problem with most nutrient density scales and there are a lot of problems actually but we don't have time to go into all of them so the main problem is that most nutrient density scales penalize foods for having high energy density meaning being high in calories high saturated fat content and sodium so if any food has sodium saturated fat or it happens to be high in calories like fat for example or meat that has a substantial amount of fat content they lowered it on the nutrient density scale even if it had nothing to do with the concentration of nutrients so Matt wanted to see what a nutrient density scale would look like if you actually just measured nutrients and you didn't penalize foods for containing fat and sodium or being high in calories and he made some other very important modifications which you'll just have to trust me about so as you can see here the text is small but organ meats are by far the most nutrient dense food so now you all know I'm constantly harping on you to eat liver its orders of magnitude higher in nutrient density than even beef down here herbs and spices that's another reason to use these in your cooking not just for flavor they actually are extremely nutrient dense even in small amounts nuts and seeds are next I put an asterisk there because as I mentioned before some foods contain phytic acid which inhibits mineral absorption and nuts and seeds are pretty much on the top of the list in terms of phytic acid content so if you're eating a lot of nuts and seeds you want to be soaking them beforehand for 12 to 18 hours at least and then either dehydrating them or roasting them at low temperatures to break down the phytic acid and make the considerable amount of nutrients that they contain more absorbable and bioavailable then we have cacao so chocolate lovers rejoice here it's one of the most nutrient-dense foods there is fish and seafood beef lamb veal wild game vegetables raw pork eggs and dairy poultry processed me quick vegetables didn't even make it on this list but there is an important caveat here which is that this nutrient density scale is based on only the nutrients that we unequivocally know are beneficial for human health and that's like all of these vitamins and the typical minerals it did not include any phytochemicals or antioxidants which tend to be found in very high concentrations and fruits and vegetables and I think now I would argue and I think not would probably agree that those the science behind those is very compelling and it's very clear that we need a substantial amount of those in our diet to be healthy so the only caveat I would have with this chart is that if we included those antioxidants and phytochemicals fruits and vegetables would probably appear higher than they here now so the last crit it's sort of we're still on the critique that paleo is not nutritionally complete the last aspect of that is that you'll hear some Rd saying well you can you you can't do a paleo diet it doesn't have grains you know we need grains to be healthy don't we no we don't actually and grains are not the super foods we've been led to believe they are they're low on the nutrient density scale so if you'd have to go you know there's vegetables and a whole bunch of other foods before whole grains are about right here and that's nice but or that's not nice but the fact is 80 percent of the grains that we eat in the US are processed and refined so and that they're at the very bottom in the scale right next to sugar and industrial seed oils which have almost no nutritive value at all grains also tend to be missing important nutrients as I mentioned before they don't have a broad micronutrient profile they're lacking in some essential amino acids they tend to be very low in terms of the bioavailability of those nutrients because they contain phytic acid and other nutrient inhibitors and there's nothing in grains that we can't get from paleo type of foods in a much more bioavailable way does this mean we should absolutely never eat any grains under any circumstances no matter what I don't think so personally I think that if you you know eliminate grains from your diet and then at some point you want to add them back in and you're willing to go through the preparation steps required to make the nutrients more bioavailable as groups like the Weston a price advocate soaking sometimes quite extensively soaking soaking in acid medium like kefir or lemon juice to break down those nutrients rinsing and then cooking if you want to do that and if you don't do that so much that they start to replace more nutrient-dense foods then I think it's hard to make an argument against that but most people aren't willing to go to those lengths of preparation and that's absolutely fine - we can unequivocally say that grains are not required for human health otherwise we wouldn't be standing here having this conversation would we so number five is that protein high-protein diet like paleo is dangerous because it wrecks your kidneys and it increases your risk of cancer right so we've heard this this has come up a lot recently in the media what's true about it is if we stretch a little and try to be you know established that common ground what's true is that high-protein diets can be harmful for people with pre-existing kidney disease all right and of course that doesn't mean that they're harmful for people that are healthy and don't have kidney problems I mean by the same logic iron and iron rich foods like red meat should be avoided if you have hemochromatosis which is a disease of aggress that causes aggressive iron storage and can kill you if you're not careful but you don't hear people going around saying we shouldn't eat everyone shouldn't eat red meat because of the tendency to accumulate iron and that's the same arguments being made here high-protein diets can harm people with kidney problems therefore nobody should eat a high-protein diet it's not logical it doesn't make sense and I think part of the confusion is that in some studies it has been observed that with a very high protein diet you'll see hyper filtration so the kidney is is working more actively to do what it does filter out stuff that is in the blood and you'll see an increase in the size and function of glomeruli which are the functional units of the kidney but so so when this was first observed people thought that this was pathological but it turns out that these are just adaptive changes this is essentially like when you work out and you're you know and your muscles get bigger this is essentially what's happening with the kidney with a high-protein diet it's just increasing its capacity to deal with the higher protein diet there's nothing pathological about it we also have gold standard randomized clinical trials with very high protein diets in healthy people that show no evidence of harm at all so what about the idea that diets they're high in animal protein specifically contribute to cancer of course we see this in the China study we just many of you may have seen this recent news headline that high-protein diets are is harmful for us as cigarettes I got about a million emails after that ones you can imagine and this one is actually a little more complicated there there may be some truth to this and I don't think we can just dismiss the finding out right there's as usual the devil is in the details and if there's one person that's really good at exploring the details it's Denise winger so she wrote an article about this that if you really want to geek out and go into a lot of depths I highly recommend it I'm just gonna summarize some of the main concepts which I've also talked about on my blog for the last several years and so the the the the first observation or idea was that high if we increase our total protein intake that increases levels of something called igf-1 insulin-like growth factor-1 which in turn promotes the growth of cancer cells okay that was then later revised to the hypothesis that it's not total protein intake that matter but the amount of methionine that we ingest that raises igf-1 and increases the risk of cancer now Messiah Neen is an amino acid that's found in primarily in lean proteins so like lean meats or egg whites or skim dairy for example and this is what this study showed it showed that diets that were high in methionine which is an amino acid found in animal lean animal products can increase the risk of cancer okay so and and the studies were well done we can't you know we're not attacking these studies in terms of their method or methodological errors like we often do these this was fairly legitimate study and legitimate finding but the question is what if there is a way to mitigate or cancel out the potentially harmful effects of high methionine diets without restricting methionine intake and it turns out that there is there glycine which is another amino acid that unlike methionine tends to be found in the odd bits of the animal so the skin the cartilage the bone the tougher more gelatinous cuts of meat if you in bone broth for example things like oxtail shanks chuck roast brisket pig's feet chicken feet all of these more gelatinous cuts that we get when we eat from nose to tail are rich in glycine and glycine balances out the effects of Metheny and in fact some studies have shown that increasing glycine intake has the same life-extending health-promoting effects as restricting methionine and that's not even considering other supportive nutrients that help balance out methionine and and complement its roles like vitamin b6 vitamin b12 folate vitamin A and choline and guess what all of these nutrients are also found in the odd bits like the organs and these tougher more gelatinous cuts of meat so if you are a paleo purist and you really want to be hardcore paleo you need to be eating the whole animal because I guarantee you our ancestors didn't kill an animal in sake can you hand me the lean the lean cut I don't really like fat or you know they weren't carving up boneless skinless chicken breasts and eating that in fact some of the some of the cultures that we studied were would throw the lean meat to the dogs so when they killed an animal they would eat the organs the brain the fatty tissues and they would just toss the lean meat to the dogs so this is a reason that we want to eat from nose to tail it's not just I mean culinary pleasure that's part of it but it's why I'm always reminding people about the organs and the odd bits because this can protect us from these potentially adverse effects of high lean protein over time so I just got the five-minute warning I'm gonna try to pick this up a little bit there's only a few more slides left number 6 is paleo is dangerous because of saturated fat I've talked about this a lot I've written about it a lot so I'm going to give it the quick summary here it's true that some people don't thrive on a high-fat diet I've seen this in my clinical practice and there are a lot of potential reasons for it some genetic mutations which alter fat metabolism lipid metabolism things like familial hypercholesterolemia which can lead to extreme response to a high-fat diet inborn genetic defects in fatty acid metabolism where people can't shuttle fat into the mitochondria very well so that there's a number of potential reasons but when you look at the studies including a very large recent meta-analysis that got a lot of play in the media you see that there's no strong association between saturated fat intake and heart disease and in fact studies show that when you replace saturated fat with carbohydrate and what are people replacing it with processed and refined carbohydrate you see worse outcomes rather than better number seven is that paleo is dangerous because it doesn't restrict red meat and this is based on three ideas and I'm going to focus on one of them which is because we've already touched on the others and that's that red meat is inflammatory so this this in turn is based on the concept that arachidonic acid which is a long-chain omega-3 omega-6 fat which is tends to be high in red meat is inflammatory so what's true about this is that arachidonic acid is pro-inflammatory but what's missed in this discussion is it also helps to reduce and resolve inflammation it's a precursor to compounds called lip auxins which activate the anti-inflammatory potential of epa and DHA which are the long-chain omega-3 fats so they work synergistically together and this is probably why we see lower levels of inflammation in epidemiological studies with higher levels of plasma arachidonic acid and epa and DHA all together it also explains why the two randomized clinical trials that have looked at feeding people up to 1,700 milligrams of arachidonic acid a day which is between three and a half and seventeen times the average intake in the u.s. found no increase in circulating inflammatory markers yeah I think that's it for that one the the the sec part of this argument which is red-meat causes heart disease as I'm sure many of you know by now a lot of the observational studies that showed a correlation between red meat intake and heart disease were confounded by something called the healthy user bias this is just a fancy way of saying that because red meat has been seen as a villain for so long and unhealthy people who are eating more red meat in these studies are likely to be engaging in behaviors that actually are unhealthy like smoking cigarettes or not getting enough physical activity not eating enough fruits and vegetables and how do we know that it's not those things that are contributing to the higher rates of heart disease rather than the red meat intake well in an ideal world we design a study that controls for all those confounding factors and that's very difficult to do in nutritional research but some of the bigger more recent studies that have done that and that have separated out the effects of red meat and processed meat have found that there is no association between fresh red meat consumption and heart disease so last argument about red meat is it causes colorectal cancer and again what's true about this is that early epidemiological observational studies suggested that it that there was a connection but again they're all confounded by the healthy user bias and two very recent within the last five years reviews one of them published in the prestigious journal Obesity reviews which is one of the highest impact scientific journals came to this conclusion the currently available epidemiological evidence is not sufficient to support an independent positive association between red meat consumption and colorectal cancer and in the text they say there's this is just crazy there's so many potential confounding factors all of these studies or many of them are poorly designed and don't well control for these confounding factors so there's really no way that we can say that red meat contributes to colorectal cancer according to the current evidence so that's my last critique I'm getting the hook here so I think we're gonna have to open it up to questions and you can ask me questions about any critiques you have during the Q&A thank you please raise your hand please raise your hand and wait for the microphone do you have questions okay this is standing room only and there's no questions for him really I did a great job I just nailed them no more critics back do you consume any dairy and if so what and win how often oh I love dairy yeah I do I've done very well on dairy I've gone long periods I was macrobiotic vegan many years ago I think some of you know this so I have a soft spot in my heart for the macrobiotic medians but it means I went you know I went a long time without dairy and then I reintroduce tit I started with full fat fermented 24-hour fermented dairy like kefir that I made at home and yogurt that I fermented for 24 hours so that had no lactose at all or no discernible lactose and and just stuck with that for a while and then I started with ghee and butter stuck with those for a while and then I started introducing some cream I love cream I consider coffee to be mostly a cream vehicle so you know my coffee is like that much cream and that much coffee and I do pretty well with it so I don't I like it and I don't see any reason to avoid it from the research that I've seen and but I do think it's important that people go a significant period of time without it and before they try that experiment well I know another reason why I like you so much Chris cream vehicle I one of the questions I have is particularly when it comes to organ meats is the accumulation of environmental toxins and we see this a lot in deep ocean fish and you know it's mercury and all that but I also wonder in terms of Oregon meets with with my understanding is that the toxins primarily accumulate in the fat tissue the or the liver processes toxins but they tend to accumulate more in the fat tissue so if we're worried about toxin accumulation it may be even more important to choose pasture-raised animal products of course that doesn't insulate us from certain environmental toxins they're falling into the grass but there's no easy way or Pat way to answer that question but I at at the moment my sense is the health benefits of eating organ meats particularly from pasture raised animals outweigh any potential toxicity that we could get from them particularly when our ability our detoxification system is working normally we do have the ability to deal with a certain level of toxins that were exposed to in the environment especially for getting the nutrients that we need to deal with them which happen to be very well represented and liver among some of the other animal foods but I think you have to wait was someone up here oh yeah I'm not very strong so I just wanted to ask you did you went through a lot of different things that people commonly will say against paleo do you think that so obviously it's going to take down inflammation and all those sorts of things do you think then on top of that the change in gut bacteria will compound all those things so in other words that the beneficial changing got bacterial you'd get from something like a paleo diet makes everything else better or more efficient does that make sense absolutely in fact I think that's probably one of the most important reasons to follow a paleo type diet with a lot of plant foods you know I mentioned before that even though fruits and vegetables weren't well represented on the nutrient density scale because they only looked at a select group of nutrients that doesn't mean we don't need to be eating them one of the main reasons we should be eating them is their high phytochemical content and and dr. walls has done a lot of great research on that and her book but also the amount of fermentable fibers they contain and I think we need to ask whenever we put something into our mouths we need to ask how is this nourishing me and how is it nourishing my gut ecosystem and that second question it's not more important than the first one but I think it's about of equal importance I mean because there's not a day that passes where we don't see another study linking the gut microbiome to some different aspect of health or disease at Chris what do you think about the fact that a Sweden recently endorsed high-fat low-carbohydrate diet and can you imagine that yeah yeah I mean it's the u.s. is notorious around the world for being slow to change in fact as far as I am aware most other industrialized countries now have no dietary restriction on cholesterol because they've reviewed the studies and they found as anyone would if they reviewed the literature on this topic the dietary cholesterol has no relationship to blood cholesterol for the vast majority of people yet the u.s. still is clinging to these old ideas and anybody have an idea what that might be about to change yeah but you know I I'm definitely a fan of low low carb high fat diets in certain circumstances but I'm also you know as many of you know of I've made a point of trying to advocate for paleo as a macro nutrient agnostic approach meaning you can do low carb high fat paleo you can do moderate carb moderate fat paleo you can do low fat high carb paleo and depending on your needs those are there's a place for all those and but I think certainly dispelling with the fear of the high fat diet is probably a very positive step thank you sorry quick question what would be your advice when your those are the toughest critics with that yeah yeah we were talking about this a little bit at lunch actually and I have to say I'm probably not the best person to ask about this because all my family follows a paleo diet I have a little easy in that regard my daughter was born into it and that's all she's known whereas some other people I'm sure in this room could tell you more about their experience transitioning someone to the Paleo diet but just in terms of what I found to be effective talking to patients and other people in that in that same way is the more you push probably the more they're going to push back and leading by example is typically the most powerful way to to encourage change and just knowing that it's very very difficult to change somebody when they're not ready to change themselves and and sometimes you can kind of further entrench the polarization by pushing hard and I know that's really hard when you love somebody and you care about them and you're concerned and you want them to you know pay as much attention to their health as you're paying to yours but typically I've found at least that that kind of stepping back is often a better approach than getting in their face is just that question of people that are predisposed to high uric acid levels [Music] yeah well there is certainly a genetic predisposition oftentimes there we know of several mutations that can they can affect that we definitely want to be investigating liver health and you know maybe with like a functional medicine specialist making sure you're getting all of the nutrients that are required for proper liver function we know of several snips single nucleotide polymorphisms that affect the vitamin absorption status SIBO small intestinal overgrowth can it impair B vitamin absorption which are important for liver function there are mutations in the methylation pathway that can lead to b6 b12 and folate deficiency all of which affect liver function so it starts to get to like another level of exploration and it's not not so easy to talk about here but but I if you find a functional medicine specialist who's familiar with those things they might be able to help and I've read a lot of the research such as the Ornish program and joel fuhrman who take more of a vegan or vegetarian approach and I've seen the results in my in you know in my own practice and I've read about it in the research how how do you rectify Paleo diet versus those diets when there has been such great success like with heart disease and diabetes and all sorts of chronic illnesses no what's the common ground and what's the part that Paleo disagrees with I guess is my question yeah it's a great question the answer is quite easily how we rectify it because what you have to look at with the Ornish program it's not ever just the diet it's always stress management meditation increasing physical activity group therapy and support which i think is extremely powerful and there's a lot of research behind that so you take someone who's doing standard American diet and totally stressed out not sleeping has no social support you put them on the Ornish program where all of a sudden they're exercising you have social support sleeping better meditating and going from eating processed and refined food to mostly Whole Foods whether it's you know regardless of whether it's vegetarian or protein but you know animal product based you're gonna see a big improvement in health from that population I guarantee it no matter as long as they're eating Whole Foods and doing all those other things they're gonna get better the question is would they get even better if they were doing those things eating a nutrient-dense paleo diet and in my experience working with patients the answer is yes because I have many patients who come to me doing one of those types of approaches and they they they work well when they're going from this the standard American diet to that but then over time they start to develop nutrient deficiencies and they're not you know they're not functioning very well and we switch them to this a similar approach with all those great things whole food based diet but add more nutrient-dense foods and they get even better so I think the similarities are Whole Foods and the difference is the nutrient density and anti-inflammatory potential of Paleo diet is higher my opinion okay this is the last question interesting to have my question come after hers because a lot of the Paleo critics in my life are raw vegans and I used to actually eat that way as well and since I moved on to paleo unfortunately I've gotten more consistently bloated and I have more acne and so my raw vegan friends they're like you know come back to the bright side and I'm couldn't I'm convinced by the research and that's why I continued to eat this way but what would be your response how should I how can I defend myself in this situation well I think you should be looking for why you're experiencing these changes you know forget about them for a little bit and there are a lot of potential causes one thing is low stomach acid production if you went a long time without eating meat and then you add animal products back in your diet sometimes stomach acid production isn't sufficient to process those the protein putrified in the stomach you get bloating and also you know small intestinal bacterial overgrowth would be more likely to happen in that context and that can cause acne and other skin problems so I would definitely be looking at the gut and trying to figure out if there's way that you can improve your digestion and absorption of these foods I would think about what you're eating more of on the Paleo diet probably certainly meat but potentially other foods and what you're eating a lot less of that you were eating before and see if there's some way that you can maybe join those together a little bit but it's it's true you know paleo is not magic it's not a panacea it doesn't work perfectly for everybody I wouldn't have a full practice if it did cuz I get the people who didn't have the brochure experience you know I the people who turned go paleo and they feel absolutely perfect they're not coming to see me just to say hi and talk to me I get people like you who switch and for various reasons none of none of which necessarily have say anything about paleo approach they get worse and I know this is true in the raw vegan community if someone switches and becomes a raw vegan and starts to have problems you can bet the raw vegans aren't saying it's because of the diet they're saying it's because they're not doing it right or well enough or whatever but it's usually just a question of figuring out how to match your unique needs and circumstances and health status with your your diet and your intake of food and forget about any of the labels you know just focus on what you need to do to feel well within the context of what we know about good nutrition and you know that's that's the goal [Music] [Applause] you

Channel: Paleo f(x)

Views: 48,020

Keywords: paleo fx, paleo diet, paleo, health, fitness, nutrition

Id: H4rIBAmfoMk

Length: 54min 57sec (3297 seconds)

Published: Fri Jan 12 2018