Friday, November 02, 2018

Stone Agers in the Fast Lane?

A destruction of Paleo Diet as a management tool for metabolic syndrome in modern humans surfaced recently in a tweet from Miki Ben-Dor, along with his comment that he views meat as the default paleo food.

Plants used as "food" come and go and are nowadays developed in to reduced toxicity versions which are what we call vegetables. Meat is meat and even the invention of factory farming does not seem to be able to convert it in to anything as toxic as a courgette. Remember this?

Courgette stew kills pensioner in Heidelberg

Anyway, back to the Pacific Islanders. This is the book chapter we're interested in and it's entertaining.

Stone Agers in the Fast Lane? How Bioarchaeologists Can Address the Paleo Diet Myth

These people appear to have read (and cite) essentially every paper on gout in archeological record of the paleo Pacific Islander population. They are using gout as a skeletally preserved marker for metabolic syndrome, a fairly reasonable approach to my mind. The assumption that meat causes gout (lots of purines don'tchano) which is threaded throughout the chapter is less acceptable.

So we end up with this as a core summing up close to the end, for anyone who doesn't want to slog through the various straw men they set up to knock down:

"We have also used a case study of Pacific Islanders’ experiences with MetS and paleopathology evidence of gout to reexamine the very basis for the “necessity” of a return to a Paleo Diet. As discussed, the ancestral diet (based on tuberous root crops, not cereals) and population history of Pacific islanders are completely different to the Old and New Worlds where the Paleo Diet debate is entrenched. Yet the burden of MetS is extremely high in the Pacific. While the adoption of westernized diets has exacerbated the expression of MetS conditions in modern Polynesians, the paleopathological evidence (especially gout) suggests the origins of these conditions stems from their Lapita ancestors, who in turn trace their roots back to Island Southeast Asia".

Gout was widespread in the pre-Westernisation Pacific Islanders, despite their paleo diet. The core quote re this paleo diet is that it is "based on tuberous root crops, not cereals".

Translation: A Paleo Diet diet based on paleo tuberous root crops gives you paleo gout.

Eat some meat and get your calories from fat. Vegetables can be viewed as a recreational indulgence if you so wish. But maybe don't over do them unless you want Paleo Diet gout.



Tucker Goodrich said...

"Bony evidence of gout in prehistoric Southeast Asia is negligible, though there
are examples."


A breathtaking paper, really. The succession of strawman arguments is only the starting point, using later Neolithic diets to critique the Paleolithic Diet concept is fundamentally disingenuous ("They're both 'Stone Age', and you can't expect an anthropologist to understand the distinction!").

Nice demonstration that a high starch, no-grain diet is harmful ajd this supporting the actual Paleo diet.

The intellectual rot is so deep in this field I guess it's impressive they retain the ability to write, although reasoned argument has clearly been abandoned.

Peter said...

Yup, quite impressive!

Peter said...

Actually the paper reminds me of the distribution of HLA B27, rare in equatorial regions where starch is common, common in circumpolar regions where starch is largely unavailable for much of the year. That's Ebringer and starch and pullulanase and ankylosing spondylitis. One clear genetic cost of eating those tubers.

The reason the HLA B27 allele is rare in starch eaters is because carriers are dead. That's selection....


Tucker Goodrich said...

Wow, had not seen that before!

Also, see here.

Due to popular demand... It's not working automatically yet, but people over there are clamoring for at least a simulacrum. Note the follower count!

kellyt said...

Gout used to own me every few months.. Stripping the sugars from my diet finally freed me of that !@#$ %@##% @#$ %@#$# ailment! I think it was fructose that was my trigger, but you couldn't pay me enough to test that. If I never get gout again it'll be too soon. If I were a Paleo man, I'd stay the hell away from Paleo sugars :)

Tucker Goodrich said...

That's the interesting part about that paper,once you get over the PC illogic: there's not much sugar in the South Pacific. It's mostly starch.

And most fructose is converted to glucose...

Passthecream said...

So many varieties of the tubers known as 'sweet potato' that it is hard to be precise but as far as the big orange ones I see a lot of -- 'kumae' perhaps? - I thought the 'sweet' part of the name was due to fructose content? ( boom-tisssh). Some of those tubers are ipomea spp, close relatives of morning glory and other extremely toxic plants containing strychnine hallucinogens deadly allergens etc. There must have been some intense selection pressure over that too!

Peter said...


Gulp. Thanks! I do have a twitter account to keep up to date with the tweets from my son's school. Gotta know what the maths etc depts are up to!

Pass, yes, to me a deep fried UK marketed sweet potato is more of a desert than a veggie, almost too sweet to eat. All that on less than a gram of fructose per 100g of sweet potato... Taste sickly sweet!

kellyT, I do gather that gout has little recreational potential!


Passthecream said...

Yup, sickly. I had a hunch in that the taste reminded me of girasole artichokes (fartpotatoes), sure enough sweet potatoes contain FOS, inulins and raffinose.

Pullulanase ---- that's why I keep coming back here. This casual mention triggered a whole train of interesting discoveries for me: eg it is used in the manufacture of sweeteners. And pullulan is now e1204, used as a coating for breath mints!!! And so on down the rabbit hole.

Peter said...

Pass, LMAO, imagine telling your rheumatologist that breath mints trigger your AS. He'd be laughing all the way to the door as he kicked you out!


Chris said...

What would be good neutral sources of carbohydrate to try if one wanted to avoid constant deep ketosis? Refined glucose (corn) syrup or dextrose?

Peter said...

Hi Chris, I've been thinking about this recently and one boiled spud, still warm, or some white rice would both do it and are almost food-like. I have wondered about the glucose powder too. That would be the dextrose. But ultimately I don't have any data and even if you looked at glycaemic index or insulin index (I suspect the latter matters most) you still don't know what would happen on a ketogenic background with reduced expression of glucokinase in the pancreas and reduced complex I as ketogenic metabolism has made a large shift to mtETFdh as a major source of electrons for the ETC.... And the initial effect would modify as the body acclimatised to rather more complex I input... Huge sets of unkowns.


Tony said...

Chris, my personal experience (disclaimer: My metabolism may be broken, and broken differently than in other people):

- I fare better when I avoid "fast acting" carbohydrates like sucrose ("sugar"), glucose, dextrose and so on. With these blood sugar goes up fast (with 1.5 hours), insulin goes up fast, lipolysis goes down (fast, I presume), my heartrate goes up, lipolysis may be sluggish to ramp up again. I definitely get problems with acne, hunger, migraine, sleepyness (almost narcoleptic at times). Furthermore it potentially messes up the digestion for me. Super small amounts don't matter (e.g. the ham recently had glucose added, which I could taste!), but a piece of cake might be problematic for me.

- Slowly digested carbs typically used in metabolic disorders are corn (e.g. tortilla chips or corn flour) and rice. Digestion is a bit slower and more drawn out than the carbs above, as starch has to be broken down in the digestive system. Rice is off the menu for me at the moment, as I had some problems with it (but there were confounding factors...). With corn I have too make sure I use only small portion sizes... And even then, after a 2 or 3 days of added carbs, I get problems with hunger, acne, ...

Personally, I have for me the suspicion of having some small but sufficiently bad metabolic defect in fat metabolism (possibly in addition to some small carb metabolism defect...) and I need to avoid carbs *AND* need keep fat "reasonably" low (unlike Peter!) without the need to outright "avoid" fat. My protein comes from meat, which makes up a large portion of my calories (again, unlike Peter!). I recently tried to ramp up the fat content (mainly cheese) while ramping down protein (meat) and it did not go well... (However confounding factor was some medication I was taking...)

Still trying to bring light in my darkness, still running my personal n=1 experiment, not done yet unfortunately...

Tony said...

Oh, one more thing:

In some disorders of carbohydrate metabolism (e.g. where the liver can not produce enough glucose, which becomes a problem at night) the goto supplier of glucose is uncooked cornstarch, as it is very slowly digested, and can supply the body with enough glucose over night and thereby protecting the person from becoming hypoglycemic. Supposedly some modified cornstarch products are being developed which are even better suited for people affected by such metabolic disorders.

But I have no personal experience with this... I would recommend starting with small amounts of carbs, and measuring your urine ketons to see where you are going, and if that is not enough then increase carbs somewhat.

Oh, one more thing: I think another way to bring down ketons is to reduce fat consumption, that is something else you might want to try and see what it does.

And your body will probably need a week or two to come closer to a new "steady state" after you change your macro-nutrient ratios.

Tony said...

One more (last?) thought:

If you want to test this, pick either cornstarch based foods *OR* white rice as a source of the carbs. Test it for some time (say a week or two, or however you feel comfortable with testing it).

E.g. let's say you go with white rice. Then, if you get funky symptoms, which you can't nail down whether this is caused by the carbs from rice, or from other stuff in rice ("phytotoxins" for lack of a better category), then you can switch over to cornstarch. (Of course you can start first with cornstarch, and then switch over to white rice.) This way you can see what carbs/starch does for you, and what might be cause by rice, and what might be caused by corn.

Alex said...
This comment has been removed by the author.
Alex said...

Chris asked how to avoid deep ketosis.

Ketogenesis and protein intake are negatively correlated.

So basically, under the precondition that carbs are very low, if you want a deeper level of ketosis, you need to decrease protein. If you want less ketones then increase protein not carbs.

A “keto” high in protein as shown by Volek & Co. (in actuality not ketolytic but rather lipolytic diet) gives you fBHB of around 0.5mM. A “keto” according to Seyfried which is low in protein gives you a fBHB of several mM.

Test yourself, make a chart and find your own sweet spot.

Peter said...

Alex, but maybe check GH/IGF-1 levels to titrate your protein intake, after all the rodent suggestions are that GHr KO mice have the maximum longevity of any model. Best not take IGF-1 too lightly.... I am slightly concerned that my own protein intake is a little higher than I would like.


Alex said...

Well, yes, but that is a different topic. The question was how to drop BHB a bit.
To decrease ketosis one only needs to increase protein a bit. I just do not think rice or any other carb is a good idea as it is an acute solution to a long-term "problem". Whether deep ketosis is one, is another question.

I am not suggesting increasing protein levels by huge amounts.

Who can chart IGF-1 vs protein intake? Most of us do not have access to labs. The cheapest ketonians can do is to have a food diary and some glucose test strips and if possible BHB as well.
If insulin increases, so does IGF-1 and ketosis goes down naturally. Or can IGF-1 be high while ketogenesis runs high? Do the two not somehow exclude themselves?

However, I have no clue whether the association is linear or exponential which might be of importance.

Five stars for your blog!
(out of five of course)

Peter said...

Yes, most of the work with protein vs IGF-1 is from rodent studies and, as you comment, ketones go down as protein goes up. And IGF-1 goes up as protein does. But there is also some degree of hepatic GH resistance in ketosis. Quite how it all pans out in a human, far more ketone prone than a rodent, is wide open (as far as I can see). But I feel rather uncomfortable about the sort of protein intakes cited for maximum muscle development... and in humans these can still be ketogenic levels. I did a lot of thinking along these lines when I was immersed in Laron mouse and Laron human papers. Never quite gelled in to any posts.


Alex said...


are IGF-1 studies not "carb-based", no? What is the effect of ketones in this matter? Protective? The association between IGF-1 and longevity might alter once ketones increase (if that is even possible!). If heavy exercise is involved, so that ketosis takes place, then things will be, again, different.

Peter said...

These are the studies I was/am interested in:

I started on these ideas based on Toy Poodles living to 18-19 years of age while Std Poodles were lucky to clear 12 years...


Alex said...


(I'm sorry for my spelling!)

the first pub states that GH/IGF1 is impaired in LC-HFD. I have a problem with this. Impaired does imply that something is not working according to optimal standards. But is it true? Is it not rather an adaptation mechanism to the KD? What is the gold standad here? A carb diet? If a keto does not deliver the same parameters as a carb diet, it is impaired? No, it is altered because it is different.
(Apart from that...I know ratty humans but no human rats.)

However...visceral fat is famous because the inflammation it can cause. The authors did not measure anything inflammatory (am I right, did not read it all). It's visceral fat. Until they show increased inflammation in visceral fat due to KD... so what?
The KD is by nature anti-inflammatory. Add exercise and things can only get better.

This group PMID: 29986720 showed reduction of visceral fat in exercising KD humans, however they did not report BHB in blood. I think they measured it, but did not write it down. The protein content is huuugeee. No significant ketosis here, I guess.

As for the second link: I don't understand the novelty of this study. These guys actually showed that rats have a ketolytic metabolism with fat-related transcription factors. If you look at the methods, you can see they took 3 months olf rats, so young ones and differences between old and young ones have been reported. The reduced lean mass, no surprise as a) the rats were not exercised and b) the KD does decrease growth factors, so putting a and b together: move it to get some!

First studies in sedentary mice actually showed an increase in median life span in KD. things will be published, for sure.

I do like poodles. We share a similar hair style.


Passthecream said...

Briefly returning to the topic, there is something I cannot remember where I read about young traditional Hawaiian men living in isolated huts and being fed massive quantities of starchy tuber food ending up like a kind of Hawaiian sumo, perhaps warriors or some other ritual significance. That would surely bias the paleoarchaeological records towards met syn! It certainly affirms that people have always known how to fatten up nicely.

Passthecream said...

... isolated I presume because the efflatus was statistically significant.

Alex said...

..or the tradition of force-feeding of girls in various African societies

Shaza said...

When you shop in HOng KOng there are so many different types of tubers, none are as sweet what I find here in Australia... I do not even eat them , if I wanted to. I agree, get calories from fat, eat meat and do what you will with veggies... Great read and conversation between you all! Fun to read too...

Eric said...

I remember the courgette case, as it happened in the nearby town of Heidenheim. How the local, who were linking to the tabloid article, changed that into Heidelberg is beyond me.

Peter said...

Maybe they are a german version of the Grauniad and it was a typo when they really meant Heidenheim????


Peter said...

Or an auto correct? They're not all bad