What follows is a list of a few things ranging from totally not paleo to totally paleo that strike me as distractions from an “Is it paleo?” perspective. This list is by no means exhaustive, and I hope you’ll add your favorites in the comments below.

After a sometimes exhausting year trying to learn about the most important period of human development with way less data than we’d like, I think it’s time for a mini-salute to modernity.

“Then with my face covered in good factory mud, covered with metal scratches, useless sweat and celestial grime, amidst the complaint of staid fishermen and angry naturalists, we dictated our first will and testament to all the living men on earth.” – F.T. Marinetti, ‘The Futurist Manifesto’, 1909

Happy New Year!

10. Creationists Glasses/Sunglasses

ZZ Top is totally paleo by the distributive power of “beards are rad”, and they wouldn’t be the same without sunglasses. I’ll leave it to you to sort out that logic. Another cool thing about sunglasses: polarization. I’m a fan of polarization as a magical coating that cuts down on glare, and in the establishment of false dichotomies and other propaganda tools. If you were a hunter-gatherer who couldn’t see, you’d probably kill for a pair of vision correcting lenses. And don’t mess with Marcello Mastrioanni.

Exception: Implicit in one version of the cover of Guy Debord’s masterwork, ‘The Society of the Spectacle‘, wearing 3-D glasses makes you a mindless automaton that’s been recuperated by the spectacle. Oh, and colored contacts aren’t fair in assessing mate value.

9. Vegans Beer

Hey, don’t question me. It’s written on the sign, and thus, totally out of my hands.

Exception: None. I mean… I could probably make a case for Hefeweizen, what with it’s gluten-bomb wheat base rather than barley. I’d rather make a case against beer with fruit in it, but if I say anything bad about fruit, the president’s vegan personal trainer might get all preachy again.

8. Birth Control

It’s just that it used to be called infanticide and infant mortality. Unless you’re a pope or other form of deviant, we’re much better off with modernity.

Exception: Trojan Condoms’ slogan, “Feels like nothing’s there.” That’s what she said?

7. Coffee

I recently heard someone sincerely say that “coffee is paleo.” Until someone establishes the Homo sapiens “Out of Seattle” hypothesis, I’m going to have to go ahead and reject that coffee is historically or logically paleo. And… I don’t care that it’s not… not even a little.

Exception: Frappuccinos. And no, getting the coconut version doesn’t make it paleo either.

6. Bicycles!

A huge number of people don’t use bikes as a substitute for other forms of exercise, but as a substitute for lazy ass planes, trains, and automobiles. That’s right, Kevin! Having the same birthday as me isn’t going to make me forget your post asking if bikes are faileo. Besides, there’s an entire blog dedicated to paleo cycling, so… game, set, and match.

Exception: None. Not even road bike weenies.

5. Computers {electricity, light bulbs, et cetera}

“You eat paleo, but you’re using a computer!?” Shut up. Seriously. Just. Shut. Up.

“…the chimpanzees I work with are keen on computerized testing: the easiest way to get them to enter our testing facility is to show them the cart with the computer on top.” –Primates and Philosophers: How Morality Evolved

Exception: Macs clearly aren’t paleo because of the high fructose content of apples.

4. Running {and endurance training in general}

Sure, I hate the pain sometimes too, but… it would be a strange evolutionary coincidence that bipedalism is the most mechanically efficient method of distance running, and only humans do it, AND it wasn’t a huge part of our evolution – ostensibly because CrossFit was the hominin fitness program of choice throughout the Pleistocene.

Exception: Clunky running shoes and endurance “sports” based on internal combustion engines.

3. Carbs

If only to shut up critics of paleo that keep saying paleo is dead because 10 Homo sapiens and 3 Homo neanderthalensis fossils show signs of starch consumption. Paleo isn’t anti-carbs! Paleo is anti-carbs in the massive quantity easily and cheaply acquired at Krispy Kreme and everywhere else in grocery store culture.

Exception: Refined sugars and mega-concentrated extracts like agave syrup. Oh, and wheat and corn and rice and all other grains and… (but the latter isn’t a carb thing)

2. Socialism

Sorry comrades. As a bourgeois capitalist, I didn’t want to believe it either. But… the predominant political organization of hunter-gatherer bands seems to be socialist anarchism, libertarian socialism, social anarchism, anarcho-socialism, or some other flavor of social organization that rejects private property and emphasizes communitarian forms cooperation. Objectivism runs into problems (not least because Rand didn’t really believe in evolution… more on that in an upcoming post), and libertarianism relies on a blatantly agrarian conception of property rights.

Exceptions: Authoritarianism, Marxism, State-Socialism

1. Evolutionary Psychology

“Neck-down Darwinism” ain’t cool. If you’ve noticed the difference in personality between golden retrievers and cats, you already understand what evolutionary psychology looks like. Denying that it applies to humans is evolutionarily unjustifiable anthropocentrism. If you still reject it, I hereby sentence you to a lifetime of riding zebras (which I’m told is not unlike herding cats).

Exception: Evolved cognitive biases are real, but I don’t like them.

Your turn! Favorite non-paleo things? Non-paleo things you’re sick of hearing about? Whatcha got?

Without further ado, it is with extreme excitement that I release my contribution to this discussion by way of an alternative hypothesis. It is currently in-press for the Journal of Applied Paleonthropological Hyperbole.

Abstract

The nature and causes of the disappearance of Neanderthals and their apparent replacement by modern humans are subjects of considerable debate. Many researchers have proposed biologically or technologically mediated dietary differences between the two groups as one of the fundamental causes of Neanderthal disappearance. Some scenarios have focused on the apparent lack of plant foods in Neanderthal diets. Here we report direct evidence for Neanderthal consumption of a variety of plant foods, in the form of phytoliths and starch grains recovered from dental calculus of Neanderthal skeletons. Some of the plants are typical of recent modern human diets, including legumes, and grass seeds (Triticeae), whereas others are known to be edible but are not heavily used today. Many of the grass seed starches showed damage that is a distinctive marker of cooking. Our results indicate that in both warm eastern Mediterranean and cold northwestern European climates, and across their latitudinal range, Neanderthals made use of the diverse plant foods available in their local environment and transformed them into more easily digestible foodstuffs in part through cooking them, suggesting that the extinction of Homo neanderthalensis may have been caused by introduction of food sources sufficiently deleterious to individual health.

The obvious question then becomes: How long do we have to wait before proclaiming Neanderthals were vegans? Why would Neanderthals continue to eat substances that were toxic?

For that, we need look no further than modern humans. When ingested items provide an observable short-term benefit in terms of calories, they are assumed to be beneficial. When the negative effects of toxic inputs are cumulative over a period of weeks, months, or years, individuals are incapable of isolating the confounding variables. This is further complicated by not being limited to dietary inputs, but also those of microbial, genetic, or other environmental factors such as shortages or overages of vitamins, minerals, and myriad chemical compounds. This problem has not been solved with modern scientific methods, and it is reasonable to assume that Neanderthals were less capable of determining cause and effect during the Pleistocene.

When the introduction of toxins does not manifest with sufficiently deleterious symptoms for a duration in excess of nine months in females, and nine seconds in males, significant adaptive pressure may not be placed on reproduction for that individual. Thus, the combination of an inability to disambiguate dietary toxins across a relevant period of time with the lack of strong selection pressure in delayed onset cumulative symptoms may result in both poor health and reproductive success, especially in the short-term. However, over time, the inability to recognize the delayed onset cumulative symptoms of the introduction of dietary toxins may lead to an increase in the consumption of the toxic sources. While a disconnect in the causal relationship between dietary input and its negative health outcomes persists, we may see a paradoxical increase in the consumption of such toxins which are believed to be beneficial. As consumption spreads through a population, the negative health consequences would come earlier in life, and with more frequency. Since we have no reason to assume adaptation in all cases (to the contrary, we must assume non-adaptation as the null hypothesis), it is possible that the paradoxical increase in consumption lead to unsustainable population levels within the species.

We are certain of two points: Neanderthals ate grains, and Neanderthals are extinct. To date, there is a complete lack of evidentiary support for hypotheses involving any benefits to the introduction of grains into the Neanderthal diet. Thus, we find all hypotheses of our colleagues that indicate grain consumption provided any survival or reproductive benefits to Neanderthals to be strange and unfounded. Since Homo neanderthalensis is extinct, and the deleterious effects of grain consumption can still be seen in the modern Homo lineage, it is more reasonable to conclude that increased consumption of grains in the Neanderthal diet played a role in their extinction.

Discussion

Grain consumption may result in death and subsequent fossilization of you and your species. Further research is required.

Acknowledgements

This research was funded by evolvify.com in connection with the upcoming book, ‘The Extinction Diet: How to Lose Weight and Save the Planet Through Individual Death and Species Extinction’.

Just as there’s truth underlying what makes comedy funny, there’s some truth in stereotypes. Rather than a reflection of truth, stereotypes typically represent a cultural amplification of minor differences. As such, it’s difficult to disentangle what’s real from what’s cultural (yes, I just said culture isn’t real). In the realm of stereotypes, the association between men and meat is pretty strong. From the [debunked] “Man the Hunter” hypothesis to the staple imagery of Dad “manning” the grill, we have no shortage of references from which to draw. Maybe it’s the fire, maybe it’s the meat, but I’ve always embraced the opportunity to run the grill. I’ve also been curious about where cultural indoctrination gives way to instinct in this area. Recently, my attention was directed back to this from a strange direction.

As part of the ongoing paleo debate about the amount of animal products vs. plant products we should consume to achieve optimal health, I turned my attention to vitamin C. The topic is doubly interesting to me because, from a “why evolution is true” standpoint, the genes to synthesize vitamin C singlehandedly refute the notion of an “intelligent” design. Vitamin C (ascorbic acid) is necessary for certain biological functions, and therefore, most animals have evolved to synthesize it. Humans have the gene coding for vitamin C synthesis, but it has been deactivated. The [almost certainly correct] hypothesis is that it was deactivated during a period of high dietary fruit consumption in distant primate evolution. Since vitamin C was ample in the diet, there was no positive selection pressure for the activated gene. Which brings us to scurvy…

Scurvy

Acute vitamin C deficiency in humans leads to scurvy. I noticed a strangely consistent risk-factor for scurvy while doing preliminary research on the condition. It seems that being a single man is itself a risk factor. It was listed in every result I saw from a basic Google search on the topic so I’m chalking this one up to common knowledge for medical professionals. Not only is being male and single a risk factor, but it’s also referred to colloquially, and in medical literature as “bachelor scurvy” (Connelly, 1982) or “widower scurvy” (Hirschmann, et al. 1999).

One of the hypotheses forwarded to explain why men are more prone to scurvy is that they don’t know how to cook. That seems strange considering that cooking destroys vitamin C. It’s found in high concentrations in a wide range of foods (raw fruit in particular) readily available to any grocery store culture. If a single guy can get to the store to buy hot dogs, he can buy an orange. Thus, I have to emphatically reject the “single guys can’t cook” hypothesis before even considering whether it’s factually accurate to say that “men can’t cook”.

Since vitamin C is ridiculously easy to consume, I’m inclined to view “bachelor scurvy” as a result of voluntary food selection choice. It seems the “single” part is because women opt for an increase in fruit/vegetable consumption rather than a Leave it to Beaver cliche of women in the kitchen. As it turns out, quasi-scientific studies confirm a certain level of disdain for vegetables by men…

Most Vegetarians Are Women

I think it’s safe to say that the go-t0 resource for wisdom related to evolutionary based diets is Vegetarian Times (VT). Thus, I’m happy to report that a study they commissioned in 1992 found that women are more than twice as likely to be vegetarians as men. At that time 68% of vegetarians were women compared to the remaining 32% of men. They went on to speculate that this difference is because women care about health and men don’t. There may be some truth to that, but since the assertion was unsupported, I remain highly skeptical. There are certainly other explanations available.

The premise of the VT article was that the president of the North American Vegetarian Society (a heterosexual female) couldn’t find a suitable vegetarian man to date (understandable, as I have recurring nightmares of this guy and his hat). Tapping into folk wisdom once again, I refer you to Pulp Fiction…

“…my girlfriend is a vegetarian, which pretty-much makes me a vegetarian.” – @ 0:53 below
[cft format=0]

Rather than assuming that only 32% of men are vegetarians, I wonder if it isn’t true that less than 32% of men would be vegetarians if they weren’t influenced by, or trying to impress, vegetarian women.

In a sidebar of the same VT article, a referenced study surveyed individuals in the 18-35 age bracket regarding their food cravings. The results showed that 33% of men craved meat or fish in the previous year, compared to only 9% of women. It seems that when thinking about taste and/or satisfaction, men display an almost fourfold increase in a desire for meat when compared to women. So aside from the ideas that men can’t cook and don’t care about health, what evolutionary explanations are available?

Hunter-Gatherer Explanation?

If the bulk of human evolution consisted of hunter-gatherer tribes in which men did most of the hunting (and therefore killing), and women did most of the gathering/foraging, could natural selection have favored mental traits that favored men with less reservations about killing animals? Could this have resulted in males more comfortable with processing, and ultimately in eating, meat? In environments in which hunting and eating animals afforded survival and reproductive advantages, it would make sense for males who psychologically objected to this practice to suffer increased selection pressure. In other words, quasi-moral vegetarian tendencies would be a direct disadvantage to men in hunting societies.

The meat craving study referenced in VT also found that the gap in cravings between men and women decreased from 24% to 16% in populations over the age of 65. While the 36-64 age group is missing from the article, we can make some assumptions about the 65+ group. Perhaps most importantly, this is beyond the reproductive age of nearly all women. Women’s cravings for meat more than double from the lower age bracket to the upper one. Thus, there could be a relevant factor in the consumption of plant matter in relation to fecundity (fertility) and/or diet during pregnancy and breastfeeding. The data in this study is insufficient to clarify this, but it’s an interesting question worthy of further study.

Parting Ponderings

First, I’m interested in any research or insight that may be relevant to this question. I find it unlikely that there isn’t research that I simply missed. If you can point out other information that may shed more light on this, please add it in the comments below.

As I said in the beginning, I can’t commit to a solid hypothesis on this. There seems to be some instinctual inclination toward increased meat collection, preparation, and consumption in men. There’s certainly a significantly larger percentage of women who are vegetarians. I find current explanations of why men would shun consumption of vitamin C containing foods to be absolutely unconvincing. So… what’s the deal?

References
Connelly, T. J., Becker, A. and McDonald, J. W. (1982), Bachelor Scurvy. International Journal of Dermatology, 21: 209–210.
Hirschmann J.V., Raugi G.J. (1999), Adult Scurvy. Journal of the American Academy of Dermatology. 41(6): 895-906.

A quick and dirty primer

Celiac (or coeliac) disease is an autoimmune disorder in which the small intestine is damaged by components of gluten, a protein found in wheat and other grains. The effects of celiac diseas are numerous, serious, and varied. For a entertaining sobering look, check out Tim Ferriss’ How to Keep Feces Out of Your Bloodstream. Strictly speaking, a “wheat allergy” can be similar to something like a peanut allergy. Folks in this group experience rapid onset symptoms that are serious, including the potential of anaphylactic shock. It’s mainly for these folks that food is required to expose the presence of wheat content on packaging.

From there, we transition into the murky terms of gluten intolerance and/or sensitivity. These two classifications are where the non-celiac, non-allergy folks may reside. Whether we should take them seriously is what the references below try to answer. There’s plenty of research and anecdotal evidence within the paleo and related nutrition/health worlds. However, since they’re in it for the money, some people tend to pass what they say off as mere profiteering. And perhaps that’s fair, but perhaps both are justified.

Below are a series of links (and abstracts when available) to recent medical literature on gluten research. Basically, I just did a search on PubMed for articles with “gluten” in the title, but without “celiac” or “coeliac” in the title. Doing this search brought up 1340+ results, so I narrowed it down. I’ve tried to filter out the articles discussing the use of gluten free diets in the treatment of autism. I’ve also endeavored to filter out everything relating to animal studies. That said, some of the animal studies are quite convincing… But I get it… Humans aren’t chimpanzees or mice. Also, I only went back to 2008 (this was written in September, 2010).

For those not familiar with medical journals, this sort of research can be beyond frustrating. Realize that you have to pay for the full versions of most of these articles if you’re not a member of an organization (University, Hospital, etc.) with a subscription. For the sake of expediency, I’m going to bias this thing like crazy and highlight (in red) some of the more salient points below. Reading only the titles and highlighted passages will give you maximum bias if that’s what you’re looking for. To get the full story, you’d need to read all of every article.

Current Barometer

My assessment of the current barometer for medical research on the effect of gluten on humans is roughly this: In the general population (those not having celiac disease or wheat allergies), gluten either causes, or is strongly correlated to a range of autoimmune and neurological disorders. Further, gluten intolerance can present with any one, or group, of symptoms or disorders with varying degrees of severity. Lastly, it is generally agreed that celiac disease and non-celiac gluten intolerance are underreported and under-diagnosed, though the numbers remain speculative.

For me, on a practical level, the correlations between autoimmune and neurological problems in the scientific literature, my personal experiences with gluten, anecdotal reports from others, and the logical framework of evolutionary biology/paleo diet is convincing enough for me to abstain from gluten.

Medical Journal References to Gluten in Non-Celiac Individuals

Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease – The American Journal of Gastroenterology

Abstract

OBJECTIVES: Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism.

METHODS: A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored.

RESULTS: A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high. Of 19 patients (68%) in the gluten group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation). On a visual analog scale, patients were significantly worse with gluten within 1 week for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001). Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8.

CONCLUSIONS: “Non-celiac gluten intolerance” may exist, but no clues to the mechanism were elucidated.

Sensory ganglionopathy due to gluten sensitivity – Neurology, 2010

Abstract

OBJECTIVES: Gluten sensitivity can engender neurologic dysfunction, one of the two commonest presentations being peripheral neuropathy. The commonest type of neuropathy seen in the context of gluten sensitivity is sensorimotor axonal. We report 17 patients with sensory ganglionopathy associated with gluten sensitivity.

METHODS: This is a retrospective observational case series of 17 patients with sensory ganglionopathy and gluten sensitivity. All patients had been followed up for a number of years in dedicated gluten sensitivity/neurology and neuropathy clinics.

RESULTS: Out of a total of 409 patients with different types of peripheral neuropathies, 53 (13%) had clinical and neurophysiologic evidence of sensory ganglionopathy. Out of these 53 patients, 17 (32%) had serologic evidence of gluten sensitivity. The mean age of those with gluten sensitivity was 67 years and the mean age at onset was 58 years. Seven of those with serologic evidence of gluten sensitivity had enteropathy on biopsy. Fifteen patients went on a gluten-free diet, resulting in stabilization of the neuropathy in 11. The remaining 4 had poor adherence to the diet and progressed, as did the 2 patients who did not opt for dietary treatment. Autopsy tissue from 3 patients demonstrated inflammation in the dorsal root ganglia with degeneration of the posterior columns of the spinal cord.

CONCLUSIONS: Sensory ganglionopathy can be a manifestation of gluten sensitivity and may respond to a strict gluten-free diet.

Gluten sensitivity and the CNS: diagnosis and treatment – Lancet Neurology, 2010

Abstract

Gluten sensitivity is a systemic autoimmune disease with diverse manifestations. This disorder is characterised by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Coeliac disease, or gluten-sensitive enteropathy, is only one aspect of a range of possible manifestations of gluten sensitivity. Although neurological manifestations in patients with established coeliac disease have been reported since 1966, it was not until 30 years later that, in some individuals, gluten sensitivity was shown to manifest solely with neurological dysfunction. Furthermore, the concept of extraintestinal presentations without enteropathy has only recently become accepted. In this Personal View, we review the range of neurological manifestations of gluten sensitivity and discuss recent advances in the diagnosis and understanding of the pathophysiological mechanisms underlying neurological dysfunction related to gluten sensitivity.

GAD antibody-associated neurological illness and its relationship to gluten sensitivity. – Acta Neurologica Scandinavica, 2010

Abstract

Background – The high prevalence of gluten sensitivity in patients with stiff-person syndrome (SPS) lead us to investigate the relationship between gluten sensitivity and GAD-antibody-associated diseases. Methods – We used ELISA assays for anti-GAD and for serological markers of gluten sensitivity. Patients were recruited from clinics based at the Royal Hallamshire hospital, Sheffield, UK. Patients with gluten sensitivity were followed up after the introduction of a gluten-free diet and serological testing was repeated. Results – Six of seven (86%) patients with SPS were positive for anti-GAD, mean titre 109 U/ml; This compared with 9/90 (11%) patients with idiopathic sporadic ataxia, mean titre 32 U/ml, 16/40 (40%) patients with gluten ataxia, mean titre 25 U/ml, and 6/10 patients with type 1 diabetes only, mean titre 8 U/ml. None of 32 patients with celiac disease only, and of 40 patients with genetic ataxia were positive for anti-GAD. The titre of anti-GAD reduced following the introduction of a gluten-free diet in patients with SPS who had serological evidence of gluten sensitivity. The same was observed in patients with gluten ataxia and anti-GAD antibodies. This was also associated with clinical improvement. Conclusion – These findings suggest a link between gluten sensitivity and GAD antibody-associated diseases.

Genetic and immunological processes in the pathomechanism of gluten-sensitive enteropathy and associated metabolic bone disorders – Orvosi Hetelap, 2010

Abstract

Celiac disease or gluten-sensitive enteropathy is the most common disease of jejunum, leading to malabsorption. It is an immune mediated disease induced by gluten at the presence of genetic predisposition. After gluten exposition, immune processes are induced by T-cell mediation causing typical intestinal and extra intestinal manifestations. The diagnosis of celiac disease is still set up on the result of jejunal biopsy and detecting of antibodies against endomysium and tissue transglutaminase. From genetic aspect, association with HLA DQ2/DQ8 is identified in celiac disease. On a strict gluten-free diet, the clinical, histological and serological results improve and remission of accompanying diseases may be achieved. In the etiopathogenesis of celiac disease several genetic and immunological mechanisms have been recognized in recent years. Connected to the accompanying diseases, more reviews have been issued about the bone metabolic changes and less about the inflammatory join disorders. In the present work, the authors review literature data that reveal common background from both immunological and genetic aspects.

Gluten sensitivity: from gut to brain – Lancet Neurology, 2010

Abstract

Gluten sensitivity is a systemic autoimmune disease with diverse manifestations. This disorder is characterised by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Coeliac disease, or gluten-sensitive enteropathy, is only one aspect of a range of possible manifestations of gluten sensitivity. Although neurological manifestations in patients with established coeliac disease have been reported since 1966, it was not until 30 years later that, in some individuals, gluten sensitivity was shown to manifest solely with neurological dysfunction. Furthermore, the concept of extraintestinal presentations without enteropathy has only recently become accepted. In this Personal View, we review the range of neurological manifestations of gluten sensitivity and discuss recent advances in the diagnosis and understanding of the pathophysiological mechanisms underlying neurological dysfunction related to gluten sensitivity.

Gluten sensitivity: an emerging issue behind neurological impairment? – Lancet Neurology, 2010

Abstract

Not Available

Gluten-free diet and steroid treatment are effective therapy for most patients with collagenous sprue. – Clinical Gastroenterology and Hepatology, 2010

Abstract

BACKGROUND & AIMS: Collagenous sprue (CS) is characterized by the presence of a distinctive band of subepithelial collagen deposition in the small bowel. We evaluated the clinical characteristics, treatments, and outcomes of patients with CS.

METHODS: Thirty patients with CS were identified at the 3 Mayo Clinic sites between 1993 and 2009. Clinical data from medical records were reviewed.

RESULTS: The study cohort was 70% female (age range, 53-91 years). Most patients had severe diarrhea and weight loss. Hospitalization to treat dehydration was necessary in 16 (53%) patients. Associated immune-mediated diseases were noted in 70% of the patients; celiac disease was the most frequent. Other associated diseases were microscopic colitis, hypothyroidism, and autoimmune enteropathy. The median thickness of the layer of subepithelial collagen deposition in the small bowel was 29 mum (20-56.5 mum). Subepithelial collagen deposition in the colon or stomach was noted in 8 patients. A clinical response was observed in 24 (80%) patients after treatment with a combination of a gluten-free diet and immunosuppressive drugs. Histologic improvement was confirmed in 9 patients, with complete remission in 5. Two patients died (1 of complications of CS and 1 of another illness).

CONCLUSIONS: Most patients with CS are treated effectively with a combination of gluten-free diet and steroids. CS is often associated with collagen deposition or chronic inflammation in other segments of the gastrointestinal tract as well as other immune-mediated disorders.

Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth? – Annals of the New York Academy of Sciences, 2010

Abstract

Patients with neurological disease of unknown etiology sometimes present with antigliadin and antitissue transglutaminase antibodies. The association between these antibodies and multiple sclerosis has been previously suggested. The purpose of this study was to determine the prevalence of these antibodies in multiple sclerosis patients. We determined the level of serum immunoglobulin A and immunoglobulin G antigliadin and antitissue transglutaminase antibodies in 98 patients with multiple sclerosis. We found a highly significant increase in titers of immunoglobulin G antibodies against gliadin and tissue transglutaminase in the multiple sclerosis patients. Seven patients had a positive IgG AGA, whereas only 2 controls presented positive titers (P = 0.03). Four patients had positive IgG anti-tTG while all the controls tested negative (P = 0.02). However, immunoglobulin A antibodies against gliadin and tissue transglutaminase were not statistically higher in the multiple sclerosis group in comparison to the control group. Our findings support the associations between antibodies against gliadin and tissue transglutaminase to multiple sclerosis. The specific role of these antibodies in the pathogenesis of multiple sclerosis remains uncertain and requires additional research. A gluten free diet should be considered in specific cases of patients who present with gluten antibodies.

Novel immune response to gluten in individuals with schizophrenia. – Schizophrenia Research, 2010

Abstract

A link between celiac disease and schizophrenia has been postulated for several years, based primarily on reports of elevated levels of antibody to gliadin in patients. We sought to examine the proposed connection between schizophrenia and celiac disease by characterizing the molecular specificity and mechanism of the anti-gliadin immune response in a subset of individuals with schizophrenia. Blood samples from individuals with schizophrenia and elevated anti-gliadin antibody titer were examined for celiac disease-associated biomarkers, including antibodies to transglutaminase 2 (TG2) enzyme and deamidated gliadin peptides, as well as the HLA-DQ2 and -DQ8 MHC genes. The anti-gliadin antibody response was further characterized through examination of reactivity towards chromatographically separated gluten proteins. Target proteins of interest were identified by peptide mass mapping. In contrast to celiac disease patients, an association between the anti-gliadin immune response and anti-TG2 antibody or HLA-DQ2 and -DQ8 markers was not found in individuals with schizophrenia. In addition, the majority of individuals with schizophrenia and anti-gliadin antibody did not exhibit antibody reactivity to deamidated gliadin peptides. Further characterization of the antibody specificity revealed preferential reactivity towards different gluten proteins in the schizophrenia and celiac disease groups. These findings indicate that the anti-gliadin immune response in schizophrenia has a different antigenic specificity from that in celiac disease and is independent of the action of transglutaminase enzyme and HLA-DQ2/DQ8. Meanwhile, the presence of elevated levels of antibodies to specific gluten proteins points to shared immunologic abnormalities in a subset of schizophrenia patients. Further characterization and understanding of the immune response to gluten in schizophrenia may provide novel insights into the etiopathogenesis of specific disease phenotypes.

Nervous system in the gluten syndrome: a close relationship. – Medical Hypotheses, 2010

Abstract

Not Available

Gluten sensitivity presenting as myoclonic epilepsy with cerebellar syndrome. – Movement Disorders, 2009

Abstract

Not Available

Gluten encephalopathy with psychiatric onset – Clinical Practice and Epidemiology in Mental Health, 2009

Abstract

ABSTRACT: Many cases of coeliac disease, a gastrointestinal autoimmune disorder caused by sensitivity to gluten, can remain in a subclinical stage or undiagnosed. In a significant proportion of cases (10-15%) gluten intolerance can be associated with central or peripheral nervous system and psychiatric disorders.A 38-year-old man was admitted as to our department an inpatient for worsening anxiety symptoms and behavioural alterations. After the addition of second generation antipsychotic to the therapeutic regimen, the patient presented neuromotor impairment with high fever, sopor, leukocytosis, raised rhabdomyolysis-related indicators. Neuroleptic malignant syndrome was strongly suspected. After worsening of his neuropsychiatric conditions, with the onset of a frontal cognitive deficit, bradykinesia and difficulty walking, dysphagia, anorexia and hypoferraemic anaemia, SPET revealed a reduction of cerebral perfusion and ENeG results were compatible with a mainly motor polyneuropathy. Extensive laboratory investigations gave positive results for anti-gliadin antibodies, and an appropriate diet led to a progressive remission of the encephalopathy.

Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis. – BMC Gastroenterology, 2009

Abstract

BACKGROUND: Gluten sensitive enteropathy (GSE) is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains in susceptible individuals. Recurrent aphthous stomatitis (RAS) may be the sole manifestation of GSE. The aim of this study was to determine the prevalence of gluten sensitivity enteropathy (GSE) in a large group of patients with RAS and assess the efficacy of gluten free diet (GFD) on the improvement of aphthous lesions in those who were diagnosed with GSE.

METHODS: Two hundred and forty seven patients with RAS were included. The patients had at least three aphthous attacks per year. Patients were screened by IgA anti-endomysial antibody (EMA), IgA anti tissue transglutaminase (TTG) and serum IgA level. Those with a positive serology underwent endoscopic biopsies of the duodenal mucosa and patients with negative serology were excluded. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histology. For patients with GSE, gluten free diet was recommended.

RESULTS: Six out of 247 RAS patients had positive TTG test alone, and one had positive EMA and TTG. All 7 patients with positive serologic tests underwent duodenal biopsies. Histological findings were compatible with GSE in all of them (Marsh I in four patients, Marsh II in two patients and Marsh IIIB in one another.). The mean age of GSE patients was 27.42 +/- 10.56 (range, 13 to 40) years old. They were suffering from RAS for an average duration of 4.5 years. All of the 7 GSE patients had not responded to the routine anti-aphthae medications, including topical corticosteroids, tetracycline and colchicine. Four patients who adhered to a strict gluten-free diet showed noticeable improvement in their aphthous lesions over a period of 6 months.

CONCLUSION: A significant minority (e.g. 2.83%) of RAS patients have GSE. This could be compared with the 0.9% prevalence of GSE in the general population of Iran. This study suggests that evaluation for celiac disease is appropriate in patients with RAS. Additionally, the unresponsiveness to conventional anti-aphthae treatment could be an additional risk indicator.

The gluten syndrome: a neurological disease. – Medical Hypotheses, 2009

Abstract

Hypothesis: Gluten causes symptoms, in both celiac disease and non-celiac gluten-sensitivity, by its adverse actions on the nervous system. Many celiac patients experience neurological symptoms, frequently associated with malfunction of the autonomic nervous system. These neurological symptoms can present in celiac patients who are well nourished. The crucial point, however, is that gluten-sensitivity can also be associated with neurological symptoms in patients who do not have any mucosal gut damage (that is, without celiac disease). Gluten can cause neurological harm through a combination of cross reacting antibodies, immune complex disease and direct toxicity. These nervous system affects include: dysregulation of the autonomic nervous system, cerebella ataxia, hypotonia, developmental delay, learning disorders, depression, migraine, and headache. If gluten is the putative harmful agent, then there is no requirement to invoke gut damage and nutritional deficiency to explain the myriad of the symptoms experienced by sufferers of celiac disease and gluten-sensitivity. This is called “The Gluten Syndrome”.

Gluten sensitivity in patients with IgA nephropathy. – Nephrology, Dialysis, Transplantaiton, 2009

Abstract

BACKGROUND: Coeliac disease is more frequent in IgA nephropathy (IgAN) patients compared to the healthy population. Several hypotheses postulate that food antigens like gluten may be involved in the onset of IgAN.

METHODS: In this study, we used a recently developed mucosal patch technique to evaluate the rectal mucosal inflammatory reaction to gluten in patients with IgAN (n = 27) compared to healthy subjects (n = 18). The rectal mucosal production of nitric oxide (NO) and release of myeloperoxidase (MPO) and eosinophil cationic protein (ECP) were measured. Serum samples were analysed for IgA and IgG antigliadin antibodies (AGA), IgA antibodies against tissue transglutaminase and IgA endomysium antibodies.

RESULTS: Gluten reactivity, defined as increase in MPO and/or NO after gluten exposure, was observed in 8 of 27 IgAN patients. The prevalence of HLA-DQ2 and DQ8 was not increased among gluten-sensitive patients, and the total prevalence among IgAN patients was the same as for the normal population. An elevated serum IgA AGA response was seen in 9 of 27 IgAN patients. The increase in IgA AGA did not correlate with the gluten sensitivity as measured by NO and/or MPO. A specific serum IgG AGA response was seen in one patient only. Antibodies against tissue transglutaminase and endomysium were not observed.

CONCLUSION: It is concluded that approximately one-third of our IgAN patients have a rectal mucosal sensitivity to gluten, but without signs of coeliac disease, and we hypothesize that such sub-clinical inflammation to gluten might be involved in the pathogenesis of IgAN in a subgroup of patients.

Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature. – Nutrition & Metabolism, 2009

Abstract

ABSTRACT: We report the unexpected resolution of longstanding schizophrenic symptoms after starting a low-carbohydrate, ketogenic diet. After a review of the literature, possible reasons for this include the metabolic consequences from the elimination of gluten from the diet, and the modulation of the disease of schizophrenia at the cellular level.

Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity. – Journal of Neurology, Neurosurgery, and Psychiatry, 2009

Abstract

BACKGROUND: Previous studies have associated coeliac disease (CD) and gluten sensitivity (defined as the presence of anti-gliadin antibodies and positive immunogenetics) with cerebellar degeneration and epilepsy with occipital calcifications. Hippocampal sclerosis (HS) in temporal lobe epilepsy (TLE) is a potentially progressive disorder with unknown aetiology; however, autoimmunity has been implicated as one of the possible mechanisms leading to HS. The purpose of this study is to analyze CD-associated antibodies and gluten sensitivity in a well-characterised group of patients with refractory focal epilepsy.

METHODS: We measured anti-gliadin, anti-tissue-transglutaminase and anti-endomysium antibodies, and coeliac-type human leukocyte antigen (DQ2 and DQ8), in 48 consecutive patients with therapy-resistant, localisation-related epilepsy. The patients were categorised into the following three groups on the basis of ictal electro-clinical characteristics and the findings of high resolution MRI: TLE with HS (n = 16), TLE without HS (n = 16) and extratemporal epilepsy (n = 16). Patients with suspected CD or gluten sensitivity underwent duodenal biopsies.

RESULTS: Seven patients in total were gluten sensitive; all of these patients fell in the TLE with HS group. On the other hand, none of the TLE without HS patients or those with extratemporal epilepsy were gluten sensitive (p<0.0002). The results of duodenal biopsies showed that three of the seven gluten-sensitive patients had histological evidence of CD and four had inflammatory changes consistent with early CD without villous atrophy. Four of the patients with gluten sensitivity had evidence of dual pathology (HS+another brain lesion), whereas none of the remaining patients did (p<0.0002).

CONCLUSIONS: The present study demonstrates a previously unrecognised link between gluten sensitivity and TLE with HS. This association was very robust in this well-characterised group of patients; thus gluten sensitivity should be added to the list of potential mechanisms leading to intractable epilepsy and HS.

Relapsing acute pancreatitis associated with gluten enteropathy. – Revista Espanola de Enfermedades Digestivas (Spanish Review of Digestive Diseases)

Abstract

OBJECTIVES: To describe the frequency and the clinical and laboratory characteristics of relapsing acute pancreatitis (AP) associated with gluten enteropathy (GE).

PATIENTS AND METHODS: We prospectively examined all acute pancreatitis cases admitted to our Department in 2006. We recorded a total of 185 patients. With recurring forms, 40 (22%) in all, we used a clinical-lab protocol including serologic and genetic markers, and duodenal biopsy to rule out GE.

RESULTS: A total of 34 patients (18%) met clinical-biological criteria for GE (group1), and were compared to the remaining non-GE AP cases (n=161) (group2). Mean age in the GE group was 54 +/- 25 years, slightly younger than group 2 (61 +/- 14) (NS). There was a mild predominance of women (50%) in group 1 versus group 2 (38.5%) (NS). Seven patients in group 1 (20%) had severe AP, as compared to 27 (17%) in group 2 (NS). The presence of cholelithiasis in group 1 involved 6 cases (18%), which was significantly lower than in group 2–72 cases (45%) (p < 0.05). Four patients with GE developed pseudocysts (12%) versus 13 (8%) in group 2 (NS). Tissue transglutaminase (tTG) was elevated only in 3 patients (9%). Nine patients (34%) were DQ2 (+) and 4 (12%) DQ8 (+); the rest (54%) were all negative for both markers. From an endoscopic perspective there was diffuse duodenitis in 32 patients (95%). Duodenal biopsies revealed villous atrophy (Marsh 3) in 2 patients (6%); submucosal inflammatory infiltration (Marsh 2) in 10 (29.4%); increased intraepithelial lymphocytes (Marsh 1) in 8 cases (23.5%), and normal mucosa (Marsh 0) in 14 patients (41.2%). Response to GFD after 1 year was excellent in 30 patients (88%).

CONCLUSIONS: Relapsing AP with GE represents a relatively common association that is indistinguishable from other APs from a clinical-evolutive standpoint, except for a lower presence of cholelithiasis (p < 0.05). A specific diagnostic protocol is much needed in the identification of these patients since GFD is the only effective therapy to prevent new AP events from developing.

Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase. – Annals of Neurology, 2008

Abstract

OBJECTIVE: Gluten sensitivity typically presents as celiac disease, a chronic, autoimmune-mediated, small-intestinal disorder. Neurological disorders occur with a frequency of up to 10% in these patients. However, neurological dysfunction can also be the sole presenting feature of gluten sensitivity. Development of autoimmunity directed toward different members of the transglutaminase gene family could offer an explanation for the diversity in manifestations of gluten sensitivity. We have identified a novel neuronal transglutaminase isozyme and investigated whether this enzyme is the target of the immune response in patients with neurological dysfunction.

METHODS: Using recombinant human transglutaminases, we developed enzyme-linked immunosorbent assays and inhibition assays to analyze serum samples of patients with gluten-sensitive gastrointestinal and neurological disorders, and various control groups including unrelated inherited or immune conditions for the presence and specificity of autoantibodies.

RESULTS: Whereas the development of anti-transglutaminase 2 IgA is linked with gastrointestinal disease, an anti-transglutaminase 6 IgG and IgA response is prevalent in gluten ataxia, independent of intestinal involvement. Such antibodies are absent in ataxia of defined genetic origin or in healthy individuals. Inhibition studies showed that in those patients with ataxia and enteropathy, separate antibody populations react with the two different transglutaminase isozymes. Furthermore, postmortem analysis of brain tissue showed cerebellar IgA deposits that contained transglutaminase 6.

INTERPRETATION: Antibodies against transglutaminase 6 can serve as a marker in addition to human leukocyte antigen type and detection of anti-gliadin and anti-transglutaminase 2 antibodies to identify a subgroup of patients with gluten sensitivity who may be at risk for development of neurological disease.

Gluten ataxia. – Cerebellum, 2008

Abstract

Gluten ataxia is an immune-mediated disease triggered by the ingestion of gluten in genetically susceptible individuals. It should be considered in the differential diagnosis of all patients with idiopathic sporadic ataxia. Early diagnosis and treatment with a gluten free diet can improve ataxia and prevent its progression. Readily available and sensitive markers of gluten ataxia include antigliadin antibodies. IgA deposits against TG2 in the small bowel and at extraintestinal sites are proving to be additional reliable and perhaps more specific markers of the whole spectrum of gluten sensitivity. They may also hold the key to its pathogenesis.

Neuromyelitis optica in patients with gluten sensitivity associated with antibodies to aquaporin-4. – Journal of Neurology, Neurosurgery, and Psychiatry, 2008

Abstract

Not Available

Association of DLG5 variants with gluten-sensitive enteropathy. – Gut, 2008

Abstract

Not Available

Shocker! News just floated my way that Mr. McClellan just happens to also be a vegan advocate! An ABC affiliate reports (emphasis mine):

“For three years, [Cornell McClellan] served on the inter-national(sic) board for Earth Save, an organization founded by John Robbins, author of “Diet for a New America.” Their mission is to bring the world closer to a plant-based lifestyle. He was a member of Roots of Peace, a Chicago-based vegan group, whose mission is to educate the children and community about the benefits of a vegan lifestyle.” –ABC News Chicago

Well now does’t that put this hokum visual of your insides rotting in a bit of melodramatic context? “Eating a steak three times a day can potentially whittle your waistline, but the impact it’s having on your insides might not be as attractive”

The other main idea I proposed in the article was that religious folks often have an axe to grind with paleolithic diets because of the reliance on adaptive principles of Darwinian evolution. And double shocker:

Cornell’s Statement of Commitment
“I want clients to understand what needs to be done, and to commit to doing it. Living a healthy life is just one way to give thanks to God for the life He has given us.”

Now, I can’t say that Mr. McClellan is a Creationist at this point. However, the implications of the statement that “God” has “given us” life are many. It hints strongly at the negation of adaptation in human evolution. Notions of a creator god don’t allow room for evolution to happen in an adaptive way. Unlike the release of Darwin’s 1959 1859 work, “On the Origin of Species”, the paleo diet has a very real and visceral day-to-day meaning to people. Using the logical framework of a paleo approach tends to inherently keep the logic of evolution in one’s mind. Like Darwin’s book, paleo has the potential to cause further erosion of beliefs in Creationist myths and the anti-adaptationist motives of ID.

The new information on McClellan’s vegan advocacy adds another dimension to the lack of journalistic integrity in his original article. With this new light, the attempts to berate paleolithic diets by completely sensationalized rhetoric is amplified by concealing a very significant motivational bias. Sinister may be too strong of a word, but hiding a vegan advocacy agenda behind a nutritional propaganda is, to borrow the words of Mr. McClellan, “somewhat questionable”. Is that enough to qualify for “shill” status? You tell me.

UPDATE: November 7, 2010

McClellan apparently has a real problem with celebrities eating meat…

“McClellan bemoans the fact that celebrities like Angelina Jolie and Jessica Simpson have misconstrued vegan diets as being unhealthful; in a recent interview for her movie Salt, Jolie said that being a vegan “nearly killed me. I found that I was not getting enough nutrition.” …The best part of the article, though, is the fact that McClellan recommends Dreena’s cookbook Eat, Drink & Be Vegan” –Arsenalia.com

…and he’s clearly not skimping on the ultra vegan bias in general.

Perhaps the more important question is whether the vegan fad diet is healthy.

For a comprehensive list of paleo related links and, including some related to veg*an ideas, you might check out paleodiet.com.

Target

The seeds of this article have been on my mind for a while, but its timing is a reaction to an article I saw yesterday in the Chicago Sun Times titled “Meaty fad diet goes back to Stone Age“. Here we go… Back to the 3.4 million year “fad”. The author added to the fad rhetoric by calling the paleo diet “silly”. That sort of title is pretty common in the anti-paleo polemics that circulate in the blogosphere. However, this was from what I presumed to be a nominally significant traditional media outlet. It was clearly written by a non-journalist, which is fine I guess, but it struck me as particularly poorly researched. There were no online responses when I read it, so I fired off a hasty, but I think accurate, comment. At the time of this writing, it’s the first of a few comments, but who knows what whims might change that.

Semi-Irrelevant Backstory

When I first read the article, I read every word, but stopped at the 2nd to last sentence of the piece: “Cornell McClellan is the owner of Naturally Fit… a personal training and wellness facility.” Maybe it’s not fair nor accurate, but when I think gym owner / personal trainer, I envision a wall of supplements and meal replacement bars and powders… you know…. merchandise that needs to be “moved”. Thus, I tend to take their advice on nutrition with a grain of yeah, right. In missing the last sentence, I missed something that would have changed my comment somewhat. Here’s that non-trivial sentence: “He is also the fitness trainer for the President of the United States and the First Lady.” Yes, you may {insert scratching record sound here}.

Let it be known that I am was in no way hostile to the Obama administration when I read the article. Sure, I could work up a reasonable critique of a dozen or so things I think were bad policy decisions, but my critiques of the Bush Jr. administration would be measured in hundreds or thousands. For reasons mentioned by neither Democrats nor Republicans, I find the health care bill to be flawed. It also strikes me as unconstitutional, but I went to the law school of James Spader and William Shatner. To the Presiden’ts credit, as a non-theist, the following may be my favorite quote by any U.S. President since James Madison:

“I’m somebody who deeply believes that the bedrock strength of this country is that it embraces people of many faiths and no faith. This is a country that is still predominantly Christian, but we have… atheists, agnostics… that we have to revere and respect….” Barack Obama, September 28, 2010.<

The only reason I’m writing this article is that I got curious and googled Cornell McClellan. It was then that I found out he’s 1 of 16 official members of the President’s Council on Fitness, Sports & Nutrition. It was only after finding that page that I went back to the article and connected all of the dots. I remain skeptical of its claim that Mr. McClellan has an “extensive knowledge of the human body and nutrition.”

The Meat of It

Cornell McClellan’s article really is garbage. I do encourage you to read the whole thing to take in the totality of its emptiness. The portrait of the paleo diet that he paints is more a cartoonish mischaracterization of the Atkins diet than paleo. And to be fair to the Atkins folks, it’s not a fair representation of them either.

The problem with this sort of article is that the average person sincerely looking for a way to improve their health is not likely to see through the unsupported assertions made by someone who’s a professional personal trainer backed by the President and officially promoted as an outstanding exemplar by the United States government. My thoughts and references follow each of the quoted snippets.

“a recent study has come out that refutes some of [the paleo diet’s] basic tenets. Findings from archeological digs in Italy, Russia and the Czech Republic suggest that cavemen did not only rely on meat for sustenance, as evidenced by traces of starch grains found on stones used for grinding and preparing food.”

Well at least Mr. McClellan did go so far as to read the Reuters blurb on this and maybe even the NYT piece [“page not found” error as of this writing]. However, the actual study did not reveal evidence of “grains” in the sense that would be appropriate for a paleo diet discussion of grains… namely, cereal grains such as wheat, barley, amaranth, millet, et cetera. The grains being referred to are grains in the sense that they are particulates; that is, the result of grinding. The popular science media misconstrued this research ad nauseum when it was first published. Its implications for paleo dieters are approximately zero. It’s been refuted many times, but Melissa McEwen provides my favorite critique thus far. It’s based on the actual study, not the other journalists’ general audience pieces, and she even bothered to include a relevant chart from the study that shows the non-grain plants in question.

Not trivial in the media coverage of this study was the post-publishing opining by some of the article’s authors. At least one made a wild and unsubstantiated guess that they used the ground plant material to make bread. I ask again, who among you thinks mashed potatoes are the same as bread? Perhaps we have to be scientists to make such a determination?

Archeologists were shocked to discover that our carnivorous ancestors actually were making and preparing foods such as roots, vegetables and perhaps even cracker-like foods.

Now this is just ridiculous. First of all, no serious scientist currently thinks our ancestors were “carnivores”. It is widely accepted by archaeologists and anthropologists that humans evolved as omnivores. I’d let laymen off the hook on this distinction, but Mr. McClellan knows better and is exaggerating for effect. The paleo diet approach simply echoes a range of foods our omnivorous ancestors would have had access to. Second, there are longstanding hypotheses and evidence of hominid “preparation” of roots and vegetables. The rest of us know that crackers were invented by the Keebler elves, no earlier than the First Age of Middle-Earth. Proving that humans made crackers in the paleolithic is about as likely as leading us to a magical elven forest.

These recent findings suggest that man cannot live on meat alone, but that hasn’t stopped thousands of people from signing up for the Paleo Diet.

Now we’re getting ridiculous-er. The paleolithic diet doesn’t suggest that anyone could, should, or would survive on meat alone.  I’m sure someone could make a case that humans could survive on meat alone, but it would remain a question of how long and how well. Scientists do hypothesize that Neanderthals were mostly carnivorous, but they’re a separate species and that argument is beside the point.

a meat-heavy diet isn’t recommended for most people. Not only do I discourage any diet that disallows entire food groups, but cholesterol levels are directly linked to the ingestion of animal products.

Meat-heavy is vague, unhelpful, and pejorative in a way the author clearly intended. Here we also have a legitimate disagreement on what constitutes a food group. Grain might be a Food Group, but it is not a group of foods or nutrients required for human health. There are no essential nutrients found in grains that are not found in dramatically higher concentrations in the other “food groups”. Yes, grains, as a practical matter, are necessary to sustain the massive current global population of Homo sapiens with the current agribusiness-dominated farming system, but they are by no means necessary for individual people. Please examine your assumptions, Mr. McClellan.

The final claim about cholesterol and animal products is too big to discuss here. I’ll blindly assert his unsupported claim has been sufficiently refuted and address references should they be provided at some future time.

Eating a steak three times a day can potentially whittle your waistline, but the impact it’s having on your insides might not be as attractive. Sadly, Paleo dieters also are encouraged to limit fruit to small helpings, as it believed that our ancestors didn’t have access to the amazing produce offerings that we now do.

Until I see a citation for the “steak three times a day” charge, I’m going to assume that it’s again made up for dramatization of the author’s non-point. While our ancestors did eat a lot of meat when it was available, it wasn’t available in steak form three times a day. Such is life when you don’t have refrigeration and a pantry.

Paleo dieters are encouraged to adjust fruit consumption based on their current body composition and how much exercise they’re getting. Fruit generally has naturally high levels of sugar. Is it really sad to suggest that obese, sedentary individuals throttle back on their intake of sugar, while marathon runners shovel it down as needed?

Not only are these diet choices somewhat questionable, it’s also worth pointing out that our Stone Age ancestors were not eating factory-farmed meat, which is full of chemicals and hormones. Unless you have a spear handy and access to unlimited buffalo, you are going to have a hard time truly eating like a caveman.

Yes, the mythical all meat diet that excludes spuriously essential food groups and bans fruit would definitely be questionable. Unfortunately for the arguments of Mr. McClellan, that isn’t the paleo diet. The paleolithic dieters are fully aware of the problems with factory farmed, chemically-treated meat and make it a point to eat naturally fed (typically grass or pastured) meats. And yes, such meats are difficult to find at a fast food window, but they are often available at standard grocery stores. And as I’ve said before, paleo is a logical framework applied to modern humans, not a historical reenactment.

Finally, any diet that is as restrictive as the Paleo Diet is problematic because it requires cavemen-sized willpower, which means many people will soon abandon their hunks of meat for a modern-day helping of lasagna.

The willpower problem is a modern diet carbohydrate addiction problem, not a paleolithic problem. Direct links have been demonstrated between carbohydrate cravings and obesity (Spring 2008). In effect, suggesting that sufficient willpower is too difficult implies that we should all simply give up and submit to an unbreakable cycle of carbohydrate addiction. The cool thing about paleolithic diets is that most people find the addiction and cravings go away. Indeed, you find yourself quite full if you eat ample amounts of meat, fruit, and vegetables.

After discovering the naive nutritional understanding of “The First Trainer”, I’m a little worried for the President. I hope his doctors aren’t using similarly anachronistic, post-medieval methods. Nobody likes leeches and bloodletting.

McClellan’s sagelike advice? Don’t eat “Big Macs”. Deet deeeet deeet deet deeeet… This just in off the news wire.

Dear President Obama, myself and many others in the paleo community would be happy to update your nutrition regime. P.S. Please tell President Clinton he could probably use a bit more protein these days. Bonus: Many of us have a natural immune system resistance to TV and radio pundits. Which brings me to my next point…

Religion

Religion (in some forms) is fundamentally anti-paleo. Obvious culprits in this regard are Creationists. While I formally and warmly invite them to apply paleolithic ideas to their eating and exercise habits, it’s also pretty obvious that the paleo diet relies on the logic of Darwinian evolution. Some folks who believe in “intelligent” design may also be inclined to reject the logic of the paleo diet. The adaptive power of natural selection in evolutionary theory is a foundation of the paleo diet. If a divine force was guiding the process, adaptation would be irrelevant. It could be claimed that the “intelligence” knew all along that humans would need grain to force an artificially large population explosion, and therefore, paleolithic habits would be irrelevant.

I personally know Creationists who have been quite successful on the paleo diet. I wonder how they ignore the implications there. If their holy books tell them eating bread is a good thing, how do they reconcile that unhealthy advice with reality?

Corporate Interests

I don’t want to get all conspiratorial, but I think it’s at least worth considering financial influence in politics as it relates to pushback against paleolithic dieting. As the famous quote from the 1976 film All the President’s Men says, “Follow the money”. And lookey here, we just happen to be talking about one of the President’s men. The list below highlights a few publicly traded companies with direct financial interest in producing, fertilizing, transporting, and/or distributing paleo-unfriendly wheat & corn products for human consumption [2010 Fortune 500 Rank, $Revenue]. Major direct producers in bold.

• Wal-Mart [1]
• Exxon Mobil [2]
• Chevron [3]
• ConocoPhillips [6]
• CVS Caremark [18]
• Procter & Gamble [22]
• Kroger [23]
• Costco Wholesale [25]
• Walgreen [32]
• Marathon Oil [41]
• PepsiCo [50, $43 billion]
• Safeway [52]
• Kraft Foods [53, $40 billion]
• Sysco [55, $37 billion]
• Coca-Cola [72, $31 billion]
• Tyson Foods [87, $27 billion]
• Rite Aid [89]
• Publix Super Markets [99]
• Deere [107]
• McDonald’s [108, $23 billion]
• Coca-Cola Enterprises [113, $22 billion]
• Tesoro [139]
• General Mills [155 $15 billion]
• Smithfield Foods [163, $14 billion]
• Pepsi Bottling [174, $13 billion]
• ConAgra Foods [178, $13 billion]
• Sara Lee [180, $13 billion]
• Kellog [184, $13 billion]
• Monsanto [197]

I’ll just leave it at that for now. Government subsidies of the crops in question raises an entirely different, yet equally important level of questioning. If I get requests to flesh this out further, maybe I’ll put some more work into it.

Vegan / Vegetarian

Noooooo… Not again! There are a lot of veg*ans out there. They’re politically active, they like to team up, and they [some] hate that other people eat meat.

Guilt by Association / Ad Hominem

We see this time and again in propagandists rallying against those of unknown motives trying to quash the idea that eating grains is bad (see the reference to Gwyneth Paltrow in the intro here). This is true in attacks on anti-gluten folks and anti-paleo folks.  Indeed Cornell McClellan injects this approach into his piece, “celebrities such as Megan Fox are rumored to owe their hot bodies to this ancient diet plan… there is no secret behind the body of your favorite celebrity”. Dismissing something as a celebrity fad is itself a fad and it carries with it a very real sign (in the semiotic sense) value. Its cultural meaning instantly evokes mental images of superficiality, imminent expiration, and flakiness. Thus, accusing something of being a celebrity fad associates the idea of hollow vapidity to whatever is linked to it. Propaganda 101, baby.

Conclusion

We have good reason to question the personal business motivations, political motivations, and religious motivations of individuals launching derisive attacks at paleo. The financial stakes alone are in the hundreds of billions (more likely trillions) annually. The perceived religious stakes are just as powerful and perhaps more, if slightly less lucrative and less…um… what’s the word I’m looking for here? The stakes for vegetarians can be just as powerful and personal.

There are reasonable arguments within the scientific community that are worth having. However, when pieces such as McClellan’s hit the media with such a gaping chasm between the known science and the claims, red flags should go off and alarm bells should ring.

Yes, our knowledge of the paleolithic environment in which humans evolved is less than 100% complete. However, we know a lot more about it than Mr. McClellan and other politically motivated paleo haters would lead you to believe. We know enough to help people in a very real and immediate way. I’ll link up a couple books below, and feel free to ask me questions if you’re not sure about where to start or where to go next.

Slainte,

Andrew

UPDATE: Cornell McClellan is a vegan advocate!

References

Spring, B., Schneider, K., Smith, M., Kendzor, D., Appelhans, B., Hedeker, D., et al. (2008). Abuse potential of carbohydrates for overweight carbohydrate cravers. Psychopharmacology, 197(4), 637-647.

Food! On this particular day, I set out amply satiated by a hearty breakfast. Knowing me, it was something intended to be an omelet,  but wouldn’t fold over once I’d thoroughly packed it with goodness. The plan was just to hit the trail and count off however many miles I cram into about four hours. And yes, I’m fully blaming the whopping 2 miles per hour average that I clocked to tasty sea creatures. When there’s a fork in the trail, and a post in the ground is etched with an arrow pointing to the left that says “beach”, and an arrow to the right that says “trail”, I go left. And when the tide is low and the rocks are exposed, I get wet.

How to Harvest Mussels

Depending on where you live in the world, harvesting shellfish can be a sketchy endeavor. Our civilization(s) have done an excellent job of bringing the oceans to the brink of death. One great thing about the Oregon Coast is that it’s often safe to eat the shellfish. Another great thing is that there’s a handy website with current updates on the safety of various shellfish. I peek at it at regular intervals just in case I happen to run into an opportunity. On this day, opportunity abounded. So I took to the water and sliced a large clump of mussels from the rocks and had an impromptu snack.

Mussels are pretty easy to procure if you can get to the rocks they’re fond of. They adhere directly to the rocks, but not enough to prevent you from pulling them off. They’re often connected together in big masses of stringy fibers that, if left intact, makes them easy to carry in a pre-arranged bunch. I just cut the stringy stuff around a big bunch, then pry them off individually without breaking the stringies holding them together. If you have a blade that you don’t mind prying them off the rocks with, this may be a little easier.

A note on mussels… the size of the shell doesn’t necessarily indicate the amount of meat inside. Of course, the tiny ones have very little meat, but the huge shelled monsters seem to have about the same amount of meat as the medium ones. When harvesting them, I try to get a patch that are all medium-huge and leave the tiny ones. You’ll typically notice they’re clustered in similar sizes based on their location on the rocks. If anyone knows the most sustainable pattern for harvesting, please let me know…. unless your answer is “go vegan”. Yeah vegans… I know you’re smart-asses, but you’re adorable all the same.

Cooking

Cooking mussels is pretty simple. They can be boiled, steamed, baked, grilled, et cetera. Just like cooking clams, they need to be cooked until they open up a bit. If they don’t open, they’re probably dead and it’s best to skip those. If you’re pulling them straight off the rocks, they’re probably not going to be dead. I didn’t have any cookware with me. All I did was start up a fire with the fire-starter I keep in my pack, then find something to hold them out of the fire while they cooked. In this case, I roamed the beach a bit and found a shipwrecked crab pot. I simply positioned the mesh metal grate lid over a fire and propped it in place with some rocks. At other times, I’ve cooked them on rocks placed in the middle of the fire, or even with sticks (very green wood) spanning the fire in a crossing pattern. In the latter case, the mussels cooked before the sticks burned.

I keep forgetting to add some salt and tiny bottles of white wine to my pack. Those can easily be tossed in and forgotten about until the moment they’re needed.

I estimate this amount of mussels would cost approximately $11,543,456,034.05 at a restaurant. Because of the bulk of the shells, they had to weigh over 10 pounds total. Yum!

The gallery below includes pictures from the paleo snackeo and the trail/beach that day. It’s from the Evolvify.com Facebook Page.

From Evolvify (Showing 34 of 101 items)

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For context, I’ve also added some of the “great” moments in agricultural history. This is followed up by a chronological links of the major books related to the paleo diet and its aliases. I’m working on making this list more detailed and potentially adding a list of scholarly articles. It would be cool to be able to visualize the relative time periods as well. In a text list, it’s easy to lose perspective of how little time humans have been eating grains.

Pre-Homo Species

-6,000,000 Divergence from other ape species

-3,750,000 Australopithecus afarensis (staples: fruit, leaves, pith, seeds)

Paleolithic Era

-2,600,000 Lower Paleolithic (first stone tools)
-1,900,000 Homo rudolfensis (staples: leaves, seeds, tubers opportunistic: fruits, large insects, small vertebrates)
-1,900,000 Homo erectus (staples: fruit, meat opportunistic: small vertebrates, insects)
-1,830,000 Homo habilis (staples: fruit, leaves, herbs opportunistic: meat from large vertebrates)
-1,810,000 Homo georgicus (staples: tubers, roots, seeds, herbs, opportunistic: fruit, meat)
-1,600,000 Homo ergaster (staples: meat, small vertebrates, tubers, fruits, seeds, nuts, insects)
-700,000 Homo antecessor (staples: herbs, seeds, tubers, roots seasonal: nuts, fruits, mushrooms, meat)
-600,000 Homo rhodensiensis (80% plant sources, 20% animal sources)
-420,000 Homo pekinensis (staples: herbs, seeds, nuts, roots, tubers seasonal: meat, fruit, berries)
-400,000 Homo heidelbergensis (80% plant sources, 20% animal sources)
-250,000 Middle Paleolithic (stone scrapers, points, backed knives, etc.)
-200,000 Homo sapiens (modern human species)
-175,000 Homo neanderthalensis (staples: large game, bone marrow, cannibalism opportunistic: plants)
-40,000 Upper Paleolithic (musical instruments, blade tools, spear-throwers, bows and arrows)
-10,000 (BCE) End of Pleistocene

Neolithic Era

-9,500 (BCE) Earliest Agriculture
-8,800 (BCE) Earliest archaeological evidence of harvested emmer wheat
-7800 (BCE) Earliest archaeological evidence of harvested eikorn wheat
-7500 (BCE) Domestication of Maize/Corn
-7000 (BCE) Neolithic Agricultural Revolution (emmer wheat, einkorn wheat, barley, lentil, pea, chickpea, bitter vetch, flax)
-7000 (BCE) Humans breed durum (pasta) wheat by artificial selection of emmer wheat
-7000 (BCE) Average human height shrinks by 5 to 6″ (An Edible History of Humanity)

Paleolithic Era Part II: The Return

1975 – The Stone Age Diet by Walter L. Voegtlin

1989 – The Paleolithic Prescription by S. Boyd Eaton, Marjorie Shostak, and Melvin Konner

1995 – NeanderThin: A Caveman’s Guide to Nutrition by Ray Audette, Troy Gilchrist, and Alan S Brown

2002 – The Paleo Diet, Cordain

2005 – The Evolution Diet by Joseph Stephen Breese Morse

2005 – The Paleo Diet for Athletes By Loren Cordain and Joe Friel

2006 –  Evolution of the Human Diet: The Known, the Unknown, and the Unknowable by Peter S. Ungar

2009 – The Original Diet: The Omnivore’s Solution by Roy Mankovitz

2009 – Primal Body-Primal Mind by Nora Teresa Gedgaudas

2009 – The Primal Blueprint by Mark Sisson

2009 – Catching Fire: How Cooking Made Us Human by Richard Wrangham

2010 – The Paleo Solution, by Robb Wolf

2010 – ‘The New Evolution Diet: What Our Paleolithic Ancestors Can Teach Us about Weight Loss, Fitness, and Aging by Arthur De Vany

2011 – ‘Everyday Paleo‘ by Sarah Fragoso (Foreword by Robb Wolf)