Ancestral diet

  

Gaining Glycemic Control Using an Ancestral Diet


Dr. Chrystyne Olivieri                                                                                                         March 2016                                                   


Our current human culture seems to be in a lot of trouble these days. Just look around and you will see that a large percentage of people weigh significantly more than in the past (www.CDC.gov).  Pre-diabetes and type 2 diabetes are common place, even among people younger than 30 years old (Jönsson et al., 2009). What gives? We know people are more sedentary than ever before in human history. This is a huge part of the problem. I always encourage an active lifestyle throughout all stages of human development. However, to what degree could it be our food? How much can we blame poor food choices on the obesity explosion, pre-diabetes and type 2 diabetes around the world? Many believe eating a healthy diet is cost-prohibitive. Fast food is among the cheapest foods to eat. It is true that eating healthy, natural foods may cost a few dollars more, but that’s not much compared to the costs of multiple medications and doctor office visits that may likely ensue with the typical American diet. Add to this the emotional toll of self-managing diabetes every day. But help is on the way in the form of Paleo Eating Patterns. The feasibility of eating a healthy, Paleo style diet was found to be achievable even for low-income consumers in one study done in 2011 (Metzger, Norton, Quinn, & Gramling, 2013).


It is well documented that lifestyle is one of the most problematic contributors to the obesity and diabetes epidemic of today (Artinian et al., 2010). Therefore, the importance of maintaining our physical health through lifestyle modifications is of utmost importance to avoid the many 21st century health problems that abound today - namely “Diseases of Western Civilization”. These include:


· Heart Disease – 

           Hypertension, Myocardial Infarction, Arrhythmias, Coronary Heart Disease, Cardiovascular 

           Disease, Atherosclerotic Heart Disease, Heart Failure

· Type 2 diabetes

· Obesity

· Metabolic syndrome, Pre-diabetes

· Irritable bowel syndrome

· Inflammatory bowel syndrome (Crohn’s Disease, Ulcerative Colitis)

· Macular degeneration

· Rheumatoid arthritis

· Osteoarthritis

· Asthma

· Cancer

· Psychiatric disorders 

· Autoimmune disease 


So what should a healthy human eat? One may look to our ancient ancestors of the Paleolithic era for the answer.


All the foods human beings consume can be put into three main categories, or “macronutrients”: carbohydrates, fats and proteins


Carbohydrates are foods that digest to sugar. As humans, it is best to eat carbohydrates from vegetable sources, and lots of them. You could dine on hundreds of varieties of non-starchy vegetables found around the globe and simply add a few fruits a day and you will get all the carbohydrates your body needs. Non-starchy vegetables are low on the glycemic index which means they will not cause a large blood sugar rise. One can also get needed nutrition from these vegetables in the forms of fiber, vitamins, minerals, antioxidants, carotenoids and flavonoids. The one thing you don’t need is to get your carbohydrates from grains like cereals, breads, pasta, rice, corn or white potatoes which are known to cause higher blood sugar rises. Legumes are also not largely present in Paleo eating patterns. Neither is dairy, which is essentially created by nature to be baby food. All mammals are weaned after infancy, including humans, however we continue to consume dairy despite what nature has designed. Foods based in grains, legumes and dairy simply did not exist during the Paleolithic era of human development (Gowlett, 2003). So how did early humans obtain calcium in their diet? Because the Paleolithic era was prior to the advent of animal domestication, calcium was obtained from green, leafy vegetables, nuts and bones. Getting calcium this way enhances our natural Ph balance.  Healthy bones are not just about getting enough calcium in the diet but not excreting too much calcium in the urine. Calcium excretion was far less in the Paleolithic era than it is today. Despite the high calcium content of dairy, after infancy high dairy intake actually promotes enhanced urinary calcium excretion (Sebastian, Frassetto, Sellmeyer, Merriam, & Morris, 2002). It’s a losing battle. Humans also never evolved to eat high sugar carbohydrates like grains, legumes; certainly not in the quantities that most people eat today (Staffan Lindeberg, 2012).  


Among evolutionary theorists, it is generally agreed that human DNA has not progressed past the Paleolithic era and that the average human living today is almost identical to our ancestors of about 50,000 years ago (Eaton, 2006). It’s true that carbohydrates are the primary source of fiber, however most people believe a high fiber diet can only be achieved by eating whole grains. Nothing could be further from the truth! Most people do not consume “whole grains” anyway. They consume mass produced grain products that were, at one time whole grain. Grinding grains into flour destroys most all of the nutritional content and increases the bioavailability of the sugar. Gram for gram, grains are a rather poor source of dietary fiber and must be consumed in large quantities to achieve any recommended amounts. If you make grains and starchy vegetables the basis of your diet, as the U.S. government guidelines have taught us, obesity and diabetes will more likely show up in your lifetime (Bazzano et al., 2014).  If fact, the U.S. guidelines have recently reduced grains and starch recommendations from about 60% (remember the “food pyramid?) to 25% of our daily food choices (www.health.gov; www.choosemyplate.gov). If they were wrong once with the old “food pyramid”, what are the chances they are still wrong, with “my plate”? Non starchy vegetables, on the other hand, have on average eight times the fiber of whole wheat bread, and fruits are about twice the fiber (Masterjohn, 2008).  Besides, vegetable fiber is far gentler on the human GI tract than grain fiber. 


Humans also need to consume healthy fats. Healthy fats such as monounsaturated and saturated fats provide a much needed energy source and help keep blood sugar stable. New research has shed new light on saturated fats. The prior belief that saturated fats will raise serum cholesterol and lead to weight gain and coronary artery disease is totally false. It is now known that it is the trans-fats which are the real culprits of poor health. Trans-fats, a man-made result of “partially hydrogenating” liquid vegetable oils, are solid at room temperature. Because of this, they were put into the category of saturated fats. This has led to the mistaken belief that all fats that are solid at room temperature are the cause of many diseases of western civilization (Masterjohn, 2008).


Animal sources of these fats are best obtained from animals that were fed a diet as close to natural as possible. Animal fat sources are the highest in omega-3 fatty acids when the animals are not fed a diet of grains (Cordain et al., 2005).  The animals that were hunted by our ancestors in the Paleolithic era (prior to the advent of agriculture and animal domestication) had the most favorable ratios of fat and protein as their diet was simply grass, which is much lower in carbohydrates. Today, we can mimic this by looking for terms like “grass-fed”, “organically raised”, “pasture raised” and “animal welfare approved” when purchasing meats, poultry and eggs. Butter is an excellent source of healthy fats, with no lactose (milk sugars). Butter from grass-fed cows is preferred. Also look for wild-caught fish instead of farm raised fish whenever possible. The fatty acid profile of wild-caught fish is far higher in heart-healthy omega-3 fatty acids. Contrarily, farm-raised fish are higher in omega-6 fatty acids, which are highly oxidized. It really matters what the animal eats! 


Vegetable sources of fats are found in foods like nuts, seeds, avocados and coconut. Coconut oil is a tropical oil and was previously vilified due to its 90% saturated fat content. New research has revealed that not only is virgin coconut oil not bad but it confers health benefits. It has been a staple for many cultures indigenous to warm climates for hundreds of thousands of years. It is a medium chain fatty acid of lauric and myristic acids, which is known to raise HDL’s, the “good” cholesterol (Lomangino, 2012).  Some recent studies are showing how adding coconut oil to your diet does not increase risk of atherosclerosis and heart disease but actually discourages formation of small, dense LDL molecules (Sabitha & Vasudeva, 2010).  It is believed that the smaller and denser the LDL molecules, the more dangerous and atherogenic. Polyunsaturated vegetable oils are composed almost exclusively of omega-6 fatty acids, which are highly oxidized when consumed. It is actually vegetable oils which, when consumed, result in smaller, denser LDL molecules. 


Incorporating saturated fats like virgin coconut oil and grass-fed butter into a healthy diet has also been found to produce weight loss, more specifically belly fat loss. Weight loss confers protection against cardiovascular disease. Specifically, coconut oil has been studied to not cause dyslipidemia and actually seems to promote a reduction in abdominal adiposity (Assunção, Ferreira, dos Santos, Cabral, & Florêncio, 2009).


Generally, fats and proteins occur together in nature in the forms of meats, poultry, fish, eggs, nuts and seeds. Protein is also important to keep blood sugar more stable. Animal protein was really significant in the development of the human beings we all are today. Humans evolved because we started hunting for meat about 2.5 million years ago (Assunção et al., 2009).  We developed our brains and broke off from the apes because we ate animal protein (Eaton & Konner, 1985; Jönsson, Granfeldt, Lindeberg, & Hallberg, 2013). Diets higher in protein have been shown to improve glycemic control in those with type 2 diabetes and to be inversely related to cardiovascular disease (D’Adamo & Caprio, 2011).  It is also believed that diets higher in protein may improve weight loss efforts due to the higher thermic effect (heat producing) than carbohydrates and fats as well as improved satiety. Of course, we should always look to consume meats of ethically raised animals that were fed healthy diets. I suggest to better understand a healthy human diet, let’s look to our past.


Any history professor will tell you that to not know history makes you doomed to repeat mistakes of the past. Understanding the basic anthropological evolution of human life can help us address modern health problems. In 1985, Eaton and Konner published the first study of its kind looking at what early humans ate (Eaton & Konner, 1985).  We know that human DNA has really not changed in about the last 50,000 years or so (Eaton, 2006; S. Lindeberg et al., 2007).  What early humans needed to do to survive and how they interacted with each other also did not change for tens of thousands of years. In fact, the human genome has been evolving for over 2.5 million years (about 76,000 generations) (Carrera-Bastos, Fontes-Villalba, O’Keefe, Lindeberg, & Cordain, 2011). 


However, big changes occurred around 10,000 years ago (about 300 generations) as far as our diet and lifestyle is concerned and this represents about 0.5% of the total genome Homo (Gowlett, 2003; Masterjohn, 2008).   This may explain how modern foods and a modern lifestyle can be the root of many health problems. Even more profound changes occurred to our food supply approximately 150 years ago, with the onset of the Industrial Revolution (5-7 generations). The Modern Age, considered to be for the last 50 years, introduced genetic modification and fast food. 

It’s easily understood that the current eating patterns of modern society is a far cry from the healthy foods our ancestors enjoyed. Our lifestyles are also vastly different. Early humans prior to the advent of agriculture and the domestication of animals about 8,000 to 10,000 years ago were nomadic (Eaton, 2006).  Clans of the Paleolithic era would move constantly. Permanent settlements were not the norm. Clans would travel with herds of large animals for their survival. Fresh and saltwater fish were a big part of most all diets. Humans would gather plant based foods, when available. Yet animal products were a staple because they provided high quality protein and were available year around. Root vegetables, nuts/seeds, and fruits could be stored for another day, when obtained. This lifestyle was perfectly in sync with our place within the ecosystem. Up until that time, there was not much in the way of grains and legumes (Carrera-Bastos et al., 2011; Masterjohn, 2008).  


Recent research suggests that there was no one “original human diet” inherent to all early humans (Boylan, 2008; Eaton, 2006; Masterjohn, 2008; Österdahl, Kocturk, Koochek, & Wändell, 2007).  In fact, it was the climate that would determine the amount of vegetable matter that was consumed with northern cultures having less reliability on vegetables due to availability.  However, the common theme was found throughout all ancient cultures – no grains, little natural sugars, high fat and high animal protein (D’Adamo & Caprio, 2011; DeBoer, 2013; Frassetto, Schloetter, Mietus-Synder, Morris, & Sebastian, 2009).  We try to mimic this, becoming what we now call Paleo Eating Patterns. High glycemic carbohydrates were just not consumed. The most successful human cultures had a large variety of available animal products and were often near the ocean, lakes or rivers. Early humans, prior to the advent of agriculture had not developed a way of producing grains and legumes as a source of food. Consequently, early humans ate a very low glycemic diet. Even up to today, these facts have not changed.


So what does all this mean to the future health of human beings, especially those struggling with blood sugar imbalances? To overcome the common health problems of our current society, we must eat the way our DNA has evolved. Consume lots of fresh, non-starchy vegetables as the basis of the diet (locally grown if possible). Then add some meats (grass fed is best), poultry (pasture-raised, free range), eggs (from ethically raised hens), fish & shellfish (wild caught is best). Eat other healthy fats as in avocados, olives and olive oil, coconut, grass-fed butter and some nuts and seeds. Also enjoy some fruits (in season is best). Avoid grains and legumes and be real careful with dairy (Jönsson et al., 2009; Jönsson et al., 2013).  This should be the basis of a healthy human diet.

 

Health is not simply about living longer. No one wants to live to 80 or 90 years old if you must spend the last 30 years of life infirmed, disabled and sick. It’s about adding quality, healthy years to however long you do live. If you could live into your 70’s or 80’s or even 90’s in very good health, feeling fit and being able to do what you want to do, would that be enough to get you to eat the way your DNA has evolved? Paleo Eating Patterns simply means avoiding processed foods to the best of your ability, and avoiding the standard American diet which is high in grains, dairy, sugar, salt, genetically modified organisms (GMO’s) and other toxins, like artificial sugars and colorings. It is conceivable that a 70 year old can essentially have the same lean, muscular body of a 30 year old. We have lots of evidence of this by observing the over 200 ancient cultures that were studied over the 20th century (Staffan Lindeberg, 2012). In summary, the long, slow decline into old age, debilitated by disease and disability is NOT normal. You are what you eat. Live a long, healthy life.

I have been a Family Nurse Practitioner in New York for over 12 years. I am a Certified Diabetes Educator (NCBDE) and insulin pump trainer for Medtronics & Omnipod. My research was on preventing the progression of pre-diabetes to Type 2 Diabetes utilizing Paleo eating patterns as I believe we should look to the past to be successful in the future. 



References

Artinian, N. T., Fletcher, G. F., Mozaffarian, D., Kris-Etherton, P., Van Horn, L., Lichtenstein, A. H., . . . Burke, L. E. (2010). Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation, 122(4), 406-441. doi: 10.1161/CIR.0b013e3181e8edf1

Assunção, M. L., Ferreira, H. S., dos Santos, A. F., Cabral, C. R., Jr., & Florêncio, T. M. M. T. (2009). Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity. Lipids, 44(7), 593-601. doi: 10.1007/s11745-009-3306-6

Bazzano, L. A., Hu, T., Reynolds, K., Yao, L., Bunol, C., Liu, Y., . . . He, J. (2014). Effects of low-carbohydrate and low-fat diets: a randomized trial. Annals of Internal Medicine, 161(5), 309-318. doi: 10.7326/M14-0180

Boylan, M. (2008). The ancestral diet. Journal of the Australian Traditional-Medicine Society, 14(2), 95-95. 

Carrera-Bastos, P., Fontes-Villalba, M., O’Keefe, J. H., Lindeberg, S., & Cordain, L. (2011). The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol, 2, 15-35. 

Cordain, L., Eaton, S. B., Sebastian, A., Mann, N., Lindeberg, S., Watkins, B. A., . . . Brand-Miller, J. (2005). Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr, 81(2), 341-354. 

D’Adamo, E., & Caprio, S. (2011). Type 2 diabetes in youth: epidemiology and pathophysiology. Diabetes Care, 34(Supplement 2), S161-S165. 

DeBoer, M. D. (2013). Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: A need for screening tools to target interventions. Nutrition, 29(2), 379-386. doi: 10.1016/j.nut.2012.07.003

Eaton, S. B. (2006). The ancestral human diet: what was it and should it be a paradigm for contemporary nutrition? Proceedings of the Nutrition Society, 65(01), 1-6. 

Eaton, S. B., & Konner, M. (1985). Paleolithic nutrition: a consideration of its nature and current implications. New England journal of medicine (USA)

Frassetto, L. A., Schloetter, M., Mietus-Synder, M., Morris, R. C., Jr., & Sebastian, A. (2009). Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr, 63(8), 947-955. 

Gowlett, J. (2003). What actually was the stone age diet? Journal of Nutritional and Environmental Medicine, 13(3), 143-147. 

Jönsson, T., Granfeldt, Y., Ahrén, B., Branell, U.-C., Pålsson, G., Hansson, A., . . . Lindeberg, S. (2009). Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol, 8(35), 1-14. 

Jönsson, T., Granfeldt, Y., Lindeberg, S., & Hallberg, A.-C. (2013). Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutrition journal, 12(1), 1-7. 

Lindeberg, S. (2012). Paleolithic diets as a model for prevention and treatment of Western disease. American Journal Of Human Biology: The Official Journal Of The Human Biology Council, 24(2), 110-115. doi: 10.1002/ajhb.22218

Lindeberg, S., Jönsson, T., Granfeldt, Y., Borgstrand, E., Soffman, J., Sjöström, K., & Ahrén, B. (2007). A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia, 50(9), 1795-1807. doi: 10.1007/s00125-007-0716-y

Lomangino, K. (2012). Coconut oil and health: assessing the evidence. Clinical Nutrition Insight, 38(12), 1-4. 

Masterjohn, C. (2008). High Cholesterol And Heart Disease—Myth or Truth? Cholesterol-and-Health. com.[Online] August, 23

Metzger, M., Norton, S. A., Quinn, J. R., & Gramling, R. (2013). Patient and family members' perceptions of palliative care in heart failure. Heart & Lung: The Journal of Acute and Critical Care, 42(2), 112-119. 

Österdahl, M., Kocturk, T., Koochek, A., & Wändell, P. (2007). Effects of a short-term intervention with a paleolithic diet in healthy volunteers. European journal of clinical nutrition, 62(5), 682-685. 

Sabitha, P., & Vasudeva, D. (2010). Lipid profile and antioxidant enzymes in coconut oil consumers. Indian Coconut J, 72, 3-6. 

Sebastian, A., Frassetto, L. A., Sellmeyer, D. E., Merriam, R. L., & Morris, R. C. (2002). Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr, 76(6), 1308-1316.