Bayesian Investor Blog

Book review: Food and Western Disease: Health and nutrition from an evolutionary perspective, by Staffan Lindeberg.

This book provides evidence that many causes of death in developed nations are due to a lifestyle that is different from hunter-gatherer lifestyles.

His studies of existing hunter-gatherer societies show moderately good evidence that cardiovascular disease is rare, that aging doesn’t cause significant dementia, and shows weaker evidence of less cancer.

He has some vaguely plausible reasons for focusing on diet as the main lifestyle difference. I’m disappointed that he doesn’t mention intermittent fasting as a factor worth investigating (is it obvious from his experience that some hunter-gatherer societies don’t do this?).

He uses this evidence to advocate a mostly paleo diet, although with less fat than is often associated with that label.

Much of the book is devoted to surveying the evidence about other proposed dietary improvements, mostly concluding they don’t do much (or in the case of calorie restriction, might work by causing a more paleo-like diet).

I don’t have a lot of confidence in his ability to interpret the evidence.

He gives the impression that Omega-3 consumption has little effect on health, citing papers such as this review, whose abstract includes:

showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03)

I’d call that evidence for a moderately important benefit of Omega-3, and I consider it strong evidence in comparison to typical dietary studies, although it’s weak compared to the evidence that other scientific fields aim for.

One response from nutrition experts says:

The null conclusion of the Cochrane report rests entirely upon inclusion of one trial, DART 2.

A quick glance at recent publications from another author he cites (Mozaffarian) got me this:

Considerable research supports cardiovascular benefits of consuming omega-3 PUFA, also known as (n-3) PUFA, from fish or fish oil.

Excessive skepticism is probably better than hype, but it will discourage many people from reading it. Plus the style is somewhere in between a reference book and a book that I’d read from start to end.