diet

All posts tagged diet

Anti-Paleo Diet

Soylent is an almost pure chemical diet, whose most natural looking ingredients are olive oil and whey protein. It provides the FDA recommended nutrients from mostly purified sources of the individual nutrients. The creator claims to have experienced improved health after adopting it (after previously eating something slightly better than a typical US diet).

This seems like a very effective way to minimize the poisons in our diet.

It’s also cheaper than most diets (he claims less than $2/day, but that seems questionable). He claims it tastes good, although eating the same thing day after day would seem a bit monotonous.

FDA recommendations are known to be suboptimal – too little vitamin D, too much calcium.

He seems confused about the fiber requirements, and is a bit reckless about his omega-6/omega-3 ratio. But these are easily improved.

He almost certainly misses some important nutrients that haven’t yet been identified, but that can be partly compensated for by adding a few low-risk foods such as salmon, seaweed, spinach, and sweet potatoes (the four S’s?).

I’m giving some thought to replacing 25-50% of my calories with something along these lines.

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.

This past spring I adopted a diet resembling Dave Asprey’s. After about 5 weeks on it, I took a fancy blood test (trying to optimize things such as my vitamin D levels, Omega-6/Omega-3 ratio, etc). When I finally got the results back, I was shocked to find that the most important results involved my cholesterol levels.

Six years earlier my cholesterol had been good enough that I hadn’t had any reason to pay attention to it. But this May it was 369, with an LDL of 208, and an amazingly good HDL of 108.

If I’d been unlucky enough to get those results from Kaiser, I’d have felt helpless for quite a while. But the WellnessFX report also mentioned that my ApoE Genotype is 3/4. When I got around to researching the implications of that, I figured out that the ApoE4 gene can contribute to some unusual reactions to fat, and that a few people with a copy of it had reported skyrocketing cholesterol in response to a diet of paleo foods plus much coconut and grass-fed butter.

So I cut back on my fat intake, and figured out how to test how my diet affects my cholesterol. I’ve been using CardioChek about once a week. It’s unreliable (about 50 mg/dL too low, judging by my two comparisons with Kaiser). And I’ve only been getting total cholesterol numbers. I could get better info by also measuring HDL with it and subtracting that from the total to get the number that I really want to reduce. But that would require getting a second blood sample, and I barely have enough patience to take one good sample (I often end up with too little blood and need to start over).

With all the uncertainty about the accuracy of those numbers and the time delay between altering my fat intake and when my cholesterol levels showed my response, I wasn’t too optimistic about getting clear results. But the first ways I quantified the evidence gave correlations of 0.540 or 0.418 using 12 or 13 data points (the first of those excludes an implausibly low reading the first time I used it). That’s using an exponential moving average of my saturated fat intake that roughly corresponds to the past week. Other averages of my saturated fat intake have produced somewhat similar results.

My saturated fat consumption ranged 23.5 to 53 grams per day for that data, and the cholesterol levels at the high end of the range are something like 30-50 mg/dL higher than the low end.

So I see a clear and moderately strong connection.

My limited attempts to analyze subclasses of saturated fat have been inconclusive.

Now, how good or bad is the combination of very healthy HDL and disturbingly high LDL?

There are a variety of algorithms to estimate my risk based on my cholesterol levels. Some weight LDL heavily and say I ought to be concerned about the higher readings. Others weight HDL more, and say I’m unusually healthy. The TC/HDL criterion says I have improved with each of the tests I’ve taken [excluding the home tests that only measured TC].

Without strong evidence about which algorithm is more reliable, I’m disposed to keep my cholesterol somewhat close to normal levels.

What about the evidence that societies with high coconut consumption are healthy? That could mean that high cholesterol with ApoE4 is a healthy sign – the body sees lots of rich food, and decides it devote more resources than normal to reducing inflammation. Or it might mean that ApoE4 genes got selected out of those populations.

It looks like coconuts have been eaten for the longest time in islands of the west Pacific, with the Philippines currently having the highest consumption for a sizable country, and high consumption extending west to India.

According to this study the ApoE4 prevalence in countries from the Philippines to India (including China, which presumably hasn’t had much dietary coconut in the north) ranges from 6 to 10 percent, as opposed to 17 percent in the US (which is about average). (This paper(paywalled) has some different-looking numbers on a not very readable map.)

So it looks like there has been enough selection against ApoE4 in those areas that I shouldn’t feel safe eating lots of coconut fat. But I suspect that there are other relevant genes which make it hard to generalize to everyone with an ApoE4 gene.

Eating Insects

In my quest for a diet that more closely resembles what we evolved to eat, I tried eating some insects.

Fluker’s Gourmet Canned Mealworms are ok, but the taste isn’t memorable. The texture is interesting, but hardly a reason to eat them again. They’re sold as pet food, and labeled not for human consumption. That might mean too much bacteria, but cooking should kill those. Could they have pesticides? Maybe, but insects are usually what pesticides kill, so it would be odd to use pesticides to grow them.

I tried some insects from Hotflix, which markets them as candy. All seem to be coated with varying amounts of sugar. The “chocolate covered insects” are mostly packaging, and have an ingredient list that includes hydrogenated oil but no chocolate. The various flavors of Larvets are better – mostly insect with only a small amount of sugar, spices, and artificial flavor or color. The spices make them taste fairly good, but the price per gram makes them too expensive to be a reasonable source of significant nutrition, and the artificial additives make me consider them less safe to eat than the bugs sold as pet food.

It seems like there ought to be a way to get affordable healthy nutrition from insects, and I’ll keep looking occasionally, but we probably need more demand for economies of scale to make that practical.

Omega-6 Revisited

I’ve researched omega-6 some more and the evidence that it is harmful is much less clear than I previously thought.

There’s some evidence that omega-6/omega-3 ratios above some threshold (between 2.5 and 4?) are harmful, but also arguments against focusing on the ratio:

This paper reviews a variety of studies that, in the aggregate, suggest that the ratio is, both on theoretical and evidential grounds, of little value. Metrics that include the n-3 FAs alone, especially eicosapentaenoic and docosahexaenoic acids, appear to hold the greatest promise.

While omega-6 can be converted into proinflammatory molecules, it also has antiinflammatory properties.

in observational studies, higher omega-6 PUFA consumption was associated with unaltered or lower levels of inflammatory markers

in 1 study in Israel,39 where 25% of the population consumes >12% of energy as omega-6 PUFA, an inverse association was found between adipose LA [Linoleic acid] and acute myocardial infarction after controlling for other omega-6 PUFAs.

This meta-analysis seems to be the most rigorous analysis:

They looked for

all RCT that increased PUFA and reported relevant CHD outcomes

For non-fatal myocardial infarction (MI)+CHD death, the pooled risk reduction for mixed n-3/n-6 PUFA diets was 22 % (risk ratio (RR) 0·78; 95 % CI 0·65, 0·93) compared to an increased risk of 13 % for n-6 specific PUFA diets (RR 1·13; 95 % CI 0·84, 1·53).

They found 7 randomized trials that raised omega-6 levels and provided a tolerable amount of info about other fats. Three that had apparently low dietary omega-3 showed that higher omega-6 combined with lower trans-fats produced more heart disease/death (i.e. above some high omega-6/omega-3 ratio, omega-6 can cause more harm than trans-fats), while four where the higher omega-6 was combined with arguably adequate omega-3 and lower trans-fats had less heart disease/death with that combination (i.e. omega-6 might have helped or might have caused harm that was small compared to trans-fats).

From another paper:

High intakes of linoleic acid were not associated with excess risk of AMI [acute myocardial infarction]

arachidonic acid, the long chain n?6 derivative of linoleic acid, was positively associated with AMI

(Arachidonic acid is found mainly in eggs, meat, and seafood).

Other sources suggest arachidonic acid is safe, mentioning studies of biomarkers that show no harm from arachidonic acid, but biomarkers are less convincing than actual disease. There are some reports that ratio of arachidonic acid to eicosapentaenoic acid (AA:EPA) in blood plasma is a useful measure of cardiovascular problems.

In my previous post I expressed doubts about high omega-3 diets, but this paper on hunter-gatherer diets gives the following estimates for fat intake:

  • Omega-3 9.6g/day
  • Omega-6 14.2g/day
  • Saturated 18g/day
  • Monunsaturated 44.3g/day

I don’t know how typical this is of our ancestors, but at least it’s likely within the range of diets that we’re adapted to. This suggests it’s hard to get too much omega-3 or too much fat from seafood (I’d get too much protein if I ate much more than 2 pounds of salmon, but not too much of any type of fat). It also suggests that it’s reasonable to aim for high enough omega-3 that I can’t easily get an omega-6/omega-3 ratio that is high enough to be of much concern.

More from that paper:

Compiled ethnographic studies of 229 hunter-gatherer societies, as well as quantitative studies of hunter-gatherers have demonstrated that animal foods contributed slightly more than half (55-65%) of the daily energy, whereas plant foods would have made up the remainder (35-45%) of the average daily caloric intake. Of the energy obtained from animal foods, historically-studied hunter-gatherers typically derived half of their energy from aquatic animals and the other half from terrestrial animals. Animal food intake would have also been constrained by the physiologic protein ceiling, which has been shown to occur between 30 to 41% of total energy.

There is an increasing body of evidence that suggests high protein diets may improve blood lipid profiles and thereby lessen the risk for cardiovascular disease (CVD).

[I plan to check this evidence later.]

Omega-6

In early April I started measuring my diet fairly carefully (using CRON-O-Meter). It is a somewhat tedious project, but it has has shown me that I’m getting too much Omega-6.

Most of the discussion I’d previously noticed implied that I should improve my Omega-6/Omega-3 ratio by consuming more Omega-3.

But after finding Dave Asprey’s website and hearing him at the Personalized Life Extension Conference, his framing of the issue as Omega-6 poisoning led me to look more carefully at my Omega-6 consumption, and is one of the reasons I tried CRON-O-Meter.

There are conflicting opinions about what ratio people ought to aim for, but those who advocate a ratio close to 1:1 seem to have a good theory (resemblance to hunter-gatherer diets), while I suspect those who advocate much higher Omega-6 levels either assume it’s hopeless to convince many people to achieve a ratio anywhere near 1:1 or have motives unrelated to Omega-fats for pushing oils with a high Omega-6 to Omega-3 ratio.

So my guess is that I should aim for a ratio less than 2:1, and be concerned if my ratio exceeds 3:1.

Even with fairly drastic changes to my diet (virtually eliminating canola oil and olive oil, and cutting back on my peanut addiction by an order of magnitude), I still find that it takes careful thought to keep my daily Omega-6 consumption below 10 grams.

I could in principle take a dozen or more fish oil pills to offset the Omega-6, but the safety of taking over 6 grams of Omega-3 per day seems unknown.

So I am working on switching to foods that have fat that’s very low in Omega-6, mainly coconut oil and butter from grass-fed cows (Kerrygold is the widely available brand).

That mostly doesn’t require eating food that’s less tasty (Kerrygold butter tastes better than most other fats), but it reduces the variety of foods I can eat. It rules out what I used to consider ordinary amounts of most nuts, and many processed foods (Trader Joes’ eggplant and red pepper spreads looked like a convenient way to get veggies until I quantified the effect of the sunflower oil that is the fourth ingredient in each).

I’ll try to post some of my best recipes in a few months.

For more references, see this pubmed entry and Wikipedia.

The Personalized Life Extension Conference 2012 presented lots of ideas, with occasionally some science to back them up.

A lot of the advice backed up by the best science won’t be followed. In spite of the title of Brian Delaney’s Calorie Restriction talk, he didn’t have a solution to the problem of feeling hungry. When Max Peto reminded us of the dangers of sitting, the percentage of people who remained seated only dropped from maybe 97 to 95. There were vendors pushing food that had higher than optimal sugar content, and I think at least one pusher had some success.

I’ve been cutting back drastically on my vitamin/supplement consumption, and Stephen Spindler’s talk (arguing that most apparently good results in other animals were due to supplements inducing calorie restriction) has me thinking about cutting back farther to just fish oil and vitamin D.

The telomere guys still haven’t come up with a good theory for why evolution didn’t do the apparently easy thing and make some telomerase available to non stem cells, so I’m still assuming there’s some tradeoff such as cancer.

The most interesting talk was by David Asprey, describing an “upgraded paleo” diet – high fat, with careful attention to the quality of the fat. He has more ideas than he has time to communicate them.

Unfortunately he seems too busy throwing out new opinions to document the evidence behind them (or maybe the evidence is hiding somewhere on his poorly organized website). But in most cases he has a plausible paleo-like theory, and I’m generally confident they’d be little worse than a placebo, so I’m trying some of them.

At the moment that involves consuming more of some paleo-like foods that I’d already been starting to add to my diet. Grass-fed (Kerrygold) butter is possibly the most important, and coconut products are also rather high on the list. The butter tastes better than my dim recollection of butter from malnourished grain-fed cows. Coconut milk works well as a substitute for milk in dishes such as chowder and cream of onion soup.

Josh Whiton had an intriguing idea about trying to get the benefits of calorie restriction via a very low protein diet once or twice a week (with a paleo-like diet the rest of the time).

Protein

A protein rich diet may make us more alert and help us lose weight.

The reaction of Hypothalamic orexin/hypocretin neurons to amino acids (especially nonessential amino acids) appears to be a mechanism for this effect.

Poultry products appear to be one of the better ways to get nonessential amino acids.

I’ve been trying to increase the protein in my diet for the past four months (in response to weaker evidence than I’ve linked to here), and have found that animal sources have been the easiest way to do that (I’ve mainly increased my egg and meat consumption). I think I’ve found it slightly easier to avoid gaining weight. I think I’ve also been more alert, but I don’t think the increase in alertness coincided too closely with the increase in protein consumption.

Assorted Links

There seem to be serious risks in some food oils that are commonly considered healthy. This report says:

hexane processing strips the remaining nutrients from the oil, and turns a significant quantity of polyunsaturated fats into inflammatory, artery-clogging trans fats!

Hexane processing is apparently common for Canola oil, soybean oil, and other plant-based oils (but not olive oil). Trans-fat levels have been measured at 0.56 to 4.2 percent in commercial oils.

Since FDA-regulated labels are only accurate to about 0.5 grams, and oils are often labeled for 14g serving sizes, a 1 or 2 percent trans-fat content would apparently show up as zero. I suspect those levels are more harmful than most additives that the FDA has banned from foods.

The bottled Canola oil I buy from Trader Joe’s says it’s expeller pressed – no solvents used, so I’m still guessing it’s healthy, but I’ll try harder to avoid processed foods containing plant oils. (There a lot of misleading arguments against Canola oil that should be ignored).