16 August 2014

Sub Optimizing Your Health

Those of you who have read my personal blog know that I am interested in planning and real asset portfolio management. When I say portfolio, it is about understanding how assets interact or correlate and how they affect the whole enterprise. For example, if a company is doing a large project, there is a system cost in doing the project that is seldom considered--when you put people or capital into a large project, there are other projects that do not get done or get delayed.

This work has caused me recently to think about a couple of things.

Maximizing the Health of an Individual at the Expense of Society

Years ago, I had a conversation with my dad who was a doctor. I was feeling pretty smug because I had read about how over-prescription of antibiotics was giving rise to the super-bugs. So I asked him what he does when a patient comes in with flu-like symptoms, but nothing definitive (or some such scenario). He said he would prescribe an antibiotic. Aha I said, you are contributing to the rise of superbugs.

His response was a little startling to me. He said that he didn't know about super-bugs, but he did know that he had a responsibility to his patient and that would be the best course of action for her.

I wrote about the super-bugs and this conversation here as well.

In essence his responsibility was to maximize the health of his patient without regard for the public health.

Maximizing the Health of an Individual Organ at the Expense of the Body

There is a parallel in the medical specialties. Dermatologists recommend people to minimize sun and use high SPF sun block. When people do this, it minimizes the chances of getting skin cancer, especially carcinoma, the most common form of skin cancer. Their focus is on skin health. It makes sense that they would make these recommendations as well in our litigious society, we all need to protect ourselves.

But, in avoiding sun, we reduce the production of vitamin D in our bodies. Vitamin D is important for immune function, and there is evidence that adequate levels of vitamin D can help prevent colds, flu, many other types of cancer, including possibly melanoma--the more deadly form of skin cancer.

So your skin might be in better shape if you minimize sun exposure, but you get the flu or something worse. Important: I do not recommend getting sunburned. Sunburn especially for those under 18 does cause damage to the skin without giving any extra vitamin D benefit. People with light complexions need to be especially careful.

 The point of this is that like my father who was focused on his patient at the expense of society at large, medical specialists focus on their organ specialty at the expense of the rest of the body. Drugs work the same way. They focus on doing some very specific thing, e.g. lowering LDL in the blood, then create systemic effects. Remember side-effects are effects.

An Important Role of Government

Who then watches over the whole body and the whole of society. Well for society in the US, we have, in theory, the government. Government entities like the EPA ensure that companies and individuals do not, while pursuing their own enrichment, exact cost on the rest of society. I believe that guarding our shared resources to prevent Tragedy of the Commons is an important role of government. We have seen that with previous systems in place, industry poisoned the environment. Was it because of lack of regulation, protection of the culprits through the anonymity of incorporation, government protections such as limitation of liability, greed, or all of the above? I don't know, but it didn't work. EPA seems to be working better.

A Bad Role of Government

When it comes to the whole body though, remember that it is your body. Nobody has a greater stake than you in ensuring that your body's system is in good health and working well. You are responsible and accountable for what goes into your mouth.

The USDA (department of agriculture) is a great example of what government agencies should not be doing. Their main goal historically has been to support the agricultural sector of the US economy. I don't know the rationale for having a department with a cabinet secretary to do that, but whatever. In 1894 they got into the personal nutrition business publishing nutrition guidelines.  Until 1956, grains were just one of 7 food groups given equal weighting. In 1992 the first food guide pyramid came out emphasizing grains. Separately the United States Senate Select Committee on Nutrition and Human Needs, aka the McGovern commission, in 1974, changed the focus of our diet towards carbohydrates and away from fats. The health of our nation has been in decline ever since. Food manufacturers bear blame as well.

Don't even get me started on the FDA.

Conclusions

1. Systems thinking is important; a holistic perspective can give important insights.
2. Listening only to experts with a very narrow perspective can lead to sub-optimization
3. Government tries, with mixed results, to look after the systemic good of our nation.
4. Some of the agencies in the US government seem very closely aligned with industry to the detriment of individuals.
5. Ultimately you are responsible for yourself. Consider the source, not just their degrees, but also their incentives in providing advice or guidance.

08 August 2014

Blood Pressure - The E4E View

What is Blood Pressure

Blood pressure is the range of pressures in your cardiovascular system exerted by the heart pumping blood in your system. it is normally expressed in units of mmHg (millimeters of mercury). So a value of 120 is enough to support a column of mercury 120 mm high. Blood pressure has two values diastolic and systolic. The systolic (higher value) is the transient pressure in your arteries experienced during a heart beat. The diastolic (lower value) is the recovery or resting pressure experienced in-between heart beats. Blood pressure is normally expressed as systolic over diastolic, e.g. 120/80.

It is very common to find articles that talk about how high blood pressure is associated with heart disease. It is also common to see articles that say that high blood pressure cause stroke and heart disease. E4E wonders about this and set out to research it.

High Blood Pressure from an Engineering Perspective
Think of the circulatory system and the heart as a pump--perhaps something like a diaphragm or a peristaltic pump. It pushes out the fluid with one stroke, then brings in fluid with the next. Each time the heart pushes out fluid, there is pressure created downstream from the heart. This rapidly dissipates for two main reasons: the arteries themselves are elastic and therefore expand when they receive pressure, the blood flows out of the arteries and into tissue and through the kidneys (and ultimately into the veins for return to the lungs and heart)--it's like having a hose without anything to stop the flow.

From this simplistic perspective then, removing the elasticity of the arteries or restricting the flow from the arteries can cause high blood pressure. Arteriosclerosis, the thickening, hardening, and loss of elasticity of the walls of arteries reduces the elasticity of the arteries, and so is a cause of high diastolic blood pressure. The loss of elasticity can be from either changes in the structure of the artery walls or by deposition of plaques inside the innermost lining of the artery, a condition known as atherosclerosis.

Additionally, renal artery disease, a blockage of the artery that brings blood to the kidneys for filtering, prevents the blood from exiting freely from the arterial system.

After the pulse of pressure from the heart, there is then a brief period for the pressure to dissipate before the next beat. So the systolic pressure indicate your body's ability to handle and dissipate the initial pressure pulse, while the diastolic pressure indicates a more general dissipation of blood into the capillaries.


Is High Blood Pressure Bad?
Medical people have said that high blood pressure (hypertension) increases the risk of kidney failure, stroke, cardiovascular disease, chronic kidney disease, and events such as abdominal aortic aneurysm (AAA). From what I can determine, there is actually very little evidence that high pressure by itself is the cause of those issues.

The problem is more likely with the factors that cause the high blood pressure; the pressure is just a symptom. There is something called hypertensive heart disease, which is a thickening of the heart muscle caused by high blood pressure. The heart has to work harder to pump blood, so it bulks up. This larger heart needs a larger blood supply, and if it an't get it, problems ensue. From what I interpret in my readings, it is unclear if the enlarged heart is a primary cause, or if obstructed coronary blood vessels are what prevents the heart from getting blood supply. Wikipedia has a good article on Hypertension.

The hypothesis that hypertension causes these issues goes something like this from MedicineNet:
"High blood pressure makes your heart work harder and, over time, can damage blood vessels throughout your body. If the blood vessels in your kidneys are damaged, they may stop removing wastes and extra fluid from your body. The extra fluid in your blood vessels may then raise blood pressure even more. It's a dangerous cycle."

E4E Take

E4E thinks that the arrow of causality may be reversed. The above quote never addresses what caused the hypertension in the first place. I believe that blood factors damage arteries (inflammation), which causes hypertension. The damage to the blood vessels also damages the blood vessels in the kidneys. Once the blood vessels are damaged, I suspect that elevation of blood pressure can rupture blood vessels, leading to events like AAA and stroke. So if your blood vessels are already damaged, it might be worth using drugs to lower BP. In my paradigm though, that does not prevent further damage to the blood vessels, but might prevent a catastrophic event in the short term.

I would guess that the "high blood pressure causes bad things" paradigm is a relic of the history of medicine. They could measure it, so they did. They found a correlation, and rationalized a causality story.

I wonder if somewhere, there is primary research, perhaps in animals, in which the researchers elevated blood pressure prior to causing damage to the circulatory system, for example, with a small pump just past the exit from the heart to somehow elevate overall pressure. That might give us a sense of whether elevated BP actually causes damage to otherwise healthy blood vessels.

[Edit: For several days after this post, the issue of blood pressure has been rattling around in my brain. There is a circularity that has confounded me somewhat, so here is what I am thinking:

A damaged vascular system causes high blood pressure. Damaged blood vessels are more prone to failure. The damage creates the danger, and also elevated blood pressure. High blood pressure can, in turn, cause failure in damaged blood vessels.

In the absence of damage, high blood pressure is not dangerous; after all, systolic blood pressure can go over 300 in times of intense exercise. Moderately high blood pressure, e.g 140/90, is indicative that there is damage, but it may not have progressed yet to dangerous levels. It is important to do everything you can to prevent further damage that would drive your BP higher. Clean up your diet, lay off junk food, eat naturally nutritionally dense foods (not barren foods that are enriched), stick with natural fats (rather than highly-processed ones), layoff sugar, exercise

Drugs that lower BP do not repair or reverse the damage. They may help prevent or delay the catastrophic failure, but they do not fix the real problem, which is the damage to your arteries.

When a water main blows and floods city streets, we don't blame the pumps for creating the pressure, we blame the pipes. Blood pressure is analogous.]

Notes and Sources

Blood Pressure During Exercise

Blood pressure is determined by the force of the heart's contraction times the resistance in the blood vessels. Normal blood pressure is 120 when the heart contracts and 80 when it relaxes. During exercise, the heart beats with increased force to raise blood pressure. It is normal for blood pressure to rise up to 200 over 80 during running, and to 300 over 200 while doing a leg press with very heavy weights. If high blood pressure is bad, why is exercise good? Again, the pressure is not what causes damage, however, high blood pressure can cause ruptures of already damaged blood vessels.

Salt and Blood Pressure
The press and medical establishment has, for years, warned us to reduce salt intake to reduce our incidence of high blood pressure. Unless you have some kind of physical problem processing salt, your blood pressure might rise by up to 6 mm Hg after ingesting salt. Notice "might" and "up to" in the last sentence. Salt is not what causes your pressure to go from 120/80 to 160/100.

Recent New England Journal of Medicine paper on reductions of death that could result from reduction in salt intake.

This paper on the Hypertension Paradox addresses the fact that despite improved means to treat hypertension, it continues to increase in the population. It seems they are considering hypertension as a disease rather than as a symptom. This is the problem with agressive drug treatment of cholesterol as well.

Gary Taubes wrote an article in Science magazine entitled "The (Political) Science of Salt." (That is a free link. Science charges for the article.) The article is written in the vein of Good Calories, Bad Calories, and Taubes received the 1999 National Association of Science Writers' Science in Journalism Award award for writing it. His conclusions were that the research supports the concept that salt is, at most, the cause of a few point of blood pressure.

Here's what he said in this article in the Daily Bell:
"Daily Bell: Can you explain more about salt in diet and blood pressure, etc?"

"Taubes: For fifty years, researchers have been trying to causally link salt consumption to hypertension and the data has continued to be, at best, ambiguous. It's a nice hypothesis, but it just hasn't panned out in human trials or even, really, in the observational studies. On the other hand, it's been known since the 1870s that carbohydrates cause water retention and the more water you retain, simplistically speaking, the higher your blood pressure will be. It's been known since the 1950s that when people go on carbohydrate-restricted diets their blood pressure drops dramatically because of that water loss, and it's been known since the 1980s that one of the many things insulin does is regulate blood pressure. Moreover, hypertension is associated with obesity and diabetes so, in one sense, whatever causes obesity and diabetes also causes hypertension, and obesity and diabetes, as I explain in GCBC, are almost assuredly caused by the quality and quantity of carbohydrates in our diet."

From everything I can tell, high blood pressure is associated with cardiovascular disease--it is not a cause of the disease. Tom Naughton (creator of Fat Head) expressed a number of alternate hypotheses on the Fat Head blog.

  • "Refined carbohydrates produce high blood sugar and high levels of insulin, which in turn are both bad news for your arteries.  Refined carbohydrates also cause water retention, which raises your blood pressure.  (So if you really want to reduce your blood pressure, give up the sugar and starch.)"
  • "Blood pressure tends to go up as we get older.  (Mine hasn’t, but bear with me here.)  We’re also more likely to suffer heart attacks and strokes as we get older.
  • "Stress causes your body to produce more cortisol, which can damage your arteries.  Stress also raises your blood pressure.
  • "Eating lots of vegetables may be good for your heart.  Vegetables are also high in potassium, which lowers blood pressure."



John Briffa - Blood pressure is a symptom. Fixing the symptom may not fix the underlying problem.
John Briffa - is lower blood pressure always better? This report on a study that shows that lowering blood pressure below140/90 did not result in any changes to outcomes. Pressure was changed through chemical/medicinal means.

There has recently been a call to arms to reduce salt in food, under the premise that doing so will save "between 44,000 and 92,000" lives every year. The articles I read didn't go into detail, but the thinking in the past has gone something like this. (WebMD, New York Times, LA Times)
1. Salt causes high blood pressure
2. High blood pressure causes heart attack and stroke
3. Reduction in blood pressure of x points reduces probability of heart attack or stroke by y%
4. Therefore, reduction of salt will reduce deaths by total susceptible population * y%

Of the above points, the basic premises (1 and 2) are not supported by research and science. The extrapolation (3) is based on a correlation in the data with no implicit causality. The conclusion is just speculation that follows from 1, 2, and 3. Repeat after me "Correlation is not Causation."

The Diet Doctor blog

Bad Science leads to Bad Government

A related subject is the link between high blood pressure and heart disease and stroke. The latest class of anti-hypertensives, angiotensin II receptor antagonists, which includes such brands as Benicar, Cozaar, and Valtran, do a great job reducing blood pressure but the scientific evidence shows they do not decrease the incidence of myocardial infarction (heart attacks). The older ACE inhibitors, such as lisinopril, reduce blood pressure and also reduce the incidence of heart attacks and death, and they are also available for $0.11 a day. Read more at: http://www.huffingtonpost.com/dr-mark-hyman/why-cholesterol-may-not-b_b_290687.html

Recent Research
The British Medical Journal published a paper recently called Hypertension: empirical evidnece and implications in 2014. Their finding is that there is no evidence that reducing blood pressure in people with mild hypertension with antihypertensive therapy will reduce cardiovascular events or mortality.


Some Additional Links:

Insulin and Hypertension from an evolutionary  perspective


Tierney NYT article



Blood Pressure reduction does not reduce cardiovascular risk in Diabetics


There is a question about the impact of Isolated Diastolic hypertension, i.e. the  high number's low and the low number's high. The Wiley article below concludes that there is little evidence of danger from IDH. There is evidence that using aural measurement of BP (with a stethoscope) can result in systematically higher readings of BP. E4E wonders whether with accurate readings of the diastolic, this might be shown to have a high risk.

Isolated Diastolic Hypertension -

Another Isolated Diastolic Hypertension (Wiley) article - doesn't find much association with adverse issues.

04 August 2012

Book Review: Practical Paleo. The Missing Manual Is Now Out

Background:

The basic idea of paleo diets and lifestyles is that man evolved eating foods and with activity patterns different from what most of us have today. Many of the foods we eat and the activities we pursue today and for that last 10,000 years (since the dawn of agriculture) are not good for us. (More accurately, do not provide optimal health). With some changes to our lifestyles, we can achieve robust or optimal health.

I have mentioned in some of my previous posts on nutrition that paleo style eating is probably a good path, and I continue to believe that. Many people have trouble actually implementing the approach. They have recipe books that call for added sugar, or breading, or the oils called for in the recipes are not healthful ones.

Now Diane Sanfilppo has written a book called Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle. It is the missing manual for Paleo.

Bottom Line - E4E Take:

Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle  by Diane Sanfilippo contains the why, what, and how of a paleo, ancestral-style diet. It is well-organized, beautiful to behold, and contains a ton of great information.

Even if you do not buy into the whole paleo movement, you can't go wrong with this book. Robb Wolf does the foreword. I think he is a highly principled person who would not put his mark on anything less than a top-rate product. It has 30-day meal plans for various goals, and all the recipes and ingredient lists you need to back it up. And keep in mind that paleo is not about caveman re-enactment, the main point is to eat healthful, natural foods that are nutritionally dense. That is not a fad diet. It's a good diet.

The book seems aimed especially at newbies to paleo, but even people who have been paleo for a while will benefit from the meal plans (and the lifestyle suggestions) and the recipes.

I notice that the macronutrient (fat, protein, and carbohydrate) ratios she recommends are pretty consistent with what I have recommended in the past (I recommended a bit more protein and less fat than she does). So maybe I like it because of confirmation bias, but more interesting is that Diane gets there by concentrating on food quality rather than macronutrients.

This book is a tour de force. I am ordering copies for my my kids and some friends. Buy pre-release and you get a discount.

Full disclaimer: I received a review copy of the book pre-release at no charge. I recognize that this can induce a bias. I have no financial or other interest in the success of the book unless you click the links to Amazon in the post, and even then it would amount to less than $1.00.

If you do want to order this (or any) book, I encourage you to go to Latest in Paleo scroll down a little and launch your Amazon search session with the keywords "Practical Paleo" from there. He does a really good service to the paleo community and we might as well give him a buck instead of Amazon.

The Book:

Diane Sanfilippo of the BalancedBites website has released a new book called Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle.

The book is gorgeous, and even just thumbing through the book you are guaranteed to learn something.

It contains everything you need to know about living a more healthy life following paleo/ancestral principles.

Following is a rundown of the table of contents with some commentary:

There are three parts to the book.

Part 1: The Why - Food and Your Body
What is Paleo
Everything We've Been Taught About Good Nutrition is Wrong
Paleo at Home: Shopping for Groceries - includes some great lists of foods that are considered paleo and information about their quality
Paleo in Public: Restaurants and Parties
On the Go: On the Road or in the Air
Your Digestive System
Is Your Gut Leaky?
Blood Sugar Regulation
Frequently Asked Questions

In Part 1, Diane talks about what paleo is, why conventional recommendations are flawed, and provides a bunch of practical tips for shopping eating out, and what to do when you're not at home. Then she goes into some detail on the science of why it is important, specifically dealing with digestive/gut health and blood sugar regulation and how those are in turn related to cardiovascular health, neurological damage, etc.

She talks a lot about questions and potential objections to paleo, including calcium, fiber, anti-nutrients, inflammation,  and cholesterol. She has good references including Robb Wolf, Mat Lalonde, Alessio Fasano, and Chris Kresser (among others) and information. I believe that the science is good.

Part 2: 30-Day Meal Plans
Autoimmune Conditions
Blood Sugar Regulation
Digestive Health
Thyroid Health
Multiple Sclerosis, Fibromyalgia, and Chronic Fatigue
Neurological Health
Heart Health
Cancer Recovery
Athletic Performance
Fat Loss
Squeaky Clean Paleo

Each of these sections contains information on overall diet and lifestyle recommendations (what to include and avoid), supplements and herbs to consider, important nutrients, then 30 days of three meals per day. These are not necessarily 90 unique meals, she does include leftovers.

The practical approach of targeting specific issues is innovative and very useful.

Part 3: Recipes
Kitchen Basics
Breakfast
Poultry
Beef & Bison
Seafood
Lamb
Pork
Sides & Salads
Sauces & Dips
Treats & Sweets

Recipes are about half of the book with almost 200 pages (over 120 recipes). We have tried a few of them at home and so far, so good. Our favorite is the Italian-style stuffed peppers. I am confident that we will cook many meals form this book over time. The photography is excellent.

The author's FAQ can be found here.

Diane has:
a blog, Balanced Bites
a facebook page, and
a twitter account. ( @balancedbites )

 

14 January 2012

Book Review - Paleo Comfort Foods: Homestyle Cooking for a Gluten-Free Kitchen

This is my first book review on e4e.

Full disclaimer: I received the book as a gift from the authors. They offered a copy to volunteers at the recent Ancestral Health Symposium. I have no financial or other interest in the success of the book unless you click the link to Amazon at the bottom of the post.
 
If you do want to order this (or any) book, I encourage you to go to Latest in Paleo scroll down a little and launch your Amazon search session with the keywords "Paleo Comfort Foods" from there. He does a really good service to the paleo community and we might as well give him a buck instead of Amazon.

I have no conflict of interest, but there is a possible bias. They were very kind to offer this book for free, with no strings attached, but with encouragement to review the book on Amazon and/or Barnes and Noble. so I am well-disposed to the book in the first place.



Paleo Comfort Foods: Homestyle Cooking for a Gluten-Free Kitchen

One of the challenges with following a low carb, paleo, or any unusual diet is the social aspect of it. There are always recipe books available, but in the end, the food is just... different. This book "Paleo Comfort Foods" gives us a way around that. The recipes yield highly palatable food that look normal. They do this by substituting  ingredients like almond or coconut flour for normal flour found in standard recipe books.

This book is excellent. The food recommendations are aligned pretty well with the e4e recommendations. It has a lot of foods that look like standard comfort foods. Your Aunt Mildred from Dubuque would recognize most of the dishes. However, what she wouldn't know is that those mashed potatoes are really cauliflower, and that the breading on the chicken is almond flour. If you want to follow a paleo diet (stay away from grains, added sugars, and processed seed oils) yet still wish to function in a world of people who do not follow that way of eating, this book provides a perfect bridge.

It is an impressive book. The photos are beautiful. The cover has a photo of fried chicken, mixed vegetables and what looks like mashed potatoes and gravy. But looks can be deceiving. The mashed potatoes are cauliflower, the fried chicken has an almond flour coating and was fried in coconut oil.

It is not a low carb cookbook per se, but rather is good real food, with carbohydrates coming mainly from vegetables, fruit, and root vegetables, such as sweet potatoes.

Recipes:
The book is in six sections
1. starters and snacks: examples - spicy salmon salad or dip, devilish eggs, maryland crab cakes, bacon-wrapped dates
2. sauces and staples: chimichurri, not peanut sauce, paleo mayonaisse, cave ketchup, turkey gravy
3. soups and salads: creamy caesar salad, gingered butternut squash salad, chicken tomatillo stew
4. on the side: mashed cauliflower; creamed spinach; scattered, smothered and chunked sweet hash, sweet potato spears, dirty cauliflower "rice"
5. main dishes: green eggs and turkey, ham and egg cups, chicken breasts with mushroom sauce, chicken enchiladas, fried chicken, cedar-plank chipotle salmon
6. desserts: banana nut bread, strawberry shortcakes, jules' banana pudding, sweet potato pie, luscoius lemon squares

Also Robb Wolf does the foreword, there is a section on foods to keep around the house, and a section on essential kitchen tools.

Bottom Line: We have tried a half dozen recipes from this book. All have been great.  (One suggestion though--if you make the decadent chocolate cake with a kick, dial back a little on the pepper). I heartily recommend this book.


A few final words:
Kurt Harris of the Archevore blog might disapprove of this book as being akin to smoking candy cigarettes. That is by creating food in the form of unhealthy foods we encourage people around us to eat those unhealthy foods. From a purist standpoint, I see where he's coming from. But sometimes, we just don't want to have to explain our choices to people.


08 August 2011

Ancestral Health Symposium Notes

I have just attended an amazing event--the Ancestral Health Symposium. It was an incredible few days. I want to tell you all about it, but have no idea where to start, so I'll just wade in.

What Is It?

A two day conference held on the UCLA Campus on August 5 and 6. The conference featured many presentations about the "Paleo" diet and exercise (all the talks will be put online over the next few months). In some of my posts on diet, I have mentioned this philosophy, so I'll start with some of the basics.

Ancestral Framework

There is not at present a standards committee that declares what is and isn't paleo. I think of it more as a framework for thinking about what is healthy for us. The idea is that, fundamentally, humans are the product of millions and millions of years of evolution. We have both very primitive and very sophisticated chemical signaling systems in our body. Our bodies evolved through many different environments and circumstances.

In the last few hundred years, and especially in the last 30 or so years, we seem to be falling apart as a species. Worldwide, obesity and diabetes are skyrocketing. A key hypothesis behind this ancestral health movement is that the foods introduced into our collective diet, since the dawn of agriculture, and especially in the past few hundred years is literally killing us. It is becoming increasingly evident that although we are living longer, we are doing so with lower health than ever before.

Much of the press and publicity for this approach to health have focused on caveman re-enactment and Fred Flintstone slabs of beef. That is simply not the point of the Ancestral Health movement. In any event

Ancestral Diet

Defining the paleo diet is easiest to do by exclusion:
1. Eliminate refined sugar, limit highly concentrated natural natural sugars
2. Eliminate grains in general
3. Eliminate oils from seeds, e.g. canola, cottonseed, and corn oil

Within the paleo community, some say you should go further and
4. Eliminate legumes i.e. beans
5. Eliminate dairy and dairy products

What remains then is animal products (muscle, organs, and fat from animals including fish, fowl, beef, pork), vegetables (both starchy and green leafy), fruit (whole fruit, not juice), nuts.

Because so many foods have changed so much in the last 10,000 years, (the advent of agriculture), we can really only guess at the specific nutrients in paleo-man's diet. There is a general consensus in the community that it is best if the animals that you eat, eat their natural diets, e.g. grass fed beef, wild-caught fish. The community also seems to believe that omega-6 oils are more prone to oxidation than other oils, so fish oil supplementation or reduction of the omega-6 oils in the diet are important. Let's not forget the importance of sunshine.

The community tends towards some degree of variability to mimic ancient patterns e.g. there were not strawberries year round in our distant past, so eating seasonally may have value; periodic fasts without food whether for 16 hours or a few days are probably something we can handle without undue problems and that might even have benefits.

In its current incarnation the paleo community has rallied around a self-experimentation paradigm. It's not "anything goes", but rather within the above guidelines, try different approaches and see what works for you.

I will put out some more details on diet and some revisions to the E4E recommendations in the near future.

Ancestral Exercise

There is much less consensus around and focus on what constitutes true paleo exercise and how to gain benefits related to that. I would say that in general, there is less emphasis on "chronic cardio" and more emphasis on periodic intensity in exercise, as well as natural movement (running, jumping, climbing).

Interesting Talks

The conference was announced about a year ago and when tickets went on sale, I started to try to arrange my schedule, etc. I waited a little too long, so by the time I tried to buy a ticket, the conference was sold out. However, they needed volunteers, so I was able to participate as a volunteer. I was present but working for many of the talks and had down time as well to focus on them.

Here is a list of the talks that I really liked and that people seemed to be buzzing about:
Denise Minger - How to Argue with a Vegetarian
Nora Gedgaudis - lots of amazing stuff on mind-body integration
Tom Naughton - entertaining talk on bad science
Erwan LeCorre - moving naturally
Melissa McEwen - clues from the colon (humans are unique)
Emily Deans and Jamie Scott - the rainforest in your gut
Dr. BG and Tim Gerstmar - curing autism through diet
Pedro Bastos - Dairy
Robert Lustig - Fructose and Leptin
Mat Lalonde - heavy chemistry talk, but the real message was that paleo needs to go beyond caveman and have really good science
Andreas Eenfeldt - Sweden's experience with lower carb as their national paradigm
Richard Nikoley - representing the blogosphere, how he has used self-experimentation to lose 70 pounds and become a better animal

All the talks will go on the internet. They will first be uploaded in raw form, but later with some editing and polish. I have little information beyond these talks. I was either not in on the buzz, they were rehashing old material, or possibly were not well received.

In the meantime, here are some other bloggers' takes on the event.
http://ethicaleats.blogspot.com/2011/08/woodstock-of-evolutionary-medicine-part.html
http://naturallyengineered.com/blog/?p=4725
http://livinlavidalowcarb.com/blog/must-hear-podcast-interviews-after-attending-the-2011-ancestral-health-symposium/11446
http://jackkruse.com/my-very-fresh-initial-thoughts-of-ahs-2011/
http://www.mattmetzgar.com/matt_metzgar/2011/08/back-from-ahs.html
http://whole9life.com/2011/08/whole9-goes-to-the-ahs/
http://blog.cholesterol-and-health.com/2011/08/reflections-on-ancestral-health.html
http://www.wildnessandwonder.com/2011/08/initial-thoughts-from-the-ancestral-health-symposium/
http://perfecthealthdiet.com/?p=4244
http://evolutionarypsychiatry.blogspot.com/2011/08/ahs-people-post.html?spref=tw


E4E Experience

I met and spoke with a lot of people while there. I was extremely gratified and thrilled at how many were familiar with this blog. I have no illusions about its place in the blogosphere, but there were a few conversations of note.

J. Stanton of gnolls.org, author of The Gnoll Credo, saw my name tag and told me that he had sent someone to my gout post and that a month later the man was free of gout. The person had made a number of changes, but my gout post was a reference for him.

Another person I met was Krista Scott-Dixon, whose work I have perused for years. She has long been a proponent of women lifting actual weights (not the pink ones). Her dork to diva series is really good and she has put out lots of good information through the years. She is also editor-in-chief of Spezzatino. I introduced myself to her, she told me that she knew about E4E and in fact had used one of my posts (I think this one) with one of her clients. I was totally thrilled that someone who I have followed through he years was familiar with my stuff.

Finally, I shared a house for the three nights with a really cool group of people from the Bay Area including a few fellow bloggers, so check out An Omnivore's Decision and Primal Girl in a Modern World. Thanks to Tess for doing all the work to get the house lined up.

I will also thank US Wellness Meats for saving my (figurative) bacon from the fast food in the student union at UCLA. The beef sticks and jerky made me tingle in the best possible way.

I feel really energized after hearing the E4E feedback from people, listening to the amazing talks, and all the geeky discussions. Over the coming months, as the edited lectures become available, I plan to highlight some of the key ones.

Stay tuned.

22 July 2011

My Voice on the Internets - Jimmy Moore Low Carb Conversations

Jimmie Moore and Mindy Noxon Iannotti spoke with Kim Bosold and me a few weeks ago on Jimmy's newest podcast endeavor "Low Carb Conversations." Hear the discussion at this link.

Here is my most recent post extolling my dietary perspective.

My take on a recent JAMA letter  Proposing real food.

Here is my take on Gout.

Some of my relationship posts get a lot of hits too.
Feelings are Facts
The Nature of Love 1
The Nature of Love 2
Emotional Needs In a Relationship
More on Needs In a Relationship

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I hope you enjoy!