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This page contains abstracts and articles in PDF Click here to download PDF reader All materials on these pages are protected. These articles are available to you as single copies for your personal use. Do not sell or redistribute. Copyright © 1997-2008 Dr. Loren Cordain. All rights reserved.
39. Treloar V, Logan Ac, Danby FW, Cordain L, Mann NJ. Comment on acne and glycemic index. J Am Acad Dermatol. 2008 Jan; 58(1): 175-7.
38. Eaton SB, Cordain L, Sebastian A. The Ancestral Biomedical Environment In: Endothelial Biomedicine. W.C. Aird (Ed), Cambridge University Press, 2007, pp. 129-134.
37. Cordain L. Dietary implications for the development of acne: a shifting paradigm. In:
36.Cordain L., Hickey MS. Ultraviolet radiation represents an evolutionary selective pressure for the south-to-north gradient of the MTHFR 677TT genotype. Am J Clin Nutr 2006;84:1243.
35.Cordain L. Implications of Plio-Pleistocene Hominin Diets for Modern Humans. In: Early Hominin Diets: The Known, the Unknown, and the Unknowable. Ungar, P (Ed.), Oxford University Press, Oxford, 2006, pp 363-83 ABSTRACT Within the anthropology community, there has been a long and sustained interest in the diets and eating patterns of Plio and Pleistocene hominins, primarily because these nutritional practices provide a glimpse into their varied and distinctive lifeways, activities, and cultural patterns. In contrast, until relatively recent times, the nutritional and medical communities have largely ignored anthropological dietary information for a variety of reasons, not the least of which is its perceived lack of immediate relevance to their respective disciplines. Beginning in the mid 1980s, a series of key publications in mainstream medical and nutrition journals (Eaton and Konner, 1985; Eaton, Konner, and Shostak, 1988; Eaton and Nelson, 1991; Eaton,1992) triggered an increased awareness of the relevance of ancestral diets to the health and well being of modern peoples. Because of that insight as well as others gleaned from a variety of medical branches of learning, an entirely new academic discipline was born, dubbed “evolutionary medicine” (Williams and Neese, 1991), or sometimes “Darwinian medicine” (Williams and Nesse, 1991). The primary tenet of evolutionary medicine is that the profound changes in the environment (e.g., in diet and other lifestyle conditions), which began with the introduction of agriculture and animal husbandry approximately 10,000 years ago, occurred too recently on an evolutionary timescale for natural selection to adjust the human genome (Eaton and Konner, 1985; Williams and Neese, 1991). In conjunction with this discordance between our ancient (millions of years ago), genetically determined biology and the nutritional, cultural, and activity patterns of contemporary western populations, many of the so-called diseases of civilization have emerged (Eaton, Konner, and Shostak, 1988; Williams and Neese, 1991).
ABSTRACT This editorial outlines the data supporting aggressive lipid goals and options for treating low-density lipoprotein (LDL) cholesterol to a range of approximately 30 to 70 mg/dl. The physiologically normal cholesterol range is approximately 30 to 70 mg/dl for native hunter-gatherers, healthy human neonates, free-living primates, and virtually all wild mammals. Randomized statin trials in patients with recent acute coronary syndromes and stable coronary artery disease have demonstrated that cardiovascular events are reduced and cardiovascular survival optimized when LDL cholesterol is reduced to <70 mg/dl. Secondary prevention trials have shown a decrease in all-cause mortality in proportion to the magnitude of LDL cholesterol reduction. An original analysis of available data shows that the ability of a lipid-lowering therapy to reduce the C-reactive protein level is closely correlated with its efficacy in LDL cholesterol reduction. Randomized trial data have shown no relation between either percentage LDL cholesterol decrease or final LDL cholesterol level achieved and the risk for myopathy or hepatic transaminase elevations associated with statins. Therefore, intensive LDL cholesterol reduction to levels of 30 to 70 mg/dl should be pursued in subjects with or at high risk for coronary artery disease.
33. Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes. In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126. No abstract
32. Abuissa H, O’Keefe JH, Cordain, L. Realigning our 21st century diet and lifestyle with our hunter-gatherer genetic identity. Directions Psych 2005;25: SR1-SR10. No abstract
31. Cordain, L. Implications for the role of diet in acne. Semin Cutan Med Surg 2005;24:84-91. ABSTRACT Within the dermatology community, a general consensus has emerged that diet is unrelated to the etiology of acne. Except for 2 poorly designed studies, now more than 30 years old, there are few objective data to support this notion. In contrast, a large body of evidence now exists showing how diet may directly or indirectly influence the following 5 proximate causes of acne: (1) increased proliferation of basal keratinocytes within the pilosebaceous duct, (2) incomplete separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct, (3) androgen-mediated increases in sebum production, (4) colonization of the comedo by Propionibacterium acnes, and (5) inflammation both within and adjacent to the comedo. This article will provide a review of the currently available literature on the association between diet and acne vulgaris as well as a discussion of the physiologic principles that may underlie this association.
30. Hoyt G, Hickey MS, Cordain L. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr 2005;93:175-177. ABSTRACT In most carbohydrate-containing foods, the blood insulin response is predictable and is closely linked to the food’s glycemic index (GI). A single study, examining whole milk and fermented milk products made from whole milk, recently reported a large dissociation between the GI and insulinemic index (II) in healthy normals. Because the fat component of a food may influence the GI and II, it is unclear if a similar dissociation may exist for skim milk in normals. We determined the GI and II of both skim and whole milk in nine healthy, male (n=6) and female (n=3) subjects (23.6 ± 1.4 years). No significant (p>0.05) differences existed between GI and II for skim and whole milks. Significant (p<0.05) differences were observed between the actual and predicted areas under the insulin curves for both skim milk (predicted 1405 ± 289 pmol-min/L; actual 6152 ± 1177 pmol-min/L) and whole milk (predicted 1564 ± 339 pmol-min/L; actual 5939 ± 1095 pmol-min/L). Consequently, a large and similar dissociation of the GI and II existed for both whole milk (42 ± 5 and 148 ± 14) and skim milk (37 ± 9 and 140 ± 13). It is concluded that the dissociation of the GI and II in milk is not related to its fat content.
29. Loren Cordain, S. Boyd Eaton, Anthony Sebastian, Neil Mann, Staffan Lindeberg, Bruce A. Watkins, James H. O’Keefe, Janette Brand Miller. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54. ABSTRACT There is growing awareness that the profound changes in the environment (e.g., in diet and other lifestyle conditions) that began with the introduction of agriculture and animal husbandry approximately 10,000 years ago occurred too recently on an evolutionary timescale for the human genome to adjust. In conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural and activity patterns of contemporary western populations, many of the so-called diseases of civilization have emerged. In particular, food staples and food processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered seven crucial nutritional characteristics of ancestral hominin diets: 1) glycemic load, 2) fatty acid composition, 3) macronutrient composition, 4) micronutrient density, 5) acid/base balance, 6) sodium/potassium ratio, and 7) fiber content. The evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of western civilization.
29a. This material includes comments about the article above and a reply by Dr. Cordain and his colleagues. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Reply to SC Cunnane. Am J Clin Nutr 2005;82:483-84.
28. O'Keefe JH, Cordain L, Harris, WH, Moe RM, Vogel R. Optimal low-density lipoprotein is 50 to 70 mg/dl. Lower is better and physiologically normal. J Am Coll Cardiol 2004;43: 2142-6. ABSTRACT The normal low-density lipoprotein (LDL) cholesterol range is 50 to 70 mg/dl for native hunter-gatherers, healthy human neonates, free-living primates, and other wild mammals (all of whom do not develop atherosclerosis). Randomized trial data suggest atherosclerosis progression and coronary heart disease events are minimized when LDL is lowered to <70 mg/dl. No major safety concerns have surfaced in studies that lowered LDL to this range of 50 to 70 mg/dl. The current guidelines setting the target LDL at 100 to 115 mg/dl may lead to substantial undertreatment in high-risk individuals.
27. Lindeberg S, Cordain L, Rastam L, Ahren B. Serum uric acid in traditional Pacific Islanders and in Swedes. J Intern Med. 2004 Mar;255(3):373-8. ABSTRACT BACKGROUND: In some western populations, increased serum uric acid has been positively associated with cardiovascular disease, possibly because hyperuricaemia could be an untoward part of the insulin-resistant metabolic syndrome. However, there is evidence that uric acid is a free radical scavenger capable of inhibiting LDL oxidation. Amongst the traditional horticulturalists of Kitava, Trobriand Islands, Papua New Guinea, cardiovascular disease, hypertension, hyperinsulinaemia and abdominal obesity are absent or rare. In contrast, serum triglycerides are similar to Swedish levels. OBJECTIVE: To compare serum uric acid between nonwesternized and westernized populations. METHODS: Fasting levels of serum uric acid were measured cross-sectionally in 171 Kitavans aged 20-86 years and in 244 randomly selected Swedish subjects aged 20-80 years. RESULTS: There were small differences in serum uric acid between the two populations, although a slight increase with age was found only in Swedish males (r = 0.20; P = 0.03) and females (r = 0.36; P < 0.0001). Above 40 years of age, uric acid was approximately 10% lower in Kitavans, a difference which was statistically significant only in males, possibly because of the limited number of females. Regarding hyperuricaemia, two Kitavan males had uric acid above 450 micromol L-1 whilst none of the females was above 340 micromol L-1. Amongst the Swedish subjects, five of 117 males and 19 of 127 females had hyperuricaemia according to these definitions. CONCLUSION: The rather similar uric acid levels between Kitava and Sweden imply that uric acid is of minor importance to explain the apparent absence of cardiovascular disease in Kitava.
26. O'Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clin Proc 2004 Jan;79(1):101-8. ABSTRACT Our genetic make-up, shaped through millions of years of evolution, determines our nutritional and activity needs. Although the human genome has remained primarily unchanged since the agricultural revolution 10,000 years ago, our diet and lifestyle have become progressively more divergent from those of our ancient ancestors. Accumulating evidence suggests that this mismatch between our modern diet and lifestyle and our Paleolithic genome is playing a substantial role in the ongoing epidemics of obesity, hypertension, diabetes, and atherosclerotic cardiovascular disease. Until 500 generations ago, all humans consumed only wild and unprocessed food foraged and hunted from their environment. These circumstances provided a diet high in lean protein, polyunsaturated fats (especially omega-3 [ω-3] fatty acids), monounsaturated fats, fiber, vitamins, minerals, antioxidants, and other beneficial phytochemicals. Historical and anthropological studies show hunter-gatherers generally to be healthy, fit, and largely free of the degenerative cardiovascular diseases common in modern societies. This review outlines the essence of our hunter-gatherer genetic legacy and suggests practical steps to re-align our modern milieu with our ancient genome in an effort to improve cardiovascular health.
26a. This "article" is a response written by Dr. Cordain to a letter about the article above, Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Please click on the item below for a complete viewing of the material.
25. Lindeberg S, Cordain L, and Eaton SB. Biological and clinical potential of a Paleolithic diet. J Nutri Environ Med 2003; 13(3):149-160. ABSTRACT PURPOSE: To explore the possibility that a Paleolithic diet, i.e. one that corresponds to what was available in any of the ecological niches of pre-agricultural humans (1.5 million-10,000 years BP), is optimal in the prevention of age-related degenerative disease. DESIGN: Literature review. MATERIALS AND METHODS: Between 1985 and December 2002, more than 200 scientific journals in medicine, nutrition, biology and anthropology were systematically screened for relevant papers. Computer-based searches and studies of reference lists in journals and books provided a vast number of additional papers. RESULTS: Increasing evidence suggests that a Paleolithic diet based on lean meat, fish, vegetables and fruit may be effective in the prevention and treatment of common Western diseases. Avoiding dairy products, margarine, oils, refined sugar and cereals, which provide 70% or more of the dietary intake in northern European populations, may be advisable. Atherosclerosis is highly dependent on dietary manipulation in animal experiments. Atherogenic dietary factors include fat (any type) and casein, and hypothetically cereals. Stroke, ischemic heart disease and type 2 diabetes seem largely preventable by way of dietary changes in a Paleolithic direction. And insulin resistance, which may have far-reaching clinical implications as a cause of unregulated tissue growth, may also respond to an ancestral diet. CONCLUSIONS: Lean meat, fish, vegetables and fruit may be optimal, rather than a strictly vegetarian diet, in the prevention of cardiovascular disease, diabetes and insulin resistance.
24. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization: more than just syndrome X. Comp Biochem Physiol Part A 2003;136:95-112. ABSTRACT Compensatory hyperinsulinemia stemming from peripheral insulin resistance is a well recognized metabolic disturbance that is at the root cause of diseases and maladies of Syndrome X (hypertension, type 2 diabetes, dyslipidemia, coronary artery disease, obesity, abnormal glucose tolerance). Abnormalities of fibrinolysis and hyperuricaemia also appear to be members of the cluster of illnesses comprising Syndrome X. Insulin is a well established growth promoting hormone, and recent evidence indicates that hyperinsulinemia causes a shift in a number of endocrine pathways that may favor unregulated tissue growth leading to additional illnesses. Specifically, hyperinsulinemia elevates serum concentrations of free insulin like growth factor 1 (IGF-1) and androgens while simultaneously reducing insulin like growth factor binding protein 3 (IGFBP-3) and sex hormone binding globulin (SHBG). Since IGFBP-3 is a ligand for the nuclear retinoid X receptor α, insulin mediated reductions in IGFBP-3 may also influence transcription of anti-proliferative genes normally activated by the body’s endogenous retinoids. These endocrine shifts alter cellular proliferation and growth in a variety of tissues whose clinical course may promote acne, early menarche, certain epithelial cell carcinomas, increased stature, myopia, cutaneous papillomas (skin tags), acanthosis nigricans, polycystic ovary syndrome (PCOS) and male vertex balding. Consequently, these illnesses and conditions may, in part, have hyperinsulinemia at their root cause and therefore should be classified among the diseases of Syndrome X.
23. Lindeberg S, Ahren B, Nilsson A, Cordain L, Nilsson-Ehle P, Vessby B. Determinants of serum triglycerides and high-density lipoprotein cholesterol in traditional Trobriand Islanders: the Kitava Study. Scand J Clin Lab Invest 2003; 63: 175-180. ABSTRACT OBJECTIVES: To analyze variables explaining the variation between serum triglycerides (TGs) and high density lipoprotein cholesterol (HDL-C) in a non-western population characterized by unfavorable TG and HDL-C levels despite marked leanness, low blood pressure and low fasting serum insulin. The study subjects included traditional Pacific Islanders from Kitava, Trobriand Islands, Papua New Guinea and a population in Sweden. METHODS: The study was designed as a cross-sectional survey. Fasting serum lipoproteins and apolipoproteins, insulin, blood pressure and anthropometric measurements were analyzed in 122 male and 47 female Kitavans aged 20 - 86 years and in a control population of 729 healthy men and women aged 20-66 from Uppsala. Main outcome measures were determinants of TG and HDL-C using a simple and multiple linear regression analysis. RESULTS: A negative association was found between TGs and HDL-C in Kitava (r = -0.38, p < 0.0001) and Sweden (r = -0.46, p < 0.0001), while TGs were positively associated with non-HDL-C and ApoB in both groups. In contrast to what was found in the Swedish subjects, TG and HDL-C levels were not associated with body mass index, waist circumference, glucose, insulin or systolic blood pressure in the Kitavans. CONCLUSION: Despite an apparent absence of cardiovascular disease and the metabolic syndrome in the Kitavans, the relationship between TGs and HDL-C was similar to that observed in Caucasians, while neither of the variables was associated with markers of insulin sensitivity in the Kitavans. Whether the findings can be explained by normal physiology or partially reflect the high intake of carbohydrates and saturated fat in Kitava is uncertain.
22. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: A disease of western civilization. Arch Dermatol 2002; 138:1584-90. ABSTRACT BACKGROUND: In westernized societies, acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population. In men and women older than 25 years, 40% to 54% have some degree of facial acne, and clinical facial acne persists into middle age in 12% of women and 3% of men. Epidemiological evidence suggests that acne incidence rates are considerably lower in nonwesternized societies. Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Ache hunter-gatherers of Paraguay. Additionally, we analyze how elements in nonwesternized environments may influence the development of acne. OBSERVATIONS: Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne (grade 1 with multiple comedones or grades 2-4) was observed. Of 115 Ache subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne (grades 1-4) was observed. CONCLUSIONS: The astonishing difference in acne incidence rates between nonwesternized and fully modernized societies cannot be solely attributed to genetic differences among populations but likely results from differing environmental factors. Identification of these factors may be useful in the treatment of acne in Western populations.
22a. This "article" includes a series of letters written in response to the publication of the article above, Acne vulgaris: A disease of western civilization, and Dr. Cordain's response. Please click on all three items below for a complete viewing of all the material.
21. Cordain L, Eaton SB, Brand Miller J, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: Meat based, yet non-atherogenic. Eur J Clin Nutr 2002; 56 (suppl 1):S42-S52. ABSTRACT Field studies of 20th century hunter-gatherers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). Consequently, the characterization of HG diets may have important implications in designing therapeutic diets that reduce the risk for CVD in westernized societies. Based upon limited ethnographic data (n = 58 HG societies) and a single quantitative dietary study, it has been commonly inferred that gathered plant foods provided the dominant energy source in HG diets. In this review we have analyzed the 13 known quantitative dietary studies of HG and demonstrate that animal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). This data is consistent with a more recent, comprehensive review of the entire ethnographic data (n = 229 HG societies) that showed the mean subsistence dependence upon gathered plant foods was 32%, whereas it was 68% for animal foods. Other evidence including: isotopic analyses of Paleolithic hominid collagen tissue, reductions in hominid gut size, low activity levels of certain enzymes, and optimal foraging data all point toward a long history of meat based diets in our species. Because increasing meat consumption in western diets is frequently associated with increased risk for CVD mortality, it is seemingly paradoxical that HG societies, who consume the majority of their energy from animal food, have been shown to be relatively free of the signs and symptoms of CVD. The high reliance upon animal based foods would not have necessarily elicited unfavorable blood lipid profiles because of the hypolipidemic effects of high dietary protein (19-35% energy) and the relatively low level of dietary carbohydrate (22-40% energy). Although fat intake (28-58% energy) would have been similar to or higher than that found in western diets, it is likely that important qualitative differences in fat intake, including relatively high levels of MUFA and PUFA and a lower ω-6/ω-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD.
20. Cordain L, Watkins BA, Florant GL, Kehler M, Rogers L, Li Y. Fatty acid analysis of wild ruminant tissues: Evolutionary implications for reducing diet-related chronic disease. Eur J Clin Nutr, 2002; 56:181-191. ABSTRACT Consumption of wild ruminant fat represented the primary lipid source for pre-agricultural humans. Hence, the lipid composition of these animals’ tissues may provide insight into dietary requirements that offer protection from chronic disease in modern humans. We examined the lipid composition of muscle, brain, marrow and subcutaneous adipose tissue (AT) from 17 elk (Cervus elaphus), 15 mule deer (Odocoileus hemionus), and 17 antelope (Antilicapra americana) and contrasted them to wild African ruminants and pasture and grain-fed cattle. Muscle fatty acid (FA) was similar among North American species with polyunsaturated fatty acids/saturated fatty acids (P/S) values from (0.80 to 1.09) and n-6/n-3 FA from (2.32 to 2.60). Marrow FA was similar among North American species with high levels (59.3-67.0%) of monounsaturated FA; a low P/S (0.24 to 0.33), and an n-6/n-3 of (2.24 to 2.88). Brain had the lowest n-6/n-3 (1.20 to 1.29), the highest concentration of 22:6 n-3 (elk 8.90%; deer 9.62%; antelope 9.25%) and a P/S of 0.69. AT had the lowest P/S (0.05 to 0.09) and n-6/n-3 (2.25 to 2.96). Conjugated linoleic acid (CLA) isomers were found in marrow of antelope (1.5%), elk (1.0%), and deer (1.0%), in AT (deer 0.3%; antelope 0.3%) in muscle (antelope 0.4%; elk, trace), but not in brain. Literature comparisons showed tissue lipids of North American and African ruminants were similar to pasture-fed cattle, but dissimilar to grain-fed cattle. The lipid composition of wild ruminant tissues may serve as a model for dietary lipid recommendations in treating and preventing chronic disease.
19. Cordain L, Eaton SB, Brand Miller J, Lindeberg S, Jensen C. An evolutionary analysis of the etiology and pathogenesis of juvenile-onset myopia. Acta Ophthalmologica Scandinavica, 2002; 80:125-135. ABSTRACT The available evidence suggests that both genes and environment play a crucial role in the development of juvenile-onset myopia. When the human visual system is examined from an evolutionary perspective, it becomes apparent that humans, living in the original environmental niche for which our species is genetically adapted (as hunter-gatherers), are either slightly hypermetropic or emmetropic and rarely develop myopia. Myopia occurs when novel environmental conditions associated with modern civilization are introduced into the hunter-gatherer lifestyle. The excessive near work of reading is most frequently cited as the main environmental stressor underlying the development of myopia. In this review we point out how a previously unrecognized diet-related malady (chronic hyperinsulinaemia) may play a key role in the pathogenesis of juvenile-onset myopia because of its interaction with hormonal regulation of vitreal chamber growth.
18. Eaton SB, Strassman BI, Nesse RM, Neel JV, Ewald PW, Williams GC, Weder AB, Eaton SB 3rd, Lindeberg S, Konner MJ, Mysterud I, Cordain L. Evolutionary health promotion. Prev Med 2002; 34:109-118. ABSTRACT Health promotion's promise is enormous, but its potential is, as yet, unmatched by accomplishment. Life expectancy increases track more closely with economic prosperity and sanitary engineering than with strictly medical advances. Notable achievements in the past century--the decreased incidences of epidemic infections, dental caries, and stomach cancer--are owed to virologists, dentists, and (probably) refrigeration more than to physicians. Prevention speaks against tobacco abuse with a single voice, but in many other areas contradictory research findings have generated skepticism and even indifference among the general public for whom recommendations are targeted. Health promotion's shortcomings may reflect lack of an overall conceptual framework, a deficiency that might be corrected by adopting evolutionary premises: (1) The human genome was selected in past environments far different from those of the present. (2) Cultural evolution now proceeds too rapidly for genetic accommodation--resulting in dissociation between our genes and our lives. (3) This mismatch between biology and lifestyle fosters development of degenerative diseases. These principles could inform a research agenda and, ultimately, public policy: (1) Better characterize differences between ancient and modern life patterns. (2) Identify which of these affect the development of disease. (3) Integrate epidemiological, mechanistic, and genetic data with evolutionary principles to create an overarching formulation upon which to base persuasive, consistent, and effective recommendations.
17. Eaton SB, Cordain L. Evolutionary Health Promotion. A consideration of common counter-arguments. Prev Med 2002; 34:119-123. ABSTRACT The proposal that Late Paleolithic (50,000-10,000 BP) ancestral experience might serve as a model for prevention research and even, if justified by experiment, as a paradigm for health promotion recommendations is sometimes discounted, before critical assessment, because of reservations based on unjustified preconceptions. Most often such biases involve comparative life expectancy, potential genetic change since agriculture, the heterogeneity of ancestral environments, and/or innate human adaptability. This paper examines these topics and attempts to show that none of them justifies a priori dismissal of the evolutionary approach to preventive medicine. Evolutionary health promotion may ultimately be invalidated because of its falsification by experiment or because another theory accords better with known facts, but these commonly held prejudices should not forestall its thoughtful consideration and investigative evaluation.
16. Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24. ABSTRACT PURPOSE: The intent of the present study was to examine the nutritional characteristics of a contemporary diet based upon Paleolithic food groups and to determine how these characteristics may impact the risk of chronic disease. METHODS: Nutritional software was employed to ascertain the macro and trace nutrient characteristics of a diet composed of commonly available modern foods, but devoid of processed foods, dairy products and cereal grains. The relative contribution of plant and animal foods to the experimental diet was based upon average values previously determined in 229 hunter gatherer societies. RESULTS: The analysis revealed that except for vitamin D, which would have been supplied by endogenous synthesis in hunter gatherers, it is entirely possible to consume a nutritionally balanced diet from contemporary foods that mimic the food groups and types available during the Paleolithic. Despite the elimination of two major food groups, the trace nutrient density of the experimental diet remained exceptionally high. The macronutrient content of the experimental diet (38 % protein, 39 % fat, 23 % carbohydrate by energy) varied considerably from current western values. CONCLUSIONS: Contemporary diets based upon Paleolithic food groups maintained both trace and macronutrient qualities known to reduce the risk of a variety of chronic diseases in western populations.
15. Cordain L, Brand Miller J, Eaton SB, Mann N. Reply to ARP Walker. Am J Clin Nutr 2001; 73:354-55. No abstract
14. Cordain L. Syndrome X: Just the tip of the hyperinsulinemia iceberg. Medikament 2001; 6:46-51. ABSTRACT When body tissues become resistant to insulin the pancreas is frequently able to maintain normal glucose tolerance by sustaining a relative degree of compensatory hyperinsulinemia. The onset of impaired glucose tolerance or type 2 diabetes marks a failure of the pancreas to maintain this state of compensatory hyperinsulinemia. Compensatory hyperinsulinemia is not necessarily benign and underlies several of the most common and deadly chronic diseases in western, industrialized nations. Hypertension, abnormal glucose tolerance, type 2 diabetes, dyslipidemia [increased plasma triacylglycerol, decreased high density lipoproteins, and smaller, denser low density lipoproteins] , coronary artery disease (CAD), and obesity, are all linked to insulin resistance and have been collectively termed syndrome X (1,2). Abnormalities of fibrinolysis and hyperuricaemia also appear to be members of the cluster of maladies comprising syndrome X (2). Because insulin resistance is such a common phenomenon (afflicting at least 25 %) of the population, it has been suggested that the various facets of syndrome X are involved to a substantial degree in the cause and clinical course of the major diseases of Western civilization (2). In the past 2 years emerging evidence suggests that the web of diseases and abnormalities associated with insulin resistance may extend far beyond the common maladies (obesity, type 2 diabetes, hypertension, dyslipidemia and CAD) that frequently present themselves concurrently in patients. Such diverse abnormalities and illnesses as polycystic ovary syndrome (PCOS), acne, myopia, epithelial cell cancers (breast, prostate and colon), reduced age of menarche and the secular trend for increased stature are all linked to the compensatory hyperinsulinemia of insulin resistance by hormonal interaction.
13. Cordain L, Watkins BA, Mann NJ. Fatty acid composition and energy density of foods available to African hominids: evolutionary implications for human brain development. World Rev Nutr Diet 2001, 90:144-161. ABSTRACT: With the emergence of our own genus (Homo habilis) 2.3 million years ago, a rapid increase in hominid brain mass relative to body mass (encephalization) occurred. Because brain is more metabolically active at rest than the average body resting metabolic rate, a relative increase in the encephalization index requires that either the total metabolic rate increases on a per weight basis, or that a concomitant reduction in the size and metabolic rate of another tissue occurs. Anatomical comparisons of humans and other anthropoids, and examination of the Klieber equation (inter-species metabolic rate versus body mass) demonstrate that our species’ large metabolically active brain evolved at the expense of a reduction in the size and metabolic rate of the gut. To relax the selection pressures that formerly required a large metabolically active gut, necessary for processing high amounts of fiber and roughage in the largely vegetarian diet of our primate ancestors, an increase in the energy density of the food supply was necessary. The fossil record shows the emergence of Homo species occurred slightly following the advent of crude, stone tools that were used to butcher carcasses of scavenged and hunted animals. Hence, increasing meat consumption by early hominids is most often cited as the likely food that increased dietary energy density and allowed for encephalization in the human ancestral line. However, the evolution of a large, metabolically active brain in early hominids, not only required a concentrated energy source, but a dietary source of 22:6n3 (docosahexaenoic acid, DHA) and 20:4n6 (arachidonic acid, AA) as well. To gain insight into the fatty acid (FA) and energy sources that allowed for hominid encephalization, we compiled nutrient values in the literature for African ruminant tissues (brain, muscle, marrow, liver, and depot fat), African freshwater fish, and wild plant foods. Our analysis demonstrated that muscle tissue would have been a relatively good source of AA, but not DHA or energy. Scavenged marrow would have likely been the most frequently obtainable concentrated energy (fat) source for early hominids, but would have been devoid of DHA and AA. Subcutaneous fat contained AA and trace amounts of DHA, but was likely infrequently encountered. Scavenged ruminant brain tissue would have provided a moderate energy source and a rich source of DHA and AA. Fish would have provided a rich source of DHA and AA, but not energy, and the fossil evidence provides scant evidence for their consumption. Plant foods generally are of a low energetic density and contain virtually no DHA or AA. Because early hominids were likely not successful in hunting large ruminants, then scavenged skulls (containing brain) likely provided the greatest DHA and AA sources, and long bones (containing marrow) likely provided the concentrated energy source necessary for the evolution of a large, metabolically active brain in ancestral humans.
12. Eaton SB, Cordain L, Eaton SB. An evolutionary foundation for health promotion. World Rev Nutr Diet 2001; 90:5-12. No abstract
11. Cordain L, Brand Miller J, Eaton SB, Mann N, Holt SHA, Speth JD. Plant to animal subsistence ratios and macronutrient energy estimations in world wide hunter-gatherer diets. Am J Clin Nutr 2000, 71:682-92. ABSTRACT Both anthropologists and nutritionists have long recognized that the diets of modern-day hunter-gatherers may represent a reference standard for modern human nutrition and a model for defense against certain diseases of affluence. Because the hunter-gatherer way of life is now probably extinct in its purely un-Westernized form, nutritionists and anthropologists must rely on indirect procedures to reconstruct the traditional diet of preagricultural humans. In this analysis, we incorporate the most recent ethnographic compilation of plant-to-animal economic subsistence patterns of hunter-gatherers to estimate likely dietary macronutrient intakes (% of energy) for environmentally diverse hunter-gatherer populations. Furthermore, we show how differences in the percentage of body fat in prey animals would alter protein intakes in hunter-gatherers and how a maximal protein ceiling influences the selection of other macronutrients. Our analysis showed that whenever and wherever it was ecologically possible, hunter-gatherers consumed high amounts (45-65% of energy) of animal food. Most (73%) of the worldwide hunter-gatherer societies derived >50% (> or =56-65% of energy) of their subsistence from animal foods, whereas only 14% of these societies derived >50% (> or =56-65% of energy) of their subsistence from gathered plant foods. This high reliance on animal-based foods coupled with the relatively low carbohydrate content of wild plant foods produces universally characteristic macronutrient consumption ratios in which protein is elevated (19-35% of energy) at the expense of carbohydrates (22-40% of energy).
10. Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Brit J Nutr 2000, 83:207-217. ABSTRACT Despite the almost universal clinical observation that inflammation of the gut is frequently associated with inflammation of the joints and vice versa, the nature of this relationship remains elusive. In the present review, we provide evidence for how the interaction of dietary lectins with enterocytes and lymphocytes may facilitate the translocation of both dietary and gut-derived pathogenic antigens to peripheral tissues, which in turn causes persistent peripheral antigenic stimulation. In genetically susceptible individuals, this antigenic stimulation may ultimately result in the expression of overt rheumatoid arthritis (RA) via molecular mimicry, a process whereby foreign peptides, similar in structure to endogenous peptides, may cause antibodies or T-lymphocytes to cross-react with both foreign and endogenous peptides and thereby break immunological tolerance. By eliminating dietary elements, particularly lectins, which adversely influence both enterocyte and lymphocyte structure and function, it is proposed that the peripheral antigenic stimulus (both pathogenic and dietary) will be reduced and thereby result in a diminution of disease symptoms in certain patients with RA.
9. Cordain, L., Brand Miller, J., Eaton, S.B. & Mann, N. Hunter-gatherer diets – a shore based perspective (letter). Am J Clin Nutrition 2000; 72:1585-86. No abstract
8. Cordain, L., Brand Miller, J., Eaton, S.B. & Mann, N. (2000). Macronutrient estimations in hunter-gatherer diets (letter). Am J Clin Nutr 2000; 72:1589-90. No abstract
7. Cordain L. Cereal grains: humanity’s double edged sword. World Rev Nutr Diet 1999; 84:19-73. No abstract
6. Cordain L, Miller J, Mann N. Scant evidence of periodic starvation among hunter-gatherers. Diabetologia 1999; 42:383-84. No abstract
5. Cordain L. Atherogenic potential of peanut oil-based monounsaturated fatty acids diets. Lipids 1998; 33:229-30. No abstract
4. Eaton SB, Eaton SB, Cordain L, Sinclair A, Mann N. Dietary intake of long chain polyunsaturated fatty acids during the Paleolithic. World Rev Nutr Diet 1998; 83:12-23. No abstract
3. Cordain, L., Gotshall, R.W. and Eaton, S.B. Physical activity, energy expenditure and fitness: an evolutionary perspective. International Journal of Sports Medicine 1998; 19:328-335. ABSTRACT The model for human physical activity patterns was established not in gymnasia, athletic fields, or exercise physiology laboratories, but by natural selection acting over eons of evolutionary experience. This paper examines how evolution has determined the potential for contemporary human performance, and advances the experience of recently-studied hunter-gatherers as the best available (although admittedly imperfect) indicator of the physical activity patterns for which our genetically determined biology was originally selected. From the emergence of the genus Homo, over 2 million years ago (MYA), until the agricultural revolution of roughly 10000 years ago our ancestors were hunter-gatherers, so the adaptive pressures inherent in that environmental niche have exerted defining influence on human genetic makeup. The portion of our genome that determines basic anatomy and physiology has remained relatively unchanged over the past 40 000 years. Thus, the complex interrelationship between energy intake, energy expenditure and specific physical activity requirements for current humans remains very similar to that originally selected for Stone Age men and women who lived by gathering and hunting. Research investigating optimal physical activity for human health and performance can be guided by understanding the evolution of physical activity patterns in our species.
2. Cordain, L., Gotshall, R.W., Eaton, S.B. Evolutionary aspects of exercise. World Rev Nutr Diet 1997; 81:49-60. ABSTRACT As a species, human work (exercise) capacities and limitations are a result of our species-specific anatomical and physiological characteristics which in turn are defined by our genetic constitution. Similar to all other organisms, the human genome was shaped by environmental selective pressures over eons of evolutionary experience. As hominids evolved and became separate from pongids between 6.3 and 7.7 million years ago (MYA), in response to selective pressures, they developed specific structural and functional characteristics which allowed them to exploit environmental niches which were previously unavailable to their pongid ancestors. Consequently, the selective pressures of the ecological niche which hominids occupied were responsible for shaping those genetic characteristics which are unique to our species (including anatomical and physiological parameters influencing our exercise capacities, limitations and requirements). Examination of both the hominid fossil record and structural and functional differences between modern humans and primates provides insight into the evolutionary changes which occurred in human anatomy and physiology which directly influenced the exercise capacities of contemporary men and women. Further, by studying modern-day hunter-gatherer societies. it is possible to not only develop models of optimal exercise patterns for fitness, but to evaluate how the discordance between the activity patterns of modern sedentary societies and hunter gatherer societies is implicated in a wide variety of chronic degenerative diseases which plague contemporary man.
1. Eaton, S.B., Cordain, L. Old genes, new fuels: Nutritional changes since agriculture. World Rev Nutr Diet 1997; 81:26-37. No abstract
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format by Dr. Loren Cordain and his colleagues.
