Tag Archives: Omega-3

Healthy Eating | The Paleo Diet

Anyone who follows the U.S. nutritional guidelines has almost certainly been frustrated at some point or another by the conflicting advice and sometimes hopelessly outdated marketing material – think the Food Pyramid that still graces the walls of many elementary school classrooms.

The frustration has reached the point that cries of government corruption and inappropriate influence of big food industry lobbyists are frequently heard. Case in point, the February 2015 draft of the U.S. Dietary Guidelines,1 published every five years, prompted over 29,000 public comments compared to a couple thousand in 2010. The outcry has been so strong it has led to a Congressional review to start in October.

And just last week journalist Nina Teicholz published a scathing review of the guidelines in the high impact factor journal BMJ.2

Teicholz accused the Dietary Guidelines Advisory Committee (DGAC) of not listing their conflicts of interest, of using reviews from industry influenced professional associations, and of overall “weak scientific standards.” Which is scary considering the importance of the 2015 Dietary Guidelines can’t be understated.

According to Teicholz, “the guidelines have a big influence on diet in the U.S., determining nutrition education, food labeling, government research priorities at the National Institutes of Health (NIH) and public feeding programs.”

So what did the Committee recommend? The overall body of evidence examined by the 2015 DAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meats; and low in sugar-sweetened foods and drinks and refined grains.

Certainly not a win for the Paleo community, but also not anything we haven’t heard from these agencies for a long time.

Dr Barbara Millen, the Chair of the Committee, published an immediate response in BMJ claiming that “the procedures used to develop the DGAC scientific report are expansive, transparent, and thoughtful, with multiple opportunities for public input.”1

Millen pointed out that the committee was nominated by their peers and rigorously reviewed. She even fired back at Teicholz saying that she was just one individual with a clear bias herself having written the book The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet.

The biggest point of contention, however, was the methods for selecting the research the recommendations were based on.

In 2010, the US Department of Agriculture established the Nutrition Evidence Library (NEL) to help ensure the quality of nutritional recommendations by establishing standards for identifying and selecting research.3

Teicholz contends that the DGAC “did not use NEL reviews for more than 70 percent of the topics” and instead selected studies ad hoc often relying on reviews by external professional associations.

Millen defended the committee claiming that “you don’t simply answer these questions on the basis of the NEL. On topics where there were existing comprehensive guidelines, we didn’t do them.” Millen also contended that the bulk of their research came from the NIH and other federal agencies.

To her credit, the Guidelines detail four methods of research selection, most of which involved at the least consulting the NEL.

Ultimately, it is the recommendations themselves that will determine the integrity of the report and Teicholz had issues with several of them, all of which are highly relevant to those of us in the Paleo world:

THE CONTESTED RECOMMENDATIONS

Teicholz addressed the recommendation for lower dietary saturated fats first, pointing out that no NEL review of the research on saturated fat from the past five years was conducted. She claimed many conflicting studies were omitted, in particular a large controlled clinical trial known as the Women’s Health Initiative (WHI). No benefits of a lower saturated fat diet were observed in a cohort of 49,000 women over seven years.4

Millen responded that the report states “dietary advice should put the emphasis on optimizing the types of dietary fat and not reducing total fat.”

Next, Teicholz addressed the report’s failure to endorse a low carbohydrate diet claiming critical research was left out including a meta-analysis and a critical review demonstrating a benefit of low carb diets for type 2 diabetes.5, 6 Millen simply replied that there is limited evidence of the long-term health effects.

One of the biggest shifts in the new guidelines was a stronger emphasis on plant-based diets with the recommendation to reduce meat particularly red meat. The draft 2015 Guidelines added for the first time a “Healthy Vegetarian Pattern” to their three recommended diets that also include a “Healthy Mediterranean-Style Pattern” and a “Healthy U.S.-Style Pattern.”

Teicholz contends that there has been no review by the NEL of the health effects of red meat. While an NEL review of a vegetarian diet does exist and states that the evidence is limited for its disease fighting power.7 Yet, Teicholz holds that the report arbitrarily upgraded the rating of the evidence. She also claimed that the Guidelines left out three contradictory NIH studies including one from the WHI that found no significant advantage of a diet high in fruit, vegetables and grains for weight loss, diabetes, heart disease, or cancer.8-11 Even the Guideline’s sole diagram addressing red meat, according to Teicholz, showed that diets high in red meat were equivocal with diets lower in red meat.

Millen did not address the question of red meat in her response, but the report stated that the three recommended dietary patterns reaffirmed the 2010 DGAC recommendations and aligned with the American Institute for Cancer Research (AICR) and the American Health Association (AHA).1

A MORE MUNDANE EXPLANATION

A friend of mine, who by her own admission had a “cushy” well-paid job at a large government nutrition agency, once gave me her impression of government nutrition.

Her job was to follow the current research and take her findings to the higher-ups. She was quickly frustrated by the all-too-common response. They would thank her for bringing it to their attention, then tell her they already knew about it and they weren’t going to do anything. Did she experience, first hand, government corruption or industry influence at play?

My friend had a much more mundane answer. In a government nutrition agency, she said, there’s one unforgivable sin – to make a recommendation contrary to the decades old accepted cannon and end up being wrong. So was something this mundane going on with the DGAC?

The Report starts by asserting it was motivated by the current state of public health in the United States, a lot of which was a result of poor dietary patterns. Half of U.S. adults have a chronic disease and two-thirds are obese. It goes on to say these patterns “adversely affected the health of the U.S. public for decades and raise the urgency for immediate attention and bold action.”1

Yet that “bold action” consists of recommendations that by their own admission are consistent with past DGAC reports.

The few new recommendations they offer – replacing refined grain products with whole grain products and the reduction of refined sugar and sodium in the diet – are neither novel nor in any way controversial within the nutrition community.

Even in the Paleo world, while we would say to bypass the grains altogether, if you’re going to eat them, we’re still generally going to recommend whole grain products over refined empty-calorie snacks.

Perhaps Teicholz’s most poignant criticism of the report was her pointing out “a reluctance by the committee behind the report to consider any evidence that contradicts the last 35 years of nutritional advice.” She goes on to say that with the failure of existing intervention strategies, they should be welcoming new views.

Nowhere is the aging nature of the report potentially more obvious than in its handling of omega-3 fatty acids. As mentioned above, Millen responded to Teicholz by stating that the committee focused more on types of fats than absolute quantity. Which would imply that omega-3 fats were a focus.

Yet omega-3s are mentioned only three times in the 571-page report. Once in the context of wild vs farm raised fish. One paragraph under mental health where they briefly review the vast research showing the benefits of omega-3 for the brain and finally to point out the single study that found an association between nutrients in the diet and type 2 diabetes because it differentiated types of fats.12

The broad ranging health benefits of consuming omega-3 fatty acids, and the ratio of omega-3 to omega-6 fatty acids in the diet are some of the most heavily researched topics currently in nutrition.13 Yet the report made no recommendations about omega-3s. Instead it focused on a decades-old concept of “achieving better saturated fat to polyunsaturated fat ratios.”

IS MUNDANE ANY BETTER?

Teicholz herself concludes by admitting the mundane may be more at play than conflict of interest or industry pressure – “nearly all nutrition scientists accept funding from industry. Of far greater influence is likely to be bias in favor of institutionalized hypothesis.”

Nonetheless, does this really make the end result any better?

The report may very well answer that question itself. It has long been accepted that there is a big difference between refined sugar, refined grain products, and whole grain products despite all being grain-based. The report is careful and thorough in making this distinction and providing very different recommendations for each.

The report also admits to a difficulty in defining meat – “there was variability across the food groupings and this was particularly apparent in the meat group.” Red meats were clumped together with processed meat and chicken, fish was grouped with eggs and sausage.

Yet, after admitting to this issue, the report still stuck with traditional lines. Where it was careful to distinguish different categories of grains and plant foods it still ultimately lumped almost all meat together in its recommendation.

That is with the exception of a small footnote that ultimately contradicted its own recommendations:

As lean meats were not consistently defined or handled similarly between studies, they were not identified as a common characteristic across the reviews. However, as demonstrated in the food patterns modeling of the Healthy US-style and Healthy Mediterranean-style patterns, lean meats can be a part of a healthy dietary pattern.

Whether it was industry influence, conflict of interest, or simply mundane adherence to nutritional cannon, when it came to their final recommendations, they were unable to see the important implications of a distinction they themselves made.

REFERENCES

  1. United States. Department of Agriculture., Dietary Guidelines Advisory Committee. Scientific Report. v.
  1. Teicholz, N., The scientific report guiding the US dietary guidelines: is it scientific? BMJ, 2015. 351: p. h4962.
  1. Library, N.E., Frequently Asked Questions. 2015.
  1. Howard, B.V., et al., Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 655-66.
  1. Feinman, R.D., et al., Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition, 2015. 31(1): p. 1-13.
  1. Ajala, O., P. English, and J. Pinkney, Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr, 2013. 97(3): p. 505-16.
  1. Library, N.E., How do the health outcomes of a vegetarian diet compare to that of a diet which customarily includes animal products?
  1. Beresford, S.A., et al., Low-fat dietary pattern and risk of colorectal cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 643-54.
  1. Knopp, R.H., et al., Long-term cholesterol-lowering effects of 4 fat-restricted diets in hypercholesterolemic and combined hyperlipidemic men. The Dietary Alternatives Study. JAMA, 1997. 278(18): p. 1509-15.
  1. Prentice, R.L., et al., Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 629-42.
  1. Prentice, R.L., et al., Low-fat dietary pattern and cancer incidence in the Women’s Health Initiative Dietary Modification Randomized Controlled Trial. J Natl Cancer Inst, 2007. 99(20): p. 1534-43.
  1. Fung, T.T., et al., A prospective study of overall diet quality and risk of type 2 diabetes in women. Diabetes Care, 2007. 30(7): p. 1753-7.
  1. Gomez-Candela, C., et al., The Role of Omega-3 Fatty Acids in Diets. J Am Coll Nutr, 2015. 34 Suppl 1: p. 42-7.

Inuit | The Paleo Diet

The Inuit have long been used as a shining example that low carbohydrate approaches to diet can work.1 2 3 4 In fact, traditionally they consumed very little vegetables or any other typically Western foods, and subsisted mainly on fish, sea mammals, and land animals.5 And despite this diet (which would horrify most mainstream dieticians) the Inuit traditionally had very low rates of disease.6

By contrast, the traditional Western diet has been correlated with a plague of health issues.7 8 9 As a further example of just how nutritionally poor the Western diet can be, one third of all cancer deaths have been linked to continued intake of low quality foods – which are everyday staples of the Western diet.10

Interestingly, when consumed in a very low carbohydrate version, a Paleo Diet looks very similar – if not identical – to the traditional Inuit diet. Since this way of eating is higher in fat than most North American diets, it is commonly presumed (erroneously) that high fat diets must somehow be “bad.”11 12 What gets (purposely) left out of these arguments is the fact that the type of fat consumed is very important.13 14 15 16 17 Consuming omega-3 fatty acids is highly beneficial for health – while consuming industrial trans fat is pretty much the worst thing you can do for your health.18

To bring all this background knowledge to a head, new research published last week, showed that the Inuit have special mutations in genes involved in fat metabolism.19 These genetic mutations may allow them to thrive on their very low carbohydrate diet. This is thought provoking because these genetic mutations are found in nearly 100% of the Inuit. By contrast, only a mere 2% of Europeans exhibit the same mutations. This means that those of us from European ancestry may synthesize omega-3 polyunsaturated fatty acids differently than the Inuit.

While the initial buzz of this paper was high, in practice it really doesn’t change anything we know about consuming a healthy Paleo Diet. Omega-3 fatty acids, like those found in wild-caught fish, are still extremely beneficial for our health. In fact, researchers have found that omega-3 fatty acids have widely beneficial anti-inflammatory properties.20 This proves beneficial for inflammatory and autoimmune diseases, in addition to maintaining good health for those without specific health conditions. The advice to consume omega-3 fatty acids is great for mitigating coronary heart disease, depression, aging, and cancer.21

Beyond this, arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosis are autoimmune diseases which may be helped by adequate omega-3 consumption.22 Of the omega-3 fatty acids available, DHA (docosahexaenoic acid) is the best, for a variety of reasons.23 24 Look for foods naturally high in DHA (such as wild-caught fish) and avoid inflammatory seed oils – like those commonly used by most major restaurants. This crucial step will help you stay healthy in the long term – no matter what genes and ancestry you may have.

REFERENCES

[1] Dewailly E, Mulvad G, Sloth pedersen H, Hansen JC, Behrendt N, Hart hansen JP. Inuit are protected against prostate cancer. Cancer Epidemiol Biomarkers Prev. 2003;12(9):926-7.

[2] Bjerregaard P, Dewailly E, Young TK, et al. Blood pressure among the Inuit (Eskimo) populations in the Arctic. Scand J Public Health. 2003;31(2):92-9.

[3] Mulvad G, Pedersen HS, Hansen JC, et al. The Inuit diet. Fatty acids and antioxidants, their role in ischemic heart disease, and exposure to organochlorines and heavy metals. An international study. Arctic Med Res. 1996;55 Suppl 1:20-4.

[4] O’keefe JH, Harris WS. From Inuit to implementation: omega-3 fatty acids come of age. Mayo Clin Proc. 2000;75(6):607-14.

[5] Kuhnlein HV. Nutrition of the Inuit: a brief overview. Arctic Med Res. 1991;Suppl:728-30.

[6] Stefansson V. The friendly arctic. The MacMillan Co, NY. 1921.

[7] Manzel A, Muller DN, Hafler DA, Erdman SE, Linker RA, Kleinewietfeld M. Role of “Western diet” in inflammatory autoimmune diseases. Curr Allergy Asthma Rep. 2014;14(1):404.

[8] Myles IA. Fast food fever: reviewing the impacts of the Western diet on immunity. Nutr J. 2014;13:61.

[9] Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002;56(8):365-79.

[10] American Cancer Society. Cancer facts & figures 2004. Atlanta: American Cancer Society, 2004.

[11] Guldstrand MC, Simberg CL. High-fat diets: healthy or unhealthy?. Clin Sci. 2007;113(10):397-9.

[12] Schwingshackl L, Hoffmann G. Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis. J Acad Nutr Diet. 2013;113(12):1640-61.

[13] Abumrad NA, Piomelli D, Yurko-mauro K, Merrill A, Clandinin MT, Serhan CN. Moving beyond “good fat, bad fat”: the complex roles of dietary lipids in cellular function and health: session abstracts. Adv Nutr. 2012;3(1):60-8.

[14] Simopoulos AP. Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr. 1991;54(3):438-63.

[15] Daley CA, Abbott A, Doyle PS, Nader GA, Larson S. A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutr J. 2010;9:10.

[16] Loef M, Walach H. The omega-6/omega-3 ratio and dementia or cognitive decline: a systematic review on human studies and biological evidence. J Nutr Gerontol Geriatr. 2013;32(1):1-23.

[17] Swanson D, Block R, Mousa SA. Omega-3 fatty acids EPA and DHA: health benefits throughout life. Adv Nutr. 2012;3(1):1-7.

[18] Ip C. Review of the effects of trans fatty acids, oleic acid, n-3 polyunsaturated fatty acids, and conjugated linoleic acid on mammary carcinogenesis in animals. Am J Clin Nutr. 1997;66(6 Suppl):1523S-1529S.

[19] Fumagalli M, Moltke I, Grarup N, et al. Greenlandic Inuit show genetic signatures of diet and climate adaptation. Science. 2015;349(6254):1343-7.

[20] Wall R, Ross RP, Fitzgerald GF, Stanton C. Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev. 2010;68(5):280-9.

[21] Harris WS, Dayspring TD, Moran TJ. Omega-3 fatty acids and cardiovascular disease: new developments and applications. Postgrad Med. 2013;125(6):100-13.

[22] Robinson DR, Knoell CT, Urakaze M, et al. Suppression of autoimmune disease by omega-3 fatty acids. Biochem Soc Trans. 1995;23(2):287-91.

[23] Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid (DHA). Pharmacol Res. 1999;40(3):211-25.

[24] Conquer JA, Holub BJ. Dietary docosahexaenoic acid as a source of eicosapentaenoic acid in vegetarians and omnivores. Lipids. 1997;32(3):341-5.

Vitamin D Omega 3 Supplements | The Paleo Diet

Choosing a Paleo diet and eating more in tune with how we’ve evolved provides the body with a robust amount of essential protein, healthy fats, gluten-free carbohydrates and nutrient dense veggies. An ancestral approach to eating also provides your body with key nutrients, vitamins and minerals the way nature intended. Does this mean that supplementation is unnecessary if you’re following a Paleo lifestyle? It’s a complicated question.

Most articles and blogs about supplements inevitably discuss the benefits or drawbacks of multi-vitamins. Research shows that if you eat a diet centered around the most nutrient dense foods – quality meats, veggies and fats – you’ll likely already be achieving a therapeutic dose for most vitamins and minerals. When intake is at a supra-physiological dose (that can never be found in nature), too many vitamins can actually put you at risk of chronic disease. Does this mean if you’re following a Paleo diet you don’t need any supplements?

Let’s look at the two most common instances where supplementation might still be a good idea, vitamin D and omega-3 fats. In both of these cases, although a Paleo diet is a great place to start, for many people this may not be enough.

SHOULD YOU SUPPLEMENT WITH VITAMIN D?

Vitamin D is classically known as an essential nutrient for bone health and immunity, however new research shows this fat-soluble vitamin has much more profound impacts on your health and well-being.

How important is vitamin D? Dr. Michael Holick, physician and vitamin D expert sums it up. “Imagine what would happen if a drug company came out with single pill that reduces the risk of cancer, heart attack, stroke, osteoporosis, PMS, depression and various autoimmune conditions? There would be a media frenzy the likes of which has never been seen before! Such a drug exists… it’s the sun.”1, 2, 3

Vitamin D is different than other vitamins because it’s created under your skin when ultraviolet light from the sun interacts with a specific enzyme to form cholecalciferol or vitamin D3. However, exposure to daily sunlight is no longer the norm as we are cooped up in cubicles all day and the deeply ingrained ancestral benefits of light exposure are overlooked.

It’s estimated that up to 70% of the American population is deficient in vitamin D (defined as blood levels below 20ng/mL or 50 nmol/L), or suffering from vitamin D insufficiency, a level above a diagnosed deficiency but still not sufficient for good health (measured as 20-32 ng/mL or 50-80nmol/L). 4

If you live in a northern climate with a true winter season, or north of the 49th parallel, it’s very difficult to achieve the required blood levels of vitamin D from food alone. While cold-water fatty fish, eggs and mushrooms are good foods sources of vitamin D, in the dead of winter they’re likely not enough. Adding a supplement can be highly beneficial.

The standard medical recommendation for vitamin D drops is 1,000-2,000 IU per day, however in the darkest winter months you may need a higher dose. Remember, always get your blood levels tested and work with a doctor if you’re thinking of supplementing with more than the recommended dose. The normal range is typically between 32-50ng/mL (80-125nmol/L) and for athletes new research suggests achieving levels greater than 40ng/mL (100nmol/L) to support superior performance and recovery.5 Be sure to take your vitamin D supplement with a meal that includes fat for optimal absorption.

SHOULD YOU SUPPLEMENT WITH FISH OILS?

Extra long-chain fats eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the omega-3 ‘all-stars’ when it comes to supporting overall health and combating chronic disease. While most people know the benefits of omega-3 fats for cardiovascular health, many don’t realize they also help reduce the risk of diabetes and depression, protect against mental stress, and even support athletic performance by improving muscle protein synthesis and controlling excessive inflammation.

How important are omega-3 fats? In 2013, the Cardiovascular Healthy Study found that people with the highest omega-3 (e.g. EPA and DHA) levels in their blood had the lowest overall mortality rates.6 In short, the more omega-3 fats you consume, the less chance you have of dying from absolutely any cause. The good news is they are found in abundance in a Paleo diet (e.g. grass-fed meats, wild ocean fish, farm fresh eggs). However, modern day living and long, busy days might mean you’ll benefit from extra support.

If you’re prone to low mood or depression, or cope with regularly high stress levels fish oils could well be an important key to improving your brain health. A study in the Journal of Clinical Psychiatry found people experiencing depression had consistently lower levels of essential fatty acids in their blood. When subjects supplemented with fish oils they had significant improvements in their Hamilton Rating Scale, a recognized evaluation system for depression.7 The British Journal of Nutrition also discovered that supplementing with fish oils helps reduce the adrenal over-activation associated with high levels of mental stress.8

Rates of diabetes and pre-diabetes have never been higher, and constantly being on the go is just one factor that can lead to snacking on convenience foods that are high in processed carbs and sugars. A recent study of fish oil supplementation effects on blood sugar and insulin levels over a 3-week period found significant improvements in insulin function in those with elevated levels.9

Of course, it’s not enough just to increase your omega-3 intake. It’s far too easy to obtain excessive amounts of omega-6 type fats in today’s world, whether from processed foods, restaurant eating, or convenience snacks. The beauty of adopting a Paleo diet is that it often naturally restores this common imbalance. However, the impacts of modern living may still leave you short.

Unless you’re eating 1-2 pieces of cold, deep-water fatty fish daily, it’s best to add an omega-3 supplement rich in EPA/DHA. Fish oil is the richest in EPA and DHA, however krill oil, sea oil, and sea algae are all viable options as well. Aim to supplement with 1,000-1,500mg of combined EPA and DHA daily.

If you’re an athlete and training intensely fish oil supplementation can be a game changer. Supplementation can lead to an amazing 50% increase in the up-regulation of mTOR, the genetic signaling pathway that stimulates lean muscle growth, leading to significant increases in muscle protein synthesis and muscular hypertrophy.10  If you’re serious about your training, adding extra omega-3 fats to your sports nutrition arsenal is important.

A Paleo diet is a great way to cover all your bases on the nutrition front. However, depending on your genetics, where you live, how busy you are, and your lifestyle, diet may not be enough to correct low or insufficient levels of vitamin D and omega-3 fats. Adding these two supplements into your regime, particularly throughout the winter months, may be the fix you need to improve your health, productivity at work and performance in the gym.

REFERENCES

  1. Holick M.Vitamin D Deficiency:What A Pain It Is. Mayo Clin Proc 2003 78(12):1457-59
  1. Holick, M. Article Review: Vitamin D Deficiency. NEJM Medical Progress. 2007, 357:266-81.
  1. Holick, M. Shinning A Light On Vitamin D-Cancer Connection IARC Report. Dermato-Endocrinology, 2009 1(1):4-6
  1. Hanley D, Davison, K. Symposium: Vitamin D Insufficiency: A significant risk Factor in Chronic Disease and Potential Disease-Specific Biomarkers of Vitamin D Insufficiency: Vitamin D Insufficiency in North America. J Nutr 2005, 135:332-37.
  1. Koundourakis, N et al. Vitamin D and Exercise Performance in Professional Soccer Players. Plos One. 2014 Jul 3;9(7):e101659.
  1. Mozaffarian D, Lemaitre RN, King IB, et al. Plasma phospholipid long-chain omega-3 fatty acids and total and cause-specific mortality in older adults. A cohort study. Ann Intern Med 2013; 158:515-525.
  1. Su K, Huang S, Chiu C, Shen W. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 2003;13(4):267-271.
  1. Delarue J et al. Fish oil attenuates adrenergic overactivity without altering glucose metabolism during an oral glucose load in haemodialysis patients. Br J Nutr. 2008 May;99(5):1041-7.
  1. Delarue J et al. Interaction of fish oil and a glucocorticoid on metabolic responses to an oral glucose load in healthy human subjects. Br J Nutr. 2006 Feb;95(2):267-72.
  1. Smith GI et al. Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and women. Clin Sci (Lond). 2011 Sep;121(6):267-78.

Boost Your Brain: Dopamine and Diet

There are many benefits of following a Paleo Diet.1, 2, 3, 4, 5, 6  The majority are aware of the physical effects of moving from a Western diet (full of processed foods, grains and sugar) to a Paleo Diet (rich with nutrients, anti-inflammatory fats, and healthy sources of carbohydrates).7, 8 However, most are likely unaware of the effects of diet on dopamine levels, and your brain.9, 10, 11, 12, 13 Numerous studies have examined the relationship, and all of the studies have fairly interesting results.14, 15, 16, 17, 18 One study showed mice fed a high fat diet during pregnancy had an increased preference for sucrose and fat.19 It must be noted, however, that what researchers refer to as a ‘high fat diet’ is instead a ‘high sugar and high fat diet.’20, 21, 22 On top of this, the diet consisted of poor sources of sugar and fat, not sweet potatoes and coconut oil.23

Boost Your Brain: Dopamine and Diet | The Paleo Diet

Wang, Gene-Jack et al. “Imaging of Brain Dopamine Pathways: Implications for Understanding Obesity.” Journal of addiction medicine 3.1 (2009): 8–18. PMC. Web. 6 Mar. 2015.

Boost Your Brain: Dopamine and Diet | The Paleo Diet

Volkow et al. “Overlapping Neuronal Circuits in Addiction and Obesity: Evidence of Systems Pathology.” Biological Sciences 363.1507 (2008): 3191.

More interesting, however, researchers ultimately found that diet actually altered the gene expression of dopamine and opioid-related genes.24 That is a pretty big find. Another study looked at the effect skipping breakfast had on dopamine levels.25 The authors of this study found breakfasts consumed with normal to higher amounts of protein, had increasingly positive effects on both dopamine secretion and reduced food cravings.

Boost Your Brain: Dopamine and Diet

Ahmad, S. Omar et al. “REDUCED NUMBERS OF DOPAMINE NEURONS IN THE SUBSTANTIA NIGRA PARS COMPACTA AND VENTRAL TEGMENTAL AREA OF RATS FED AN N-3 POLYUNSATURATED FATTY ACID-DEFICIENT DIET: A STEREOLOGICAL STUDY.” Neuroscience letters 438.3 (2008): 303–307. PMC. Web. 6 Mar. 2015.

If you’re having a hard time swallowing the idea that diet alters dopamine levels, this was only first “discovered” by researchers in 2003.26 Other researchers have stated that excessive intake of dietary fats leads to diminished brain dopaminergic function.27, 28, 29, 30 What must be noted here, again, is that they are not referring to healthier fats, but rather poor quality ones. By contrast, one can extrapolate that healthy fats (such as those included regularly in a Paleo Diet) will improve, or at the very least normalize, dopamine levels.31, 32, 33

As other researchers have also noted, sugar and fat bingeing have notable differences in addictive-like behavior.34 This, again, suggests we should avoid a Western diet at all costs, especially the unhealthiest versions, if you want to maximize dopaminergic function in the brain. Researchers have also found that the lack of opiate-like withdrawal signs after fat bingeing underscores the importance of opioid systems in differentiating sugars and fats and their subsequent effects on behavior.

While fat may not have the same effects on the brain as sugar,combining the two in one’s diet (especially in their worst forms) is akin to putting your brain in the freezer, or maybe even throwing it out in front of traffic.35, 36, 37 Healthy fats, like the omega-3 fatty acids found in abundance in a Paleo Diet, will help to maximize dopamine levels, as well as neuronal and physiologic functioning.38, 39, 40, 41, 42

Boost Your Brain: Dopamine and Diet

Teegarden, Sarah L., Eric J. Nestler, and Tracy L. Bale. “ΔFosB-Mediated Alterations in Dopamine Signaling Are Normalized by a Palatable High Fat Diet.” Biological psychiatry 64.11 (2008): 941–950. PMC. Web. 6 Mar. 2015.

In summary, proper dopamine levels are vital to leading a healthy life. A Paleo diet helps to optimize dopaminergic and neuronal health, meanwhile providing the multitude of healthful benefits. Check out the brand new The Real Paleo Diet Cookbook and check out over 250 delicious, healthy recipes that will help fuel your brain!

REFERENCES

[1] Kowalski LM, Bujko J. [Evaluation of biological and clinical potential of paleolithic diet]. Rocz Panstw Zakl Hig. 2012;63(1):9-15.

[2] Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010;25(6):594-602.

[3] Frassetto LA, Schloetter M, Mietus-synder M, Morris RC, Sebastian A. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009;63(8):947-55.

[4] Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC. Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013;12:105.

[5] O’keefe JH, 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;79(1):101-8.

[6] Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341-54.

[7] Gutiérrez-fisac JL, Angel royo-bordonada M, Rodríguez-artalejo F. [Health-risks associated with Western diet and sedentariness: the obesity epidemia]. Gac Sanit. 2006;20 Suppl 1:48-54.

[8] Myles IA. Fast food fever: reviewing the impacts of the Western diet on immunity. Nutr J. 2014;13:61.

[9] Wang GJ, Volkow ND, Thanos PK, Fowler JS. Imaging of brain dopamine pathways: implications for understanding obesity. J Addict Med. 2009;3(1):8-18.

[10] Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond, B, Biol Sci. 2008;363(1507):3191-200.

[11] Berthoud HR. Vagal and hormonal gut-brain communication: from satiation to satisfaction. Neurogastroenterol Motil. 2008;20 Suppl 1:64-72.

[12] Volkow ND, Wise RA. How can drug addiction help us understand obesity?. Nat Neurosci. 2005;8(5):555-60.

[13] Batterham RL, Ffytche DH, Rosenthal JM, et al. PYY modulation of cortical and hypothalamic brain areas predicts feeding behaviour in humans. Nature. 2007;450(7166):106-9.

[14] Dallman MF, Pecoraro N, Akana SF, et al. Chronic stress and obesity: a new view of “comfort food”. Proc Natl Acad Sci USA. 2003;100(20):11696-701.

[15] Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav. 2007;91(4):449-58.

[16] Rada P, Avena NM, Hoebel BG. Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience. 2005;134(3):737-44.

[17] Liang NC, Hajnal A, Norgren R. Sham feeding corn oil increases accumbens dopamine in the rat. Am J Physiol Regul Integr Comp Physiol. 2006;291(5):R1236-9.

[18] Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20-39.

[19] Vucetic Z, Kimmel J, Totoki K, Hollenbeck E, Reyes TM. Maternal high-fat diet alters methylation and gene expression of dopamine and opioid-related genes. Endocrinology. 2010;151(10):4756-64.

[20] Gibson SA. Are high-fat, high-sugar foods and diets conducive to obesity?. Int J Food Sci Nutr. 1996;47(5):405-15.

[21] Molteni R, Barnard RJ, Ying Z, Roberts CK, Gómez-pinilla F. A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience. 2002;112(4):803-14.

[22] Kuo LE, Czarnecka M, Kitlinska JB, Tilan JU, Kvetnanský R, Zukowska Z. Chronic stress, combined with a high-fat/high-sugar diet, shifts sympathetic signaling toward neuropeptide Y and leads to obesity and the metabolic syndrome. Ann N Y Acad Sci. 2008;1148:232-7.

[23] Axen KV, Dikeakos A, Sclafani A. High dietary fat promotes syndrome X in nonobese rats. J Nutr. 2003;133(7):2244-9.

[24] High-fat diet alters the dopamine and opioid systems: effects across development. International Journal of Obesity Supplements. 2012;:S25.

[25] Hoertel HA, Will MJ, Leidy HJ. A randomized crossover, pilot study examining the effects of a normal protein vs. high protein breakfast on food cravings and reward signals in overweight/obese “breakfast skipping”, late-adolescent girls. Nutr J. 2014;13(1):80.

[26] Montgomery AJ, Mctavish SF, Cowen PJ, Grasby PM. Reduction of brain dopamine concentration with dietary tyrosine plus phenylalanine depletion: an [11C]raclopride PET study. Am J Psychiatry. 2003;160(10):1887-9.

[27] Tellez LA, Medina S, Han W, et al. A gut lipid messenger links excess dietary fat to dopamine deficiency. Science. 2013;341(6147):800-2.

[28] Volkow ND, Wang GJ, Telang F, et al. Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: possible contributing factors. Neuroimage. 2008;42(4):1537-43.

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Balancing Migraine Pain with a Paleo Diet | The Paleo DIet

As a migraine sufferer, I was all too excited several years ago when the local hospital hosted an expert panel on migraine remedies which included diet. The 45 minute presentation covered the basic physiology, briefly mentioned chocolate and alcohol, and then spent the bulk of the time on medications – Aspirin, Excederin, Midrin, and Fioricet. During the Q&A I asked about omega-3 PUFAs since they are known to inhibit COX-2. One expert replied that she was unaware of any research on PUFAs or COX-2 for migraine. I appreciated her congenial reply, but sat down disappointed. Most of the medication identified did only one thing in the body – inhibit COX-2.

Let’s start at the beginning. Migraine is a complex condition with many subclasses including with aura (Classic,) without aura (Common,) chronic, retinal, and hemiplegic migraine.1-3

Whatever the name, for the 10-15% of Americans who suffer from them, migraines mean episodic, intense headaches, often with nausea and light and sound sensitivity. In all cases, it affects our quality of life and ability to work.4, 5

While medication remains the primary focus of migraine treatment, its use as the primary treatment has its own concerns. There’s now a class of chronic migraine called medication overuse headache (MOH) where overuse of pain medication can actually cause near daily headaches.6-8

This has led many to seek alternative treatments.

Diet may help. Migraineurs – a term that makes it sound like an exclusive club with a very low voluntary applicant pool – often cite dietary triggers for their migraines. The most common are alcohol, chocolate, cheese, caffeine, MSG and fasting.9 On the other side of the coin, dietary elements such as magnesium and omega-3 fatty acids may be therapeutic.10

Unsurprisingly, all of these dietary elements fit with a healthy, Paleo Diet lifestyle. So let’s take a look at the physiology of a few key elements of the Paleo Diet that can help you spend less time at the ”Migraineur Club House.”

MIGRAINE 101: DON’T GET HYPEREXCITED

There are many theories about the cause of migraines, but the most widely accepted is the neural hyperexcitability theory. Backed by recent MRI studies, it proposes neurons in the trigeminal-vascular region of the brain’s cortex become inappropriately activated, releasing a series of neurotransmitters that cause vasodilation, mast cell degranulation, increased permeability, platelet aggregation, inflammation, and ultimately pain.2, 9, 11-14 Recently, some suggest hyperexcitability is a result of a dysfunction in sodium-potassium transporters.15

For some, their migraine is preceded by a visual aura. This aura is caused by an initial depolarization of the neurons referred to as Cortical Spreading Depression.2, 15

That’s a very short summary of a very complex process. The take home message: an imbalance in excitation signals, neurotransmitters, and electrolytes may be at the root of your migraine pain. Dive in deeper with the references listed below.

POLYUNSATURATED FATTY ACIDS: MIND YOUR 3S AND 6S

While living out of the medicine cabinet may not be the best long term strategy, it’s important to point out that NSAIDs, such as ibuprofen, are very effective at reducing acute migraine pain.1, 4, 16 They do one thing – prevent the formation of molecules called prostaglandins by inhibiting a key enzyme called cyclooxygenase (COX).

So, it’s not surprising prostaglandins have been linked to migraine.1, 17-21 Simply injecting prostaglandin E2 (PGE2) into both healthy subjects and migraine sufferers was enough to cause migraine pain.22-25 The fact that  pain was immediate, indicates that PGE2 may actually be the direct cause of pain for sufferers.22

But how does this relate to diet?

Prostaglandins are created from the polyunsaturated fatty acids (PUFAs) we eat.1 Our bodies are not particular – they will use whatever type of PUFA is available. But we end up with very different prostaglandins depending on whether we consume more omega-3 or omega-6 PUFAs.26

The figure below shows the types of prostaglandins (and other eicosanoids) formed from arachidonic acid (omega-6) verses EPA (omega-3).26

Balancing Migraine Pain with a Paleo Diet | The Paleo Diet

PGE3 and PGI3 from omega-3 PUFAs may actually help prevent both the inflammation and electrolyte imbalance that causes migraines.15, 26, 27 In fact, they have anti-inflammatory benefits for many chronic illnesses including cancer and heart disease.28-32

By contrast PGE2 and PGI2 from Omega-6 PUFAs are pain-causing. Hence they are the targets of most over-the-counter pain killers. These prostaglandins and their precursor arachidonic acid are elevated during migraines and may sensitize of the trigeminal nerve which is the location of migraine pain.1, 15, 19, 20, 33, 34 In fact, the highest level of PGE2 receptors in the body are found in the trigeminal nucleus caudalis.22

Fortunately, when diets are high in omega-3 fatty acids such as EPA from fish oil, the good prostaglandins tend to supplant the bad.26

So, why then was it that studies of omega-3 supplementation have had mixed results for migraine?35-37

The potential answer gets at a key tenant of the Paleo Diet – just popping a few fish oil supplements and calling yourself healthy isn’t enough. It’s all about balance.

Due to the huge increase in vegetable oils and grain fed livestock in the western world, the ratio of omega-6 to omega-3 PUFAs in our diets have risen to 10:1 from an estimated 3:1 or even 2:1 in Paleolithic times.26, 38-40

To see if the ratio influenced migraines, a 2013 study by Ramsden et al, not only increased omega-3 in Migraineurs’ diets, but reduced the omega-6 content. The pain improved significantly. Interestingly, the investigators included a second group that only reduced omega-6 PUFAs in their diet. While not as dramatic, this group also improved.35

Issues with the high ratio of omega-6 to omega-3 fatty acids in the western diet go beyond migraines. The ratio has been associated with many chronic conditions including depression (due to its influence on serotonin), rheumatoid arthritis, inflammatory bowel disease, asthma, heart disease and chronic inflammation.26, 27, 38, 41

A Paleo Diet promotes a better omega-3 to omega-6 ratio. The best source of omega-3 PUFAs is EPA from fish, but other sources include walnuts, lean meats, and some vegetables such as broccoli and spinach.42 Just remember that the shift from omega-3s to omega-6 PUFAs in our bodies takes time – from 6 – 18 weeks.43

MAGNESIUM: THE PAINFULLY FORGOTTEN ELECTROLYTE

Magnesium is sometimes referred to as the “forgotten electrolyte” since it is frequently overshadowed by calcium in the research.44-46 Magnesium is involved in over 300 functions in our body, which means it is not a nutrient we want to forget about. Yet almost 48% of Americans eat less than the RDA.15, 44

Most magnesium is found in our bones and cells with less than 1% in our blood,45 which means that a blood test for magnesium isn’t very effective.47 Up to 14% of the population may be deficient and this deficiency has been associated with many chronic conditions including heart disease.48

Evidently, magnesium deficiency has been clearly linked to migraines.9, 47, 49, 50 In multiple studies, migraine sufferers had lowered levels of magnesium in their blood, saliva, and cerebrospinal fluid during attacks.51-56

Magnesium affects many processes linked to migraine including neurotransmitter release, serotonin receptors, inflammatory mediators, and the inhibition of platelet aggregation.56-63 It may even block some of the inflammatory effects of omega-6 PUFAs.44

Magnesium supplements help migraine sufferers.51, 56 Even more strikingly, people going to the emergency room with migraine pain are frequently treated with an infusion of magnesium sulfate which is more effective than the pharmaceutical treatments dexamethasone and metoclopramide.47, 57

Unsurprisingly with current migraine research pointing to electrolyte imbalances, the “forgotten electrolyte” may play a key role in migraine hyperexcitability.15

Sodium-potassium imbalance may trigger migraines, but overactive calcium channels could be the cause.2 High levels of calcium in the brain make neurons easily excitable.2, 44 Magnesium is a key regulator of calcium and might be able to control this calcium-induced hyperexcitability.44

In fact, in a review of migraine hyperexcitability, Welch proposed that the changes in magnesium levels during a migraine may be an attempt by the brain to restore electrolyte balance.2

Here again, migraines show why a properly balanced diet is far more important than just popping supplements.

With the concern over osteoporosis, daily calcium consumption has been increasing over the past four decades.44 This Western focus on calcium has led to one of the biggest criticisms of the Paleo Diet for its elimination of dairy. This is in spite of recent research questioning the benefits of high calcium intake and worse, linking it to heart disease.64-68

What may be more important than the absolute calcium level is the ratio of magnesium to calcium in the diet which has been decreasing.44 Not something to overlook considering increased magnesium consumption reduced all-cause mortality associated with high calcium intake.69

Worse yet, consuming too much calcium can exacerbate magnesium deficiency.70

The higher calcium-magnesium ratio of the Western diet may contribute to a variety of chronic conditions beyond migraine, including stress, metabolic syndrome, Type II Diabetes, hypertension and vascular disease.44

The Paleo Diet promotes a better calcium-magnesium ratio through the consumption of foods high in both including almonds, cashews, green leafy vegetables, and fish. While research is limited, it is believed that alcohol and sugary drinks can limit magnesium absorption.

ELIMINATING DIETARY PAIN

Food sensitivity remains one of the most common migraine triggers,71, 72 but the foods tend to be highly individual. A food diary is one way for migraine sufferers to identify their triggers. Though this can be difficult since foods interact and sometimes the migraine appears a day or more after eating the culprit foods.9

Fortunately, there may be another way to identify your triggers. Food that causes an IgG antibody response has been associated with migraines.9 Studies eliminating these foods have produced dramatic results with up to 93% of participants becoming headache free.71, 73, 74

Balancing Migraine Pain with a Paleo Diet | The Paleo DietWhile the point of an IgG-elimination diet is individualization, the table to the left shows the most common IgG-inducing food groups.71

This study found that an IgG-elimination diet also helped Irritable Bowel Disease, another condition affected by dietary imbalance.71, 75 Up to 50% of people with IBS suffer from migraines76 with neural hypersensitivity77 and mitochondrial DNA mutations75 linked to both.

We frequently recommend Paleo Dieters suffering from chronic conditions try an elimination diet. Seeing your allergist to help you identify IgG-provoking foods may be a shortcut to help you get past migraine pain.

Certainly PUFAs and magnesium have dominated the literature on diet and migraines – to the point that they were used as a proof of concept for literature research.78 But this doesn’t mean they are the only dietary factors. Both low fat79 and ketogenic diets80 improved migraine symptoms. Migraine hyperexcitability can be affected by the sodium-potassium balance in the diet and hydration status (with dehydration and hypohydration causing migraines).15

The underlying message is migraine pain may be a disease of imbalance. So, while I’ve reached for the Excedrin bottle more than a few times to get through my day, a balanced diet more attune with our evolutionary make-up may ultimately be what keeps us Migraineurs away from the medicine cabinet altogether.

Trevor Connor | The Paleo DietTrevor Connor is Dr. Cordain’s last mentored graduate student and will complete his M.S. in HES and Nutrition from the Colorado State University this year and later enter the Ph.D. program. Connor was the Principle Investigator in a large case study, approximately 100 subjects, in which he and Dr. Cordain examined autoimmune patients following The Paleo Diet or Paleo-like diets.

 

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68. Weaver, C.M., Calcium supplementation: is protecting against osteoporosis counter to protecting against cardiovascular disease? Curr Osteoporos Rep, 2014. 12(2): p. 211-8.

69. Kaluza, J., et al., Dietary calcium and magnesium intake and mortality: a prospective study of men. Am J Epidemiol, 2010. 171(7): p. 801-7.

70. Bertinato, J., et al., Small increases in dietary calcium above normal requirements exacerbate magnesium deficiency in rats fed a low magnesium diet. Magnes Res, 2014. 27(1): p. 35-47.

71. Aydinlar, E.I., et al., IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache, 2013. 53(3): p. 514-25.

72. Peatfield, R.C., et al., The prevalence of diet-induced migraine. Cephalalgia, 1984. 4(3): p. 179-83.

73. Arroyave Hernandez, C.M., M. Echavarria Pinto, and H.L. Hernandez Montiel, Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex, 2007. 54(5): p. 162-8.

74. Egger, J., et al., IS MIGRAINE FOOD ALLERGY – A DOUBLE-BLIND CONTROLLED TRIAL OF OLIGOANTIGENIC DIET TREATMENT. Lancet, 1983. 2(8355): p. 865-869.

75. Chang, F.Y. and C.L. Lu, Irritable bowel syndrome and migraine: bystanders or partners? J Neurogastroenterol Motil, 2013. 19(3): p. 301-11.

76. Watson, W.C., et al., Globus and headache: common symptoms of the irritable bowel syndrome. Can Med Assoc J, 1978. 118(4): p. 387-8.

77. Cady, R.K., et al., The bowel and migraine: update on celiac disease and irritable bowel syndrome. Curr Pain Headache Rep, 2012. 16(3): p. 278-86.

78. Weeber, M., et al., Using concepts in literature-based discovery: Simulating Swanson’s Raynaud-fish oil and migraine-magnesium discoveries. Journal of the American Society for Information Science and Technology, 2001. 52(7): p. 548-557.

79. Bunner, A.E., et al., Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain, 2014. 15: p. 69.

80. Di Lorenzo, C., et al., Migraine improvement during short lasting ketogenesis: a proof-of-concept study. Eur J Neurol, 2015. 22(1): p. 170-7.

Top 10 Paleo Foods for Heart Health | The Paleo Diet

One of the things I love most about a True Paleo regime is being able to enjoy so many of the foods I used to think were unhealthy choices.

And despite diet trends coming and going, many people get caught up with some of the less healthy versions along with the inaccurate hype that tends to surround them.

Some of the foods I now savor are ones I never would have dreamed of eating a mere decade ago, simply because I thought they were too high in fat (90’s mindset), didn’t provide enough carbohydrate (Endurance athlete? Go heavy on the carbs.), or simply because the sheer number of calories might exceed what I’d need in a given day (Exercise physiology thesis: Calories In vs. Out is the single, most important factor in determining whether you would lose weight, gain weight or stay the same), source of calories aside.

Testing and trying a number of ways of eating thankfully brought me back to a Paleo diet in 2005. Guess what? The many foods I didn’t consider are ones I’ve come to relish. It turns out they not only taste great, but are increasingly beneficial to our health.

February is National Heart Month and there is no better diet than a Paleo diet to promote heart health.

Salmon

One of the best sources of anti-inflammatory omega-3 fatty acids which can lower the risk of irregular heart beat as well as plaque build up in the arteries. 1  Stick with wild, not farmed.

Blueberries

Rich in anthocyanins and flavonoids, antioxidants that can decrease blood pressure and dilate blood vessels.2 Freezing wild berries makes for a surprisingly decadent treat, all on their own!

Citrus

High in flavonoids that are linked with a reduced rate of ischemic stroke caused by blood clots, and rich in vitamin C which has been associated with lower risk of heart disease, like atherosclerosis.3 Boost your heart health by adding tangerines to your spinach salad and quadruple the amount of iron you absorb.

Green Tea

Researchers estimate the rate of cardiac arrest decreases by 11% with consumption of three cups of tea per day.4 Green tea is rich in Theanine, the amino acid that will offset caffeine’s effect.

Tomatoes

Cardio-protective functions provided by the nutrients in tomatoes may include the reduction of low-density lipoprotein (LDL) cholesterol, homocysteine, platelet aggregation, and blood pressure.5 Go local and organic with this fruit in particular.

Extra Virgin Olive Oil

Rich in monounsaturated fats (MUFAs), EVOO may help lower your risk of heart disease by improving related risk factors. For instance, MUFAs have been found to lower your total cholesterol and low-density lipoprotein cholesterol levels.6  Promote heart health by upping your intake of this delicious fat in favor of relying too heavily on nuts.

Spinach

Lutein (a carotenoid); B-complex vitamins; Folate; magnesium; potassium; calcium; fiber.7  Looks like Popeye had the right idea!

Avocados

Consumption of ½ – 1½ avocados a day may help to maintain normal serum total cholesterol. More evidence that good fat is good!8

Wine (Sulfite-Free)

Rich in resveratrol, studies have shown that adults who drink light to moderate amounts of alcohol may be less likely to develop heart disease than those who do not drink at all or are heavy drinkers.9  Cheers to that!

Dark Chocolate

In humans, flavanol-rich cocoa counteracts lipid peroxidation and, therefore, lowers the plasma level.10  Just make sure to stick to the real stuff and go as close to 100% cacao as you can find!

And, just in time for Valentine’s Day, why not use this as the special occasion to enjoy my signature Paleo truffles!

While it’s no surprise wild salmon and leafy greens are included in my list of Top 10 Paleo Foods, when there’s room for the occasional glass of red wine and raw, dark chocolate on a lifelong Paleo regime too, it’s something that many people, myself included, enjoy wholeheartedly.

 

REFERENCES

[1] “The Role of Fish Oil in Arrhythmia Prevention”, Anand RG, Alkadri M, Lavie CJ, Milani RV. Mar-Apr 2008

[2] “Daily Blueberry Consumption Improves Blood Pressure and Arterial Stiffness in Postmenopausal Women with Pre- and Stage 1-Hypertension: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial”, Sarah A. Johnson, PhD, RD, CSO, Arturo Figueroa, MD, PhD, FACSM, Negin Navaei, Alexei Wong, PhD, Roy Kalfon, MS, Lauren T. Ormsbee, MS, Rafaela G. Feresin, MS, Marcus L. Elam, MS, Shirin Hooshmand, PhD, Mark E. Payton, PhD, Bahram H. Arjmandi, PhD, RD, October, 2014

[3] Woollard KJ, Loryman CJ, Meredith E, et al. Effects of oral vitamin C on monocyte: endothelial cell adhesion in healthy subjects. Biochem Biophys Res Commun. 2002 Jun 28;294(5):1161-8.

[4] Cooper R, Morre DJ, Morre DM. Medicinal benefits of green tea: Part I. Review of noncancer health benefits. J Altern Complement Med. 2005;11(3):521-8.

[5] Crit Rev Food Sci Nutr. 2003;43(1):1-18. Tomatoes and cardiovascular health. Willcox JK1, Catignani GL, Lazarus S.

[6] Lecerf JM. Fatty acids and cardiovascular disease. Nutrition Reviews. 2009;67:273.

[7] Ursula Arens, dietetician at the British Dietetic Association, Kathleen Zelman, WebMD director of nutrition. U.S. Highbush Blueberry Council. British Heart Foundation. British Dietetic Association. The Journal of the American Medical Association , July 23/30, 2003.

[8] Influence of avocados on serum cholesterol.[Proc Soc Exp Biol Med. 1960]

[9] Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ. 2011;342:d636.

[10] Wiswedel I, Hirsch D, Kropf S, Gruening M, Pfister E, Schewe T, Sies H. Flavanol-rich cocoa drink lowers plasma F(2)-isoprostane concentrations in humans. Free Radic Biol Med. 2004; 37: 411–421.

Seafood Mercury Concerns Subside Amid New Research | The Paleo Diet

Fish and other marine life have been integral to human diets since the Paleolithic era. Some researchers even speculate that these foods “made us human” by enabling the rapid expansion of grey matter in the cerebral cortex. For three million years of evolution during the time of Australopithecus, brain capacity remained constant, but then curiously doubled during a one-million-year period between Homo erectus and Homo sapiens.1 The reasons for this great expansion are not entirely known, but increased dietary omega-3 from fish and shellfish was likely involved.

Fish consumption remains critically important today, but comes with complications unimaginable to our distant ancestors. Industrial pollution has greatly increased environmental mercury, much of which ends up in oceans and lakes, and finally, in small amounts, in the bodies of fish. In higher amounts, mercury is toxic and is especially problematic for developing babies. For years, the FDA was advising pregnant women to limit their fish consumption during pregnancy, but last year, they issued a draft revision encouraging prenatal fish consumption.2 This draft, which will eventually replace their previous recommendations, reflects a growing awareness, seen in the scientific literature, that fish is essential for developing babies and contains nutrients that limit, or even counter, the potentially harmful effects of mercury.

Recently published in the American Journal of Clinical Nutrition, a new study, representing 30 years of research in the Seychelles, is one of the longest and largest population studies regarding seafood and mercury.3 The Seychelles is a nation of islands clustered together in the Indian Ocean, where residents consume 10 times as much seafood as do Europeans and Americans, making it an ideal place to study the long-term impact of mercury exposure via seafood. The researchers concluded that high fish consumption by pregnant mothers, as much as 12 meals per week (the FDA recommends three), does not cause developmental problems in children.

To the contrary, fish is extremely beneficial for development, and contains special nutrients that protect against mercury. Lead author Dr. Sean Strain explained, “This research provided us the opportunity to study the role of polyunsaturated fatty acids [PUFAs] on development and their potential to augment or counteract the toxic properties of mercury.”4 Mercury is thought to damage the brain through oxidation and corresponding inflammation. Fish are rich in omega-3 PUFAs, which prevent inflammation, as opposed to omega-6 PUFAs, which promote inflammation. This was reflected in the study whereby children of mothers who had higher omega-6 blood levels performed worse on tests designed to measure motor skills.

This study builds upon an impressive body of research conducted by Dr. Nicholas Ralston and colleagues at the University of North Dakota. Ralston has demonstrated that selenium also protects against mercury toxicity and that foods with relatively higher amounts of selenium with respect to mercury, pose neither developmental nor neurological risks based on mercury toxicity.5 “This may explain,” Ralston says, “why studies of maternal populations exposed to foods that contain Hg [mercury] in molar excess of Se [selenium], such as shark or pilot whale meats, have found adverse child outcomes, but studies of populations exposed to MeHg [methylmercury] by eating Se-rich ocean fish observe improved child IQs instead of harm.”6

The vast majority of commonly consumed fish and shellfish contain far more selenium relative to mercury and many have significant amounts of omega-3 PUFAs. This means that fish and shellfish, two important components of the Paleo diet, should not be limited nor discontinued based on mercury concerns. Whether for pregnant women, babies, children, or adults, we encourage you to keep seafood on the menu.

Christopher James Clark, B.B.A.

@nutrigrail
Nutritional Grail
www.ChristopherJamesClark.com

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.

REFERENCES

[1] Bradbury, J. (May 2011). Docosahexaenoic Acid (DHA): An Ancient Nutrient for the Modern Human Brain. Nutrients, 3(5). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257695/

[2] U.S. Food and Drug Administration. (June 2014). Fish: What Pregnant Women and Parents Should Know. Draft Updated Advice by FDA and EPA. Retrieved from http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm393070.htm

[3] Strain, JJ, et al. (January 2015). Prenatal exposure to methyl mercury from fish consumption and polyunsaturated fatty acids: associations with child development at 20 mo of age in an observational study in the Republic of Seychelles. American Journal of Clinical Nutrition, 101(1). Retrieved from http://ajcn.nutrition.org/content/early/2015/01/21/ajcn.114.100503

[4] University of Rochester Medical Center. (January 21, 2015). Fatty acids in fish may shield brain from mercury damage. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2015/01/150121144835.htm

[5] Ralston, NV and Raymond, NJ. (November 2010). Dietary selenium’s protective effects against methylmercury toxicity. Toxicology, 278(1). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20561558

[6] Ibid, Ralston.

Paleo Diet Primer: Fats and Oils | The Paleo Diet

When it came to fats and oils, the choice was simple for our hunter gatherer ancestors. All dietary fats were consumed directly from the food source and were based on their geographic availablity. They ate the whole carcass of wild animals, including all of the organs and visceral fat, and foraged for fatty, high oil plants. These foods balanced the fatty acids in their diet. Today, as technology engineers oils from vegetable seeds, like mustard seed, cottonseed, and grapeseed (canola) oil, not only is the yield unnatural, it is also unsafe for consumption.

All animal fats, such as lard, tallow, duck and chicken fat, can withstand very high temperatures without oxidizing,1 and have prolonged shelf lives. However, navigating the bottled oil aisle at any grocery store can overwhelm even the most advanced label reader to decipher which  oils are safe and optimal for health.  A thorough explanation of the fatty acid composition of vegetables oils, as well as identifying the six vegetable oils (flaxseed, walnut, olive, macadamia, coconut, and avocado)  that are best suited for the Paleo Diet can be found HERE.  Yet, many of us still struggle with which cooking oil to select and how to heat it without compromising the nutritious benefits.

When heating any oil, it is important to keep them below their smoke point, (before oil burns to the point of smoking). Oils heated above their stability point begin to decompose, releasing free radicals along with toxic fumes. Oils are often refined to raise their smoke point. The refining process (heating, neutralization, filtering, and processing with chemicals and bleaching agents) removes the  oils from their pure state.2 Thus, despite their lower smoke point, unrefined virgin oils are preferential.

Flaxseed oil

If we look to hunter-gather-societies, we see they did not regularly use flaxseed oil. It was originally included in The Paleo Diet as a tool to balance out increased omega-6/omega-3 fatty acid ratio due to the excessive intake of omega-6 vegetable oils, especially linoleic acid, in the average western diet. Flaxseed oil is exceptionally high in alpha-linolenic acid (ALA), which is the parent fatty acid to Omega-3 fatty acids. Omega-3 fatty acids are extremely sensitive to heat, oxygen, and light,3 so refrigerate and never heat, but instead use in a salad dressing or as a finishing oil over cool vegetables.

Walnut Oil

Walnut oil possesses many antioxidants, including ellagic acid, which research suggests is antiatherogenic and supports osteoblastic activity.4 It’s a great source of omega-3 fatty acids 5 and although the refined version is often labeled safe for high-heat cooking, it is best not to heat it to high temperatures. Not only will the omega-3s be damaged, but the oil will also develop a bitter taste. The unrefined version can be heated to 320°F,6 so sauté vegetables in walnut oil  at low-to-medium heat, or drizzle on any salad.

Extra-Virgin Olive Oil

Olive oil contains at least 30 phenolic compounds.7 Phenols have been shown to reduce the amount of oxidative stress on the body8 and  protect the polyunsaturated fat in the olive oil from oxidizing. Olive oil is a great source of healthy monounsaturated fats, which help control cholesterol levels and have been linked with heart health. There are many varieties of olive oils, sourced from all over the world. Each has its own unique flavor and color that can be experimented with to highlight whatever dish you are cooking. And, while extra virgin olive oil has a smoke point of 325°F,9 it is fairly resistant to oxidation, even when used for high-heat deep-frying.10, 11

Macadamia Nut Oil

Macadamia nut oil is higher in monounsaturated fats than olive oil12 and provides the lowest level of omega-6 fats of any nut.13 It is high in phytochemicals, (qualene, tocotrienols and tocopherols), which protect against oxidation, making it suitable for room temperature storage for up to two years.14 Macadamia nut oil has been shown to improve the biomarkers of oxidative stress, inflammation, and reduce the risk factors for coronary artery disease.15

With a smoke point of 413°F, 16 macadamia oil can be used for almost any dish whether you’re grilling, sautéing or stir-frying. It can even be used a binder for homemade Paleo mayonnaise.

Coconut Oil

Coconut oil is more than 90% saturated fat; specifically it is high in medium chain triglyceride (MCT). MCTs do not require bile acids for digestion, which makes them easy to digest and available immediately as a fuel source.17 Coconut oil is also rich in lauric acid, a fatty acid found in mother’s milk that has anti-fungal, anti-bacterial and anti-viral properties.18 Unrefined coconut oil, which has not been bleached or filtered to remove impurities or natural flavors, has a smoke point of 320°F.19

Coconut oil, which is solid at room temperature, can be used as a replacement in any recipe that calls for butter, such as for coating a whole chicken before roasting. It also works well with Caribbean or Asian recipes, especially to those who aren’t quite accustomed to the flavor. We use it regularly to sauté vegetables, like kale or onions, as well as to grease the pan for cooking eggs.

Avocado oil

Avocados, thought classified as a fruit, are high in oil content. Cold pressing of avocados retains a high concentrations of vitamin E 20 and chlorophyll (40-60mg/kg), which gives the oil a green tint. 21 Research shows consuming avocado oil enhances carotenoid absorption from vegetables,22 and can decrease your risk of coronary artery disease.23 Similar to olive oil, avocado oil has a higher Omega 6:3 ratio (13.1:1).24 Avocado oil can withstand the heat. Virgin (unrefined) avocado oil has a smoke point of 40025 and can be used in any high heat cooking, dressing or as a finishing oil.

 

REFERENCES

[1] Sherwin, E. R. Oxidation and antioxidants in fat and oil processing. Journal of the American Oil Chemists’ Society 55.11 (1978): 809-814.

[2] Available at: http://www.business2community.com/health-wellness/the-danger-of-cooking-with-healthy-oils-past-their-smoke-point-0418150. Accessed on October 28, 2014.

[3] Choo, W. S., E. J. Birch, and J. P. Dufour. Physicochemical and stability characteristics of flaxseed oils during pan-heating. Journal of the American Oil Chemists’ Society 84.8 (2007): 735-740.

[4] Papoutsi, Z., et al. Walnut extract (Juglans regia L.) and its component ellagic acid exhibit anti-inflammatory activity in human aorta endothelial cells and osteoblastic activity in the cell line KS483. British journal of nutrition 99.04 (2008): 715-722.

[5] Available at: http://www.hsph.harvard.edu/nutritionsource/omega-3/.  Accessed on October 28, 2014.

[6]Available at: http://www.goodeatsfanpage.com/collectedinfo/oilsmokepoints.htm. Accessed on October 28, 2014

[7] Tuck, Kellie L., and Peter J. Hayball. Major phenolic compounds in olive oil: metabolism and health effects. The Journal of nutritional biochemistry 13.11 (2002): 636-644.

[8] Kim, Hwa-Young, Ok-Hee Kim, and Mi-Kyung Sung. Effects of phenol-depleted and phenol-rich diets on blood markers of oxidative stress, and urinary excretion of quercetin and kaempferol in healthy volunteers. Journal of the American College of Nutrition 22.3 (2003): 217-223.

[9]Available at: http://culinaryarts.about.com/od/culinaryreference/a/smokepoints.htm. Accessed on October 28, 2014.

[10] Casal, Susana, et al. Olive oil stability under deep-frying conditions. Food and Chemical Toxicology 48.10 (2010): 2972-2979.

[11] Sutherland, Wayne HF, et al. Effect of meals rich in heated olive and safflower oils on oxidation of postprandial serum in healthy men. Atherosclerosis 160.1 (2002): 195-203.

[12] Ako, H, Okuda D, and Gray D. Healthful new oil from macadamia nuts. Nutrition (Burbank, Los Angeles County, Calif.) 11.3 (1995): 286.

[13] Avaialable at: http://blog.lluniversity.com/nuts-and-oils-why-coconut-and-macadamia-nut-are-king/. Accessed on October 28, 2014.

[14] Wall, Marisa M. Functional lipid characteristics, oxidative stability, and antioxidant activity of macadamia nut (Macadamia integrifolia). Food chemistry 121.4 (2010): 1103-1108.

[15] Garg, Manohar L, et al. Macadamia nut consumption modulates favourably risk factors for coronary artery disease in hypercholesterolemic subjects. Lipids 42.6 (2007): 583-587.

[16] Available at: http://www.naturalnews.com/029202_olive_oil_smoke_point.html.  Accessed on October 14, 2014.

[17] Prior, IA, et al. “Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies.” The American journal of clinical nutrition 34.8 (1981): 1552-1561.

[18] Isaacs, CE, et al. “Antiviral and antibacterial lipids in human milk and infant formula feeds.” Archives of Disease in Childhood 65.8 (1990): 861-864.

[19] Available at: http://www.livestrong.com/article/446041-is-coconut-oil-good-for-frying-on-high-temperature-cooking/. Accessed on October 28, 2014.

[20] Eyres L, Sherpa N and Hendriks G. Avocado oil: a new edible oil from Australasia. Lipid Technol 2001;Vol 13, no 4:84-88.

[21] Swisher, Horton E. Avocado oil. J Am Oil Chem 65 (1988): 1705.

[22] Unlu, Nuray Z., et al. “Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil.” The Journal of nutrition 135.3 (2005): 431-436.

[23] Watts GF, Lewis B, Brunt JNH, Lewis ES, Coltart DJ, Smith LDR, Mann JI and Swan AV. Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas’ Atherosclerosis Regression Study (STARS). Lancet 1992;339:563-569.

[24] Available at: https://theconsciouslife.com/omega-3-6-9-ratio-cooking-oils.htm. Accessed on October 28. 2014.

[25] Available at: http://www.vegkitchen.com/tips/avocado-oil-expeller-pressed-naturally-refined/attachment/smoke-point-chart/. Accessed on October 28, 2014.

Vegetarian Diet | The Paleo Diet

Did you miss Vegetarian and Vegan Diets: Nutritional Disasters Part 1 or Part 2?
Read Part 1 HERE
Read Part 2 HERE

Vegetarian Diets: Other Nutritional Shortcomings

You don’t have to look any further than the ADA’s Position Statement28 or the USDA’s recommendations on vegetarian diets142 to discover additional nutrient shortcomings caused by plant based diets. The ADA matter of factly mentions that “…key nutrients for vegetarians include protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B12..28 The USDA notes that “…vegetarians may need to focus on…iron, calcium, zinc, and vitamin B12.142 These subtle admissions of potential nutrient deficiency problems associated with vegetarian diets represent the tip of a nutritional nightmare. Just as was the case with vegetarian diets and vitamin B12 deficiency, there is little credible scientific evidence to show that people eating a lifelong plant based diet (without taking supplements or eating fortified foods) can achieve adequate dietary intakes of omega 3 fatty acids (EPA and DHA), iron, zinc, iodine, calcium, and vitamin D. To this list you can also add vitamin B6 and taurine, an amino acid.

Mineral Deficiencies and Vegetarian Diets

One of the major complications with the assessment of dietary nutrient adequacy in vegetarian diets, or for that matter, any diet has to do with whether or not the vitamins and minerals measured in certain foods actually get absorbed into our bodies. The bioavailability of vitamins and minerals in foods is just as important in how they impact our health as is the simple content of these nutrients in a food. By now you know that phytate is not a good thing because it prevents absorption of essential minerals. Whole grains and legumes are rich sources of phytate. Accordingly, our bodies have great difficulty extracting certain minerals from these foods because they are tightly bound to phytate. Phytate in whole grains impairs calcium absorption and may adversely affect bone health. Further, phytate also binds zinc, thereby interfering with its assimilation and incorporation into our cells. To this list you can add iron and magnesium. Because vegetarian diets are virtually impossible to follow without including lots of whole grains, beans, soy and legumes, they are inherently high in phytate. This is why it is difficult or impossible for vegetarians and vegans to maintain adequate body stores of calcium, zinc and iron.

Zinc Deficiencies in Vegetarian Diets

From the discussion above, you know that zinc is crucial for normal male reproductive function, but it is also required for good health and disease resistance in virtually every cell in our bodies, whether you are a man, woman or child.20, 41 Marginal zinc status impairs our immune system, slows wound healing, adversely affects glucose and insulin metabolism, and damages our body’s built in antioxidant system.16, 55 Without adequate dietary zinc we experience more upper respiratory illnesses that last longer. Zinc lozenges can slow or prevent common cold symptoms, and zinc oxide creams applied topically can speed healing. If you have ever experienced painful cracked heels or nose bleeds that just wouldn’t stop, try rubbing zinc oxide ointments on these wounds – you will be amazed at how rapidly zinc can heal these stubborn sores. How we got into this problem (marginal zinc status or deficiencies) in the first place originates directly from our diets. Anybody eating excessive whole grains and/or legumes and not eating meat, fish or animal products on a regular basis45, 59, 62 puts themselves at risk for all illnesses and health problems associated with borderline or deficient zinc intakes.

Iron Deficiencies in Vegetarian Diets

Your body stores of iron run hand in hand with zinc. The same types of diets that produce zinc deficiencies also create iron deficiencies. High phytate vegetarian diets based upon whole grains, beans, soy and other legumes invariably cause iron deficiencies5, 135 which are the most common nutrient deficit worldwide. In the U.S. 9% of all women between 12 and 49 years are iron deficient, while 4% of 3 to 5 year old children have insufficient stores of this crucial mineral.25 If you are pregnant, low iron status increases your risk of dying during childbirth, and frequently causes low birth weights and preterm deliveries. Even more disturbing is the potential for iron deficiencies to prevent normal mental development in our children and young adults.39, 90, 96 As a parent, I would never wish upon my child or for that matter anyone else’s, a diet causing nutritional deficiencies known to impair brain development and normal mental function. But this is just the case if you eat a vegetarian diet and impose it upon your children. Plant based diets not only increase the risk of impaired cognitive function in your children, but will hamper your own mental functioning. Numerous experimental studies show that inadequate iron stores in adults can slow or impair tasks requiring concentration and mental clarity.73

One of the most important outcomes of diets that cause iron deficiencies is that they make us fatigued and tired. If you are an athlete or have a demanding job requiring physical exertion, low iron stores will invariably reduce your performance. A recent (2009) experiment involving 219 female soldiers during military training showed that iron supplements improved blood iron stores, increased performance for a 2 mile run and enhanced mood.92 Similarly a study by Dr. Hinton and colleagues demonstrated that iron supplements in iron deficient male and female athletes improved endurance performance and efficiency.56 Whether you are an athlete, a laborer or even an office worker, your best nutritional strategy to improve iron stores, add vigor to your life and improve performance is to eliminate whole grains and legumes from your diet by adopting The Paleo Diet.

The burden of proof that vegetarian diets will not produce multiple vitamin and mineral deficiencies lies upon the governmental (USDA) and dietary organizations (ADA) that recommend these diets to us all and tell us that they are safe.28, 142 You might expect that the experimental evidence surrounding vegetarian diet recommendations would be convincing and overpowering. Nothing could be further from the truth, particularly when it comes to iron deficiencies and vegetarian diets.

As always the devil is in the details when it comes to getting correct answers to nutritional questions. Scientists who believe that vegetarian diets don’t adversely affect our iron stores often cite scientific papers showing no difference between blood iron concentrations in vegetarians and meat eaters. What they don’t tell us is how iron measurements were performed in the experiments they quote to support their viewpoint. This information is absolutely essential in knowing if iron deficiencies exist or not. Any study examining blood levels of iron in vegetarians using either measurements of hemoglobin (an iron carrying substance in red blood cells) or hematocrit (the concentration of red blood cells) are unreliable indicators of long term iron status. A much better marker is an iron carrying molecule called ferritin.75 Virtually all epidemiological (population) studies of vegans or ovo/lacto vegetarians show them to be either deficient or borderline iron deficient when blood ferritin levels are measured. Given this nearly unanimous finding from epidemiological studies, you might think that either the USDA or the ADA would become concerned and re-examine their endorsement of vegetarian diets. Unfortunately, we still live with governmental and institutional dietary recommendations that may do considerable harm to our health.

The most convincing type of experiments to reveal whether or not vegetarian diets may cause our iron stores to nosedive are called dietary interventions. Why not put a large group of non-vegetarians on a plant based diet for an extended period and see what happens to their blood iron levels? Wow what a great idea – unfortunately no such study has ever been conducted. The closest we have come to this experiment is a short term study (8 weeks) by Dr. Janet Hunt and co-workers at the Grand Forks Human Nutrition Research Center in North Dakota.63 The results of this experiment were anything but conclusive as the researchers made a fundamental blunder in the design of their experiment – they forgot to include a control group. Without a control group, it is impossible to interpret the outcome of this or any experiment.

Nevertheless, when women were placed on lacto/ovo vegetarian diets, their intestinal iron absorption was reduced by 70%; however, inexplicably, blood ferritin levels (a marker of their long-term iron status) did not decline for the group as a whole. It should be noted that nearly half of the subjects did experience drops in blood ferritin concentrations. Because the authors of this study failed to include a control group, then extraneous variables likely swayed the experiment’s outcome. You recall from earlier in this essay that vegetarian diets caused 7 out of 9 women to stop ovulating. With the cessation of menstrual periods, monthly blood loses also cease which in turn prevents monthly iron losses because blood is a rich source of iron. Hence, in any study evaluating blood iron stores in women, it is absolutely essential to know if their normal menstrual cycles were altered. Unfortunately, Dr. Hunt did not provide us with this information, thereby making the correct interpretation of her experiment difficult or impossible.

In order to once and for all know whether or not vegetarian diets cause iron deficiencies, we would need to perform Dr. Hunt’s experiment again, for at least a year with more subjects, a control group and monitor changes in menstrual periods. You would think that this kind of very basic experimental evidence would have already been in place before any governmental or institutional organization told us that vegetarian diets were safe and didn’t cause nutritional deficiencies. Unfortunately, these precautionary steps have never been taken, and millions of Americans who adhere to vegetarian diets with the mistaken belief that they will benefit health-wise will actually suffer.

Iodine Deficiencies in Vegetarian Diets

A number of studies have reported that vegetarian and vegan diets increase the risk for iodine deficiency.40, 77, 102, 153 One study from Europe demonstrated that 80% of vegans and 25% of ovo/lacto vegetarians suffered from iodine deficiency.77 Additionally, a dietary intervention by Dr. Remer and colleagues in 1999 confirmed this epidemiological evidence.102 After only five days on ovo/lacto vegetarian diets, iodine status and function became impaired in healthy adults.102 The primary reason why vegetarian diets cause iodine deficiencies is that plant foods (except for seaweed) are generally poor sources of iodine compared to meat, eggs, poultry and fish. Gross deficiencies of iodine cause our thyroid glands to swell producing a condition known as goiter, and in pregnant women result in severe birth defects called cretinism.141 Because salt is fortified with iodine, most people in the U.S. and Europe rarely develop gross iodine deficiencies.40, 140, 141 However moderate to mild iodine deficiencies appear in westernized countries, particularly among vegetarians and vegans.77, 102 Moderate iodine deficiency impairs normal growth in children and adversely affects mental development.140, 141, 152 A large meta analysis revealed that moderate childhood iodine deficiency lowered I.Q. by 12-13.5 points.153 Paleo Diets are not just good medicine for adults, but they also ensure normal physical and mental development in our children because of their high iodine content.

One of the problems with plant based diets is that they may put into play a vicious cycle that makes iodine deficiencies worse. When the thyroid glands iodine stores become depleted, as often happens with vegetarian diets, then certain antinutrients found in plant foods can gain a foot hold and further aggravate iodine shortages. Soy beans and soy products are frequently a mainstay in vegetarian diets and may promote inflammation.66 Unfortunately soy contains certain antinutrients (isoflavones) that impair iodine metabolism in the thyroid gland,43, 95 but only when our body stores of iodine are already depleted. Other plant foods (millet, cassava root, lima beans, sweet potatoes, and cruciferous vegetables [broccoli, cauliflower, turnips, kale, cabbage]) also contain a variety of antinutrients which hinder normal iodine metabolism. So, plant based diets put us at risk for developing iodine deficiencies in the first place, and when this happens our bodies become vulnerable to plant antinutrients that worsen the pre-existing deficiency. The important point here is that antinutritional compounds have virtually zero effect upon our thyroid gland when our body stores of iodine are normal and fully replete. Because meats, fish, eggs and poultry are rich sources of iodine, you will never have to worry about this nutrient when you eat Paleo style.

Vitamin D and Vitamin B6 Deficiencies in Vegetarian Diets

In my paper, Cereal Grains: Humanity’s Double Edged Sword, I have pointed out how excessive consumption of whole grains adversely affects vitamin D status in our bodies.148 Hence it goes without saying that vitamin D deficiencies run rampant in vegetarians worldwide because it is nearly impossible to become a full-fledged vegetarian without eating lots of grains. In the largest study of vegetarians ever undertaken (The Epic-Oxford Study), Dr. Crowe and fellow researchers reported that blood concentrations of vitamin D were highest in meat eaters and lowest in vegans and vegetarians.29 Nearly 8% of the vegans maintained clinical deficiencies of vitamin D. Vitamin D is not really a vitamin at all, but rather a crucial hormone that impacts virtually every cell in our bodies.

By now, you are starting to get a pretty good picture of what a nutritional nightmare vegetarian diets really are. When we let the data speak for itself, the number of nutrient deficiencies and adverse health effects associated with plant based diets are appalling and far outweigh any supposed health effects of this unnatural way of eating. One of the biggest kept secrets about vegan or vegetarian diets is that they frequently cause vitamin B6 deficiencies. If you recall, neither the ADA,28 nor the USDA142 has given us any warning that meatless diets increase our risk for vitamin B6 deficiencies.

On paper, it would appear that vegetarian diets generally meet daily recommended intakes for vitamin B6. This assumption comes primarily from population surveys examining the foods that vegans and vegetarians normally eat. In contrast, when blood samples are analyzed from people relying upon plant based diets, they unexpectedly reveal that long term vegetarians and vegans frequently are deficient vitamin B6. A recent study of 93 German vegans by Dr. Waldman and colleagues showed that 58% of these men and women suffered from vitamin B6 deficiencies despite seemingly adequate intakes of this essential nutrient.131 It turns out that the type of vitamin B-6 (pyridoxine glucoside) found in plant foods is poorly absorbed.47, 103 The presence of pyridoxine glucoside in plant foods along with fiber has been reported to reduce the bioavailability of vitamin B6 so that only 20 to 25% is absorbed and completely utilized.47 In contrast, vitamin B6 found in animal foods is easily assimilated, and an estimated 75 to 100% fully makes its way into our bloodstreams.47

Compelling evidence that vegetarian diets relying upon the plant form of vitamin B6 adversely affect our body’s overall vitamin B6 stores comes from Dr. Leklem’s laboratory at Oregon State University.47 Nine women were put on diets either high or low in the plant form of vitamin B6 (pyridoxine glucoside). After only 18 days, the high pyridoxine glucoside diets consistently lowered blood concentrations and other indices of vitamin B6 status. Deficiencies in this vitamin elevate blood homocysteine concentrations and increase our risk for cardiovascular disease similar to shortages of folate and vitamin B12. Further, vitamin B6 is an important factor in normal immune system functioning149 and shortfalls of this crucial nutrient have been identified in depression150 and colorectal cancer.151

Omega 3 Fatty Acid Deficiencies in Vegetarian Diets

A few years ago I was involved in a series of experiments here at Colorado State University in which we were interested in determining how high and low salt diets affected exercise-induced asthma. Our working hypothesis was that high salt diets would make measures of lung function worse, and low salt diets would improve things. One of our concerns with this experiment was to somehow make sure our subjects had fully complied with either the high or low salt diets. Completely removing salt from your diet is not an easy thing to do, and if some of our subjects had decided to sneak in a piece of pizza or some Doritos, it would mess up the experiment’s outcome. Fortunately, there was an easy way to figure out if our subjects had been compliant with the prescribed diets. All we had to do was to spot check their urine, because measurement of urinary salt levels is an accurate gauge of dietary salt consumption. High urinary salt levels universally reflect high salt consumption, whereas low urinary salt concentrations indicate low salt consumption. Short of major disease, there is virtually no other way high amounts of salt in the urine don’t indicate high amounts of salt in the diet.

In a similar manner, there are equivalent telltale indicators of omega 3 fatty acids in our bloodstreams that tell us beyond a shadow of a doubt whether or not we have regularly consumed fish, seafood or other good sources these healthful fats. The three main types of omega 3 fatty acids we need to concern ourselves with are EPA, DHA and ALA. EPA and DHA are called long chain omega 3 fatty acids and are only found in high amounts in fish, seafood, certain meats, and other foods of animal origin. Plant foods contain no EPA or DHA. On the other hand, ALA is called a short chain fatty acid and is found in both plant and animal foods. Both EPA and DHA in our red blood cells are markers of these important fatty acids in our diet. Without good dietary sources of EPA and DHA such as are found in fish, seafood and certain meats, our blood levels of EPA and DHA will decline. Just like salt in our urine was an indicator for dietary salt, EPA and DHA concentrations in our red blood cells are markers for our dietary intake of these long chain omega 3 fatty acids. It is virtually impossible to achieve high blood levels of EPA and DHA without regularly consuming fish, seafood and certain meats and organ meats (particularly grass produced meats and organ meats).

One of the major nutritional shortcomings in vegans is that they obtain absolutely no EPA or DHA from their diets.108, 110, 111 Consequently, they are totally dependent upon plant based ALA, supplements or fortified foods to obtain these healthful long chain omega 3 fatty acids. Without supplements or fortified foods, all vegans will become deficient in EPA and DHA because plant based ALA is inefficiently converted into these long chain fatty acids in our bodies. The liver converts less than 5% of ALA into EPA and less than 1% of ALA into DHA.15, 97 Virtually every epidemiological study that has ever been published shows that vegans, who do not supplement or consume long chain omega 3 fortified foods, to be deficient in both EPA and DHA76, 88, 108, 110, 111 Lacto/ovo vegetarians don’t fare much better because milk and egg based vegetarian diets simply do not supply sufficient DHA or EPA to maintain normal blood concentrations.88, 111

There is little doubt that vegan or vegetarian diets cause reductions in blood concentrations of DHA and EPA, which in turn represent a potent risk factor for many chronic diseases. Perhaps the single most important dietary recommendation to improve your health and prevent illness is to increase your dietary intake of EPA and DHA. Thousands of scientific papers covering an assortment of diseases clearly show the health benefits of these fatty acids. In randomized clinical trials in patients with pre-existing heart disease, omega-3 fatty acid supplements significantly reduced cardiovascular events (deaths, non-fatal heart attacks, and non-fatal strokes).19, 48, 138 Omega-3 fatty acids lessen the risk for heart disease through a number of means including a reduction in heart beat irregularities called arrhythmias, a decrease in blood clots, and reduced inflammation which is now known to be an chief factor causing atherosclerosis or artery clogging.

In addition to lowering the risk for heart disease, regular consumption of fish or supplemental omega-3 fatty acids may be useful in averting, treating, or improving a wide range of diseases and disorders, including virtually all inflammatory diseases (any disease ending with “itis”): rheumatoid arthritis,99 inflammatory bowel disorders (Crohn’s disease, ulcerative colitis), periodontal disease (gingivitis). Also mental disorders (autism, depression),3, 84 postpartum depression, bi-polar disorder, borderline personality disorder, impaired cognitive development in infants and children) may respond favorably to these beneficial fatty acids. Further, acne, asthma, exercise induced asthma, many types of cancers,120 macular degeneration, pre-term birth, psoriasis, insulin resistance, type 2 diabetes, cancer cachexia, intermittent claudication, skin damage from sunlight, IgA nephropathy, lupus erythematosus, type 1 diabetes, multiple sclerosis, and migraine headaches also improve with omega 3 fatty acids.

Taurine deficiencies in Vegetarian Diets

Although the number of nutrients which are frequently lacking in vegetarian and vegan diets may seem endless to you, we are now at the end of the list. Taurine is an amino acid (actually a sulfonic acid because it lacks a carboxyl group) in our bloodstreams that has multiple functions in every cell of our body. Unfortunately, this nutrient is not present in any plant food and is found in low concentrations in milk (6 mg per cup).80 In contrast, all flesh foods are excellent sources of taurine.80 For example, ¼ pound of dark meat from chicken provides 200mg of taurine. Shellfish are even richer still with over 800mg per quarter pound. The daily taurine intake in non-vegetarians is about 150mg, whereas lacto/ovo vegetarians take in about 17mg per day, and vegans get none. Although our livers can manufacture taurine from precursor molecules, our capacity to do so is limited – so much so that this amino acid is regularly fortified in infant formulas. As you might expect, studies of vegans show that their blood taurine levels are lower than meat eaters.81, 100 How depleted blood concentrations of taurine affect our overall health, is not entirely understood. Nevertheless, shortages of this amino acid and omega 3 fatty acids (EPA and DHA) may cause certain elements (platelets) in our blood to clot more rapidly which in turn increase our risk for cardiovascular disease.85, 91 Despite their meat free diets, vegetarians almost always exhibit abnormal platelets that excessively adhere to one another. In one dietary intervention, Dr. Mezzano and colleagues demonstrated that after eight weeks of EPA and DHA supplementation normal platelet function was restored in a group of 18 lacto/ovo vegetarians.85 Obviously, compromised taurine status will never become a problem in Paleo Diets, because meat, fish, poultry and animal products are consumed at nearly every meal.

In summary, if you have adopted, or are considering adopting a plant based diet for reasons of improving your health, make sure you reread this chapter and look up all of the references I have provided you. The evidence that vegetarian and vegan diets almost always cause a multitude of nutritional deficiencies is overwhelming and conclusive. Over the course of a lifetime, vegetarian diets will not reduce your risk of chronic disease and will not allow you to live longer. Rather, this abnormal way of eating will predispose you to a host of health problems and illnesses. Vegetarianism is an unnatural way of eating that has no evolutionary precedence in our species. No hunter-gatherer society ever consumed a meatless diet, nor should you. The ADA has labeled The Paleo Diet a fad diet because it eliminates “two entire food groups” (grains and dairy). Yet hypocritically, they exempt vegan diets from this characterization despite also eliminating two food groups (dairy, meats and fish). If The Paleo Diet is a fad diet, then it is the world’s oldest.

Cordially,

Loren Cordain, Ph.D., Professor Emeritus

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Selecting Seafood for Health and Sustainability | The Paleo Diet

There’s no question that seafood is a great source of protein and omega-3 fatty acids, and that it should form an integral part of the Paleo Diet. But seafood doesn’t thrive in polluted waters, overfished waters, or in habitats damaged by fishing gear. So to get the good without the bad—and to ensure we have it for years to come—we need to know which species have the holy trinity of seafood: sustainable, safe, and nutritious.

Sustainable

Sustainably caught fish may seem like a nice-to-have, but it should really be on par with nutrition for importance when selecting seafood. Not only do we want our food to be harvested or caught in its highest nutritive state, we want that to continue indefinitely. It hasn’t always been that way, but more and more fisheries are making sustainability a reality by considering the health of ecosystems and fish populations as well as their profits. Seafood Watch® makes science-based recommendationsfor sustainable seafood.1,2,3 Here’s their current list of best choices, good alternatives, and choices to avoid.

Selecting Seafood for Health and Sustainability

The seafood recommendations in this guide are credited to the Monterey Bay Aquarium Foundation ©2014. All rights reserved.

Download the PDF

Safe

In the seafood world, mercury, dioxins, and PCBs are the usual suspects when it comes to contamination. They’re not normally features of a “healthy and abundant stock” which is a fundamental criterion for sustainability1—so if you’re choosing sustainable, you’re likely choosing safe too. In addition, SeafoodWatch® posts health alerts if there are specific concerns for human health from a fishery.

Mercury, however, is a changing story. Mercury accumulates in fat tissues of large, long-lived predatory fish or shellfish, ultimately ending up on our dinner plates. We’ve been cautioned to limit these species in our diets, but surprisingly, that’s not the whole story. Mercury readily and irreversibly binds to selenium,4 which means that as long as the fish you’re eating has more selenium than mercury, your body won’t actually be retaining the mercury you ingest. And since the oceans are full of selenium, most ocean fish are perfectly safe to eat.5,6 Simply avoid shark and limit swordfish, tilefish, and king mackerel or use this infographic to moderate your consumption . Also keep in mind that in freshwater, mercury and selenium levels vary greatly with the composition of the surrounding soil. Check with your local authorities for health alerts.

Nutritious

Fish are great sources of vitamins and minerals as well as protein, but the biggest benefit from eating fish is the omega-3 fatty acids EPA and DHA.7 Anyone who’s had king salmon and a haddock fillet can tell you, however, that all fish are not created equal when it comes to fat—and they’re not all created equal when it comes to omega-3 to omega-6 ratios either—and that matters! Here’s some nutritional data from the USDA for some popular fish and shellfish.6

Sustainable Choices in SeafoodSustainable Choices in Seafood

Highlighted numbers in the first four columns are amounts greater than 1 g/100 g; highlighted numbers in the last column are the fish with ratios greater than 5. A few things jump out.

  • Total fat isn’t everything: the number of fish hitting 1 g/100 g decreases as we move from total fat to polyunsaturated fat to omega-3s.
  • Atlantic mackerel, chinook salmon, herring, swordfish, and Bluefin tuna have high total fat and great omega-3/omega-6 ratios.
  • Only farmed Atlantic salmon has more than 1 g/100 g of omega-6s.
  • All but tilapia have an omega-3/omega-6 ratio greater than 1.
  • There doesn’t seem to be a relationship between total fat and the omega-3/omega-6 ratio. There are high fat options with low ratios (Atlantic salmon) and high ratio options with lower fat (squid).

Sustainable + Safe + Nutritious

So can we have our fish and eat it too? Yes! There is an impressively wide array of sustainable options to choose from, and we can assume that they’re safe choices, not only because they’re sustainable, but because they’re high in selenium. Many of those sustainable options are also fatty fish with great omega-3/omega-6 ratios (anything above 1 is great). SeafoodWatch® compiled their “Super Green List” based on these criteria, but let’s look at the poor performers to compare.

  • Atlantic salmon: not sustainably caught, high omega-6s, ratio close to 1
  • Bluefin tuna: great fat profile, great ratio, but not sustainable
  • Tilapia: sustainably farmed, but lower in fat, ratio less than 1
  • Sharks: more mercury than selenium, not sustainably caught

The bottom line: while some seafood looks good in the nutritional breakdown, from a sustainability standpoint, some species may be better than others. So, eat your recommended portion of omega-3s, but choose options that tick all the boxes for your health as well as the ocean’s.

Andrea MooreAndrea Moore has dipped her toes in a lot of ponds, lakes, and oceans over the years. She has adventured around the world doing odd jobs and studying biology, languages, and sailing.

Now surprisingly settled in Halifax, Nova Scotia, Andrea’s still up to a bit of everything as a marine biologist, a writer, and an editor, living the Paleo lifestyle.

fix-logoFix.com is a lifestyle blog devoted to bringing you expert content to make your life easier. From products, to food, to fishing, to projects, we’ll be providing you with a daily fix of content from our experienced and knowledgeable team of writers.

 

REFERENCES

1. Monterey Bay Aquarium. Developing Seafood Watch® Recommendations. Version: January 23, 2014.

2. Monterey Bay Aquarium. Seafood Watch® Criteria for Aquaculture. Accessed: September 5, 2014.

3. Monterey Bay Aquarium. Seafood Watch ® Criteria for Fisheries. Version: March 31, 2014.

4. Ralston NVC, Ralston CR, Blackwell 3rd JL, Raymond LJ. Dietary and tissue selenium in relation to methylmercury toxicity. NeuroToxicology 2008;29(5):802-11.

5. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.

6. US Department of Agriculture, Agricultural Research Service, Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 27. Version Current: August 2014.

7. Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007;12(3):207-27.

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