Sunday, October 3, 2010

Temple Secrets

The song for the day is Finlandia (right click to open in new tab) by Sibelius, one of my favorite composers.

At first, evolutionary medicine and a paleolithic diet was a great way to take off the baby weight. I'd never needed to lose so many pounds before, though I'd spent some time in the past (like many modern people) pursuing a smaller jeans size, and in that quest had studied quite a lot of sports nutrition. Even back then the sports nutrition folks outside the endurance sphere were encouraging lower carb intake and carbohydrate cycling. They were, however, very fat phobic and into eating 5-6 times a day, so the recommendations were too high in protein, not satisfying due to a reliance on fiber rather than fat to fill you up, difficult to maintain, and required lugging around lots of food everywhere. The minute you relaxed and went out for a nice dinner, it seemed those goal jeans were tight again. It also required about 6 hours of running and gym time a week - something I could usually squeeze in back in the day, but would require a lot of sacrifices I'm not willing to make in my life now. That's not to say I don't exercise a lot now - just not in the time-intensive or planned way that I used to.

All that effort over years kept me a normal weight, with a BMI smack in the middle of the "normal" range. And that effort - calorie counting, fat restriction, monitoring nutrient ratios, and a cardio-intensive exercise regimen - is pretty much exactly what the government recommends for maintaining a normal weight or losing weight at a healthy slow pace. If you look around, you'll notice the "20 minutes a day" exercise recommendation for weight maintenance and loss fell by the wayside in 2005 and was replaced with 30 minutes a day for weight maintenance, and 60-90 minutes a day if you wanted to lose weight (1). So there you have it. If you want to lose weight on the government-recommended diet, you can possibly do it by becoming an endurance athlete.

Enter the reality of having two little kids, and the resultant long periods of sleep deprivation, which, being every single night, was more difficult than the periodic sleep deprivation of medical training. There was no human possibility of long runs 4 times a week and long sessions at the gym in between. There were plenty of walks, but do the math - if you are counting calories, walking is a depressing way to take off the pounds. And I don't know if any of you have tried to count calories while breastfeeding - it's nearly impossible. The hunger is unbelievable. While pregnant, I could smell if someone brought powdered donuts into the office 4-5 rooms away, but, in general, I could limit myself to one little donut hole, as long as I was eating plenty of real food from home. While breastfeeding, I would fight the urge to rifle through other people's desks to find a snickers bar, and I could leap over tables to sample the office donut holes.

Enter a paleolithic inspired diet. Despite the above rare indulgences, I did limit vegetable oils, high fructose corn syrup, and processed food for the past 3-4 years. The main difference was dropping carbs by avoiding grains and low-fat dairy, skipping a meal 2-3 times a week and pretty much eliminating snacks, and increasing the fat. No counting. No nutrient ratios. The recommended exercise (which I followed) was a 20 minute sprint session once a week, lots of hiking and running around (with the kids, which gave me the time to do it), and mostly body weight lifting I could do at home, quickly, in the morning before everyone else woke up. Or tabatas in the back yard while the kids are digging around in the sandbox. It was, compared to the old days, extremely simple and easy, and the transition was accompanied by a much-needed increase in energy levels and even increased mental clarity and serenity. I was back into my old pre-baby jeans after 3 months. Now I'm having to buy smaller jeans.

It worked so well, and my reading had dug up so many links between the modern disastrous diet and chronic Western disease, that I felt obligated to start up this blog, looking for connections between the modern diet and poor mental health. It's a simple approach. I keep an eye out for nutrition-related research articles, follow the tips from blog readers who have seen interesting related case studies or papers, and I also look specifically at known differences between modern diets and past ones - daily amount of magnesium being one of those.

It seems that everywhere I look, I find something that has the potential to be major (fructose, magnesium, omega 3/6 ratio, vitamin D, phospholipids), and enough is already known about it to have a very solid basis for further meaningful research, even on a piecemeal basis. And the pleiotropic effects of adding back all the "real food" minus all the poisons we so regularly consume could be simply staggering on a public health basis. This is what evolutionary medicine and evolutionary psychiatry means to me now.

Last week, while researching magnesium, I stumbled on this news bit from Science in April of 2009 - "Darwin Applies to Medical School." It discusses a recent push to add more evolutionary training to medical school, a classic example being a better understanding of the development of antibiotic resistance. (I don't quite understand this example - does it really require extra evolutionary training to understand the concept of generations of microbes being exposed to antibiotics so some develop resistance and live on, taking over the population assuming vast exposure to the antibiotics? I think it takes about 30 seconds to understand that concept, assuming a basic knowledge of genes and biology.) The evolutionary training that is needed is the comparison of the health of our paleolithic ancestors, an understanding of natural selection as it pertains to human populations (including a discussion of K-type selection and grandmothers), and, frankly, reading Stephan Guyenet's entire blog archives.

Here's what James Lupisky, of Baylor College of Medicine said in the Science article: "Medical schools have a lot on their plate." (Next is from the article, but not Dr. Lupisky's quote) They are "already straining from an explosion and information and technology, and clamors for change come from many directions." And Harvard evolutionary biologist David Haig says, "Evolutionary thinking is not going to give cheap medical solutions."

On that, I think he is dead wrong. In fact, I know we can't afford to go forward as we are, pursuing more and more pharmaceuticals and technology to slow down our dying. Maybe David Haig should check out the cost of grassfed beef liver once a week, sunlight, sardines, and magnesium pills.

Again, I don't understand. Why doesn't even the evolutionary biologist get it? Granted, I had an interest in anthropology and evolution and a solid grounding in molecular biology prior to medical school, and the field of psychiatry lends itself, perhaps counter-intuitively, to look for holistic solutions to human problems. Still, I don't understand why just a few of us, in 2010, are pulling together this information and trying to work the biggest problem in human health in the evolutionary way. I'm simply baffled by how easy it is to find enormous clues as to the pathogenesis of biologic mechanisms of modern mental health problems with this ridiculously simple approach. It used to be exciting - I knew the secret to weight loss and metabolism. I knew the secret to good health and reducing the ravages of stress. The temple secrets were right there, within reach. At the same time, the work is frustrating. I feel a bit like Cassandra, blessed (I hope) with knowledge but knowing that no one in charge who could make some real difference would believe me.

Here is the orchestral version of Finlandia. Those who misspent a childhood watching the Smurfs might recognize the introduction.


  1. nice write up!!!! glad you breastfed your babies too!!! i cant wait to be preggo one day!

  2. I use my Harrison's Principles of Internal Med to prop up my 2nd computer at home... and like post today reflects each time I look at it 'Again, I don't understand'?!

    Evolutionary med is SO OBVIOUS. To physicians and non-physicians who get it...


    Love the title of this POST, the hawwwwtest temple goddess of enlightment and Finlandia!!

    malpaz, I LOVE LOVE love your spunk and your blog! Keep up strong work -- I sincerely hope you get KNOCKED UP SOMEDAY AND BREASTFEED ur beautific paleo/evo babies.... *heee*.

  3. Heh - my advice should perhaps be ignored - if you don't like the taste of grassfed beef, you aren't cooking it in enough pastured butter.

    At least while breastfeeding I had enough time to make nice meals. While pregnant I was too nauseated even to go to the grocery store! Back then, instant mashed potatoes was lifesaving. If I decide to have more kids, I'll parfry a bunch of things for the freezer for immediate use.

  4. The words from Finlandia, translated into English:

    O Finland behold your day is dawning, The threat of night has been banished away, And the lark of morning in the brightness sings, As though the very firmament would sing. The powers of the night are vanquished by the morning light, Your day is dawning, O land of birth. O, rise, Finland, raise up high Your head, wreathed with great memories. O, rise, Finland, you showed to the world That you drove away the slavery, And that you did not bend under oppression, Your day is dawning, O land of birth.

  5. I don't understand how David Haig could have made his mind up already.

    If "evolutionary medicine" turns out to help lots of people, it won't take much time and effort to teach it to medical students. Just substitute EvMed for the time they take now to teach outdated ideas about nutrition.

  6. Emily,

    The words are TRULY beautiful... indeed it is starkly magnificent when the indominatable human collective spirit rises from carnage and confusion. [It's funny, I've never met anyone from Finland, and within 60min after listening to Sibelius from ur post, when I took my children, nieces and the dog we're sitting to the park, I met a native Finnish person and his fluent 3 children! It was W-E-I-R-D like X-files...? *skin tingles*]

    Thank you again for your posts, G

  7. Awesome post, but I would expect nothing less at this point :) I love how you simplified your routine and eating regime and found such success. I think I'm pretty stuck in the old bodybuilder meets paleo mentality. I'm still eating smaller, more frequent meals with a lot of veg. I use a lot of animal fat too, all our food is organic and pastured. Still, I'm definitely not seeing results after two years of eating paleo. I've tried eating less frequent meals with more fat and protein and less veg, but I felt very sluggish and I didn't see any weight loss there either.

    I still get wicked sweet cravings. I still need to lose 20 lbs. I keep seeing and hearing about these great weight loss stories and I wonder if there's a piece to this that I'm just not getting. I lift heavy weights 4 times a week and do some interval sprints/hill training once a week. Any ideas?

  8. Hi Tara - it is SO easy to blog on general recommendations, but everything breaks down when it comes to the chaos of one person's physiology. I can only suggest several n=1 experiments for you - go without dairy for a month. Go ketogenic for a few weeks - coconut oil being half your calories. Go perfect health diet for a month (see the website I link on my "Of Like Minds" list).

    On a personal level, I think I do better with some carbs on board. However, I do IF many times a week. IFing was difficult at first, but now it is no problem. I eat squash or rice or other (non-poisonous) starchy carbs nearly every day, though.

  9. Hi Emily,
    I am a new reader. Stephan Guyenet recommended your blog to me as I have been searching for a real foods/paleo blog that focuses on mental health for some time. I want to understand the underlying causes, prevention, and maybe get to some real cures, not just medications that mask the symptoms.
    My personal experience of the mental health field has not been very encouraging thus far. I have a father and 2 brothers who have schizoaffective disorder, one brother has a very severe case becoming extremely psychotic on a regular basis and is in and out of mental institutions frequently. No one really seems to know how to help him, none of the interventions so far have helped for long, and I really worry about the long term side effects of all these heavy duty psych meds they load him up on. I am a pre nursing student now, thinking of perhaps specializing as a psychiatric nurse practitioner.
    Anyway I am super excited to have found a blog where the focus is on evolutionary psychiatry! I am looking forward to reading and learning as i go through the archive here, thank you for sharing your knowledge with us :)
    ~ Leah

  10. Tara - one more thing - cortisol will definitely cause us to cling to those last 10-20 pounds. Sleep, relaxation and fun are vital.

    Honeybee - sorry to hear about the family illness. I've seen the right medication work miracles too many times to lose faith in the medicines altogether. My overall impression is that appropriate diet and stress reduction and supportive therapy focusing on coping skills, nutrition, schedule, functioning will be helpful for anyone with severe mental illness. My great hope is that an appropriate diet will also ultimately be preventative, helpful for severe illness, and possibly even curative for milder illness - though there is certainly not specific data to robustly support any "cure" with a paleo diet at this point. My blog is (thoughtful and science-driven) speculation and information gathering, and I wouldn't want anyone to go forth without individual help to self-treat his or her mental illness with a Paleolithic diet and some supplements...


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