Thursday, March 31, 2011

Answering the Critics and Paleo 2.0

It may encourage you to know that I do have critics.  They don't typically show their faces on my blog itself (and I haven't moderated any comments away except some insane unrelated treatise on vaccines and when one single commenter was being a bit too enthusiastic about curcumin to the tune of 10 comments at a time, and all the viagra and birds nest soup spam ("Katherine Woo" and "alan," I'm looking at you)), but they do exist.

An early one had a review of my blog, here - his main critique is that paleolithic human's health is debatable.  Certainly their mental health is, but bones are bones, and metastasis and iron deficiency and whatnot are there for the discovering.  This critique falls into the general one that evolution isn't a good paradigm on which to base a lifelong health prescription.  To which I say - you haven't studied enough anthropology or evolution.  And I still contend that it is a very reasonable assumption that wild-type humans did not struggle with anxiety and depression and other major mental illness to the tune of 26% of the population per year.

Another critique is more generic and one I see on tweets on reddit (where the really cool people tweet rather indifferently) - that I am not proscriptive enough.  "That post was I guess kind of interesting but she didn't really say what to do."  Well, I've trained as a therapist, after all.  Any therapist who tells you exactly what to do is a fool.  If you follow my advice to the letter, you don't give yourself enough credit.  If you do the opposite in defiance, you don't give yourself enough credit. Either way you don't learn a damn thing.  (Little hint to newly minted therapists out there - never ever ever tell someone explicitly not to have an affair.) I'm interested in putting out the information.  It's your life, your body, your mind.  Do whatever you want.

Predictably, the other common critique is that I overreach (that I am perhaps too proscriptive).  An example is this doctor/farmer's tweet -  and that is the critique that I am perhaps most sensitive to.  The wisdom of alternative medicine has been undone by overreaching in the past.  I have no interest in repeating the meme of ridiculous alternative assertion and self-righteous conventional medicine refutation.  I hope I am careful not to overstate my case (as I was careful in the Wheat and Schizophrenia post the good doctor objected to).   Most of what I am interested in has not been properly studied.  But, of course, it ought to be :)

There have been other random and downright bizarre critiques along the way, but, for the most part, the internet reception has been quite positive.  Now that I have moved more mainstream with Psychology Today, I have encountered a bit of anti-psychiatry critique in general, and to be honest I'm not too interested in spending the time refuting it, but I guess I will do my best until it gets too boring.  The major issue I have is when someone assumes I know nothing about mental illness or the natural history of mental illness just because I also have experience with and utilize the medications in treating mental illness.  Yes, I know there are horrific side effects.  Yes, I know there is controversy.  There are even hopeful and Pollyanna ideas that psychosis is more appreciated and accepted in traditional cultures and that our modern ideas and lifestyle have falsely defined and pathologized psychosis.  Well, one of my professors in residency spent a lot of time in remote areas of Africa, and what he found was that the rare-ish person in a hunter gatherer population who is psychotic is either able to keep it together enough to be a bit of a shaman, or he or she is tied to a tree for most of his or her life.

I wish the Pollyanna version was true.  But I live in the real world, as do all of you.

Here is one of my favorite pieces of classical music (right click to open in new tab).  I'm positive I've linked it before, but there are a lot of new readers now, and it is apropos.  La Befana is harsh, and obnoxious, and wonderful, and fast, and celebrates life and humanity.  It is messy and offensive, but everything resolves into beauty at 3:06.  Hold out until 3:06.  In the last part of La Befana is encoded the secret of life and the universe, I promise.  La Befana is science, and surety, and slaughter.  Blood and celebration.  Roman orgies.  Sacrifice, and spring, and life.  Fires at sunset, and a smoky hung-over dawn.

Paleo 2.0 is a go.  (Well, I do take a little exception and think that early human migration patterns suggest that we did, indeed, eat an awful lot of marine animals for many many generations).  But, yeah, for the most part I am a Kurt Harris acolyte - all the more so because he would be uncomfortable with that term.  He is the lean paleo (as in archaic) wordsmith machine.  It's all right to admire.  We need a few touchstones in this post-modern industrial wasteland of human health advice.  What I don't need is some other self-important jerk with a pot belly and bedazzled glasses telling me to eat boneless skinless chicken breast and quinoa.

By all means, make it simple.  What is good for the body is good for the brain.  The neolithic agents of disease are wheat, excess fructose, and excess linoleic acid.  What goes without saying is the nonfood.  Don't eat it.  Oh, and be sensible otherwise.  For the most part, eat when hungry, and don't when you aren't.  Fast every once in a while to enjoy the full human experience of hunger and repletion (not to mention ketosis and autophagy).   Be strong.  Run around the yard and swim in the ocean and sprint up the street and hike up the hill.

What is in store for us?  Inflation?  Peak oil?  Epidemics?  Natural disaster?  Technology and brilliance and flourishing human populations?  Irregardless you will be flexible and physically and mentally healthy, as much as is practical and possible.

Or at least I hope that is so.  For me.  For my children.

20 comments:

  1. Thank you for such a lovely post, Dr. Deans.

    I appreciate your kind way of presenting common sense.

    Your deep respect for the sanctity of life and each one living it for him- or herself is a blessing.

    Thank you very much for your blog, and for your offerings at the Psychology Today site.

    Indulgent food today: dried nori dipped in pastured butter.

    ReplyDelete
  2. Evolution isn't a good axiom in the study of nutrition? A subject that is decidedly and inexorably biology? That is such nonsense, evolution is therefore the default axiom. Now of course it doesn't follow that hunter-gatherers did this and didn't do this so that is absolutely what we should and should not do. It is a hypothesis and a priori speculation which in science needs to be qualified by empirical evidence, which is pretty much exactly what this blog does. It simply helps when you are looking for an explanation, like in the case of a particular disease, to look at what a human MIGHT be adapted to given the difficulty of evolving to tolerate certain foods.

    Grains obviously caused disease in early agrarians and if you use (gasp) evolution to think about it, you realize that a grass seed that practices kin selection is going to manufacture some gnarly poisons to harm animals who try to eat his genetic material in other bodies. Of course then we have to actually go and look and what do you know! Grains are poisonous even when you soak and cook them. Same with legumes.

    The other criticisms are just silly. No need to mention them.

    Paleo 2.0 indeed. I just wish Dr. Harris had emphasized micro-nutrition a little better. It is surprisingly easy for someone eating a modern version of the standard paleo diet (SPD?) to become deficient in stuff like magnesium and copper. Few people want to eat animal insidey parts but that is exactly what our ancestors did, so we need alternatives if we don't love liver, brains and whatnot. But definitely grains, sugar and linoleic acid are disease-causing.

    This blog is swell. I am so glad that the mainstream is receptive to the implication of cherished foods like wheat and vegetable oil. Psychologists tend to take this stuff better than your average person and throw the word evolution in there and our tails (or coccyx as it were) start wagging.

    ReplyDelete
  3. @Stabby

    Get plenty of sleep, and eat some liver, and call your sister on her birthday, and be kind to domestic animals, and don't forget to brush your teeth and take magnesium.

    Is there anything else I left out? I do push "animal products" constantly - must I specify liver and brains parenthetically every time I do?

    Sheesh...

    @Emily

    The paleo version of "the aquatic ape" will be dealt with in the future. I will try to be kind, but can't be too much kinder than anthropologists like Hawks.

    Not saying there is anything wrong with fish, I'm just a denier when it comes to the "couldn't have evolved without it" meme.

    Thanks very much for your support. Your needn't be anyone's acolyte. Friend is good enough for me.

    "science, and surety, and slaughter. Blood and celebration. Roman orgies. Sacrifice, and spring, and life. Fires at sunset, and a smoky hung-over dawn."

    Now you've gone all poetic - I am going to have to raise the poetry level, too, just to keep up.

    ReplyDelete
  4. @Kurt - My father is a fisherman, so other arguments face a steep uphill climb.

    ReplyDelete
  5. You could start by a wearing a shirt that says "Brains: they're what's for dinner". Eh? Eh? Just consider it. Bumper sticker?

    Come to think of it you do mention nutrition all the time, and if people are dumb enough to run into nutrient-deficiencies because they're too busy making sure they're low carb it isn't the fault of Paleo 2.0 manifesto, I just find that a lot of people aren't paying attention.. Again, not the fault of the manifesto, it's implied. We need the stuff that our body needs to not die, or we die. I suppose I'm just frustrated. Maybe I need a brains nutrition facts shirt.

    ReplyDelete
  6. Just for you, Stabby, my next post on Psychology Today will be Zombieland.

    ReplyDelete
  7. Wahoooo! It was plainly obvious that it was one of my favorites.

    ReplyDelete
  8. Taught my first seminar on ancestral health today to 18 bright eyed undergrads. They're very excited about what's to come. And I anyck in a scathing assessment of modern health and disease due to modern nutrition and lifestyle in my comparative psychology class filled with 125 pre-med students. Many if them came up to me afterwards surprised that they had never heard this before and were eager to learn more. One even asked me about research oportuniries in this area! Hook 'em while they're young!

    Btw, it wasn't until grad school that I learned that irregardless is not a correct word. Sorry, the pedantic in me can't help editing. :)

    ReplyDelete
  9. #*^}%#^}!!!!!

    I clepped out of all my college English classes. Only y'all can tell me if my time was better spent at this point,

    Funny thing is I never use that word.

    I'm going to leave it in there, mostly to bug you, Aaron.

    ReplyDelete
  10. Great post... but I do have a question: Why is it reasonable to assume that anxiety and depression weren't present in early humans? Given our ancestors' relatively short life expectancy, wouldn't it be just as reasonable to assume that they simply didn't live long enough for those conditions to manifest themselves broadly? I'm not asserting, just asking.

    ReplyDelete
  11. Hopefully on topic, an interesting study in BMC Medicine today on the gut as a 'new' objective for medicine:
    http://www.biomedcentral.com/1741-7015/9/24/abstract
    Looks like the secret is out?

    ReplyDelete
  12. @Kurt - don't worry, I'm not going to light a candle and hang out on your lawn or anything. But it is interesting that all the anthropologists who bite on the marine dependency of the human brain also believe in the population bottleneck 75,000 years ago, something that Hawkes thinks is bunk. I'm thinking your point is that most anthropologists are not nearly rigorous enough in evaluating the data, just like most medical scientists, leading to very wrong perpetuated assumptions. However, I'm also remembering Stephan Guyenet (not an anthropologist, but a thoughtful guy) reporting in his blog that even mountain dwelling human populations seemed to go to great lengths to get seaweed and fish. And populations did end up in southern Asia and Australia and New Zealand and the Pacific Islands along a shore migration pattern…

    @Paul - one can only hope! Cool link. Thanks!

    @George - two answers for you. One, the short life expectancy is more a function of high infant and child mortality, once you hit 30-40 you were likely to get to 70 like we are today. Thus the old argument that all these diseases that strike in old age have nothing to do with evolution and genes, we just never lived long enough to experience it isn't valid. Also the grandmother argument- women are genetically programmed to stop having their own kids and then live 20-30 years more. That doesn't make any sense in a strict evolutionary context until you look at longevity. It seems likely that children with grandmothers had a better shot at surviving due to grandmotherly wisdom and extra food collection - thus, again, our long childhoods and relative youthful helplessness seem to mean that longevity is evolutionarily selected for.

    Second answer - anxiety in particular strikes quite young - many of the varieties of anxiety before the age of 10 (though that may be different than it was in the past, of course). Depression, while the risk increases as you get older, will also tend to strike fairly young (this population however is obviously getting quite a bit younger compared to 30 or 50 years ago).

    A good argument against using an evolutionary basis as an underlying hypothesis for the increase in mental health disorders (particularly a dietary change) is that hunter-gatherers probably weren't exposed to the long term chronic stress we are used to. Back then if there was no food, you moved on. For the most part if you were ill or wounded you got over it quickly or you died. However, just with my bit of rooting around in the literature I think I've uncovered several dietary deficiencies (not yet properly studied, so all this is speculative) that would leave us much more vulnerable to chronic stress - magnesium, phospholipids. Also, hyperglycemia pounds on the brain in a similar fashion to chronic stress.

    ReplyDelete
  13. Thanks Emily, now I have something of yours to quote in my opening remarks at the Ancestral Health Symposium! ;)

    Thanks for doing such a great job with the inclusive fitness and describing the non-linearity of mortality rates in your response to @George.

    ReplyDelete
  14. @Emily

    Populations in the mountains may have been prescient enough about lack of iodine in the soil and consequent cretinism due to glaciation to seek iodine. I don't see that having much to do with human brain development being dependent on DHA from fish.

    I hardly ate any fish in my first 30 years of life - and I think my brain seemed to develop somewhat anyway.

    I like to eat fish -especially maguro dipped in fake wasabi and non-paleo soy sauce - and exploitation of marine life by hominins is indisputable.

    But the "specialness" of fish smells a lot like the olive oil fad to me. I would be similarly skeptical of arguing that tubers or ruminants are the "key" to human brain development.

    ReplyDelete
  15. You may overreach in your eagerness to uncover the mysteries, but we also don’t have the luxury of waiting for multiple double-blind studies costing millions to postulate on the truths yet unknown and try them on for size. Common sense, education, and critical thinking are badly needed, especially if you are already trained in scientific method. Corporate and political spin and “conventional wisdom” (i.e. the world is flat, cholesterol clogs your arteries) are far more insidious than critical thinking that leads you down some erroneous paths.

    ReplyDelete
  16. @Kurt Speaking of the “specialness” of any number of foods, isn’t the current rage about antioxidants a marketing gimmick? Doesn’t the body produce its own antioxidants? In fact, aren’t too many antioxidants harmful? I was already long-since disgusted by cereal boxes, orange juice containers and so much more touting “no cholesterol” and “heart-healthy.” Now it’s hard to go to the market without seeing “rich in antioxidants.”

    ReplyDelete
  17. Gary - I suppose I may answer your question too - the body's real antioxidants are glutathione and anything that helps with energy efficiency (coenzymeq10, creatine, etc). The so-called antioxidant vitamins aren't really thought of in that context in scientific circles. It is truly a marketing thing.

    ReplyDelete
  18. Dr. Deans, I've been ordering seaweed from Larch Hanson, at Maine Seaweed Company, for several years, and have been very pleased with everything I've bought.

    http://www.alcasoft.com/seaweed/index.html

    I don't use any fancy recipes. I enjoy just eating the seaweed straight out of the bags. It is good, too, when cut in small pieces and put it in stews and soups.

    ReplyDelete
  19. H - I ordered some seaweed snacks online (not from that company) and they were HORRIBLE (my husband had a taste, wrinkled his nose, and said, "This tastes like fish ass.") However, I do take kelp flakes or dulse and add them to soups and stews. I might consider baking up my own nori in pasture butter, as that does sound delectable.

    ReplyDelete
  20. In the 1960s, Desmond Morris theorized about our aquatic heritage in The Naked Ape. He specifically cites the human "dive reflex" as an evolutionary adaptation. Other mammals capable of diving under water for food (polar bears) have adapted in a similar fashion. The reflex only occurs in cold water (above 70 degrees F). I wonder what the mean water temperature is off the coast of East Africa? Interesting stuff.

    ReplyDelete