Monday, August 8, 2011

Ancestral Health Symposium

I am still in my hotel in California - planning to meet the New Zealand contingent later today for some hiking (for some reason they aren't interested in the Walk of Fame) and then fly back tonight.  Since my arrival on Thursday afternoon, this little space of an hour or so on Monday morning has been my first moment, while rested and contemplative, to do a real post.  I believe I will split up the posts into my thoughts on the talks, then a reflection on the people, then one on MovNat (which I attended yesterday).  It's been busy, and a blast.

First, the conference.  The speakers (including myself!) were an eclectic mix of academic bigwigs and paleo luminaries with fewer credentials.  It should be no surprise that the talks by the less-credentialed luminaries were, in general, more enjoyable.  After all, the paleo bloggers and book writers in general made their mark with a bit of flair, some have extensive public speaking experience and and they are not as conditioned to the expectation of the classic powerpoint talk in a dark room at an academic conference.

The first talks were by the true "paleo grandfathers," Boyd Eaton and Loren Cordain, and of course the amazing "Kitava" and paleo diet researcher, Staffan Lindeberg.  I agree with many that Dr. Eaton appeared to have a rosier view of paleolithic life than I would expect, but the talks were full of interesting information, and it was delightful to see these professors in person.  Dr. Lindeberg's talk was my favorite of those three, though that may be because I am still in awe of his amazing textbook, Food and Western Disease.  And Dr. Lindeberg has an MD and real live patients - there is definitely a difference in perspective among those of us seeing patients and those of us who spend all our time studying science.  (Eaton is an MD too, but his talk didn't reflect the patient experience as much).

The morning wrapped up with Robb Wolf, who gave an engaging and charismatic presentation as expected.  The afternoon I popped over to the alternate room for my presentation with Jamie - which was well-received.  I'm laughing a bit at my description of speakers as I am neither a "paleo luminary" or an "academic bigwig" - and I think my presentation was somewhere between a basic powerpoint slide-reading and some entertaining and interesting facts.  The gist of it (and the slides should be uploaded for all to see fairly soon, if they aren't already…) is that:  there is compelling evidence that many mental health disorders (including eating disorders, depression, anxiety, psychosis, bipolar disorder, ADHD, etc.)  are, in fact, diseases of civilization.  There are many, many lines of evidence showing plausible physiologic mechanisms for how the differences between our diet and lifestyles of today compared to the diet and lifestyle for which we are evolved could result in mental illness.  I hope people found the presentation (a little less dry than those last two sentences) enjoyable and thought-provoking.

Dr. BG and Dr. Gerstmar did a great talk on the intestinal biome and clinical implications right after our presentation.  (More will follow in my "people" post, but it was gratifying to realize that most folks in person are very, very much like their online personas.)

Later in the afternoon I caught the last part of Dr. Eades's talk, then went back to the alternate room for Dr. Feinman and Chris Masterjohn.  Dr. Eades makes a great speaker (unsurprisingly) but I have to admit I don't remember much about the facts of the talk - same is true for Dr. BG's - must have to do with the post-presentation adrenaline meltdown.  My facilities came back online about halfway through Feinman's, which was an expose of crappy interpretation of dietary studies and even crappier media coverage (the best example was a media article about how fat causes something horrible in humans and we should NEVER EVER eat it except to choke down our tiny requirements with no enjoyment and great repentance (I may be exaggerating that just a little) -  based on the findings of a study not in humans, but of mice… but oh wait, it wasn't even mice, it was mouse cells in a test tube!)

Dr. Lustig attended Feinman's talk and harangued him a bit about how actual amounts of fat have not decreased in the modern diet, but that carbohydrate/sugar have increased along with total calories so the percentage of fat has decreased… it was not particularly relevant to Dr. Feinman's point in this presentation, as he was merely making the case that the literature vilifying fat is ridiculous, not that high fat is necessarily good or bad.  But it was fun to watch. (My thought during this exchange was - but how much of those absolute fat grams today are omega 6 compared to 100 years ago?  How much was trans fat during some of the initial studies.  Mark Sisson said "fat is not a monolith" in one of his recent posts, and the whole low-carb/high-carb paleo issue frustrates me, because macronutrients alone are not the entire picture by any stretch of the imagination.  If they were, obesity, inflammation, and type II diabetes would be cured and we could all go home.)

Chris Masterjohn gave a fantastic talk on cholesterol - very similar to his recent podcast with Chris Kresser.  Lustig was taking notes, and Dr. K asked some interesting questions at the end with respect to leptin, thyroid, etc.

Now on to day 2:  In the morning I really enjoyed Lustig's talk, which was not very similar at all to "Sugar, The Bitter Truth" as he focused more on leptin.   I happened to be sitting behind Dr. Feinman (who is not the world's biggest Lustig fan) at the lecture, and someone asked him what he thought of the talk - he maintained that Lustig is "half-right, half wrong" about biochemistry, similar to the blog post I linked above on the subject.  I have to admit I liked Lustig's leptin talk much better than his fructose one.  The funny thing is (well, I think it is funny, but that's because I'm particularly amused by brain biochemistry) is that at the poster presentation 10 feet from the lecture hall on Day 2, Dr. David Pendergrass from the University of Kansas had a fabulous diagram he's painstakingly cobbled together from the literature outlining the brain feedback mechanisms and neuroregulation of appetite and fat storage and how it becomes derailed to promote obesity.  Frankly, it renders the entire fructose/glucose argument somewhat irrelevant.  But more on that later.

Mat Lalonde PhD "The Kracken" had the next talk - excellent, hard-hitting, and I agree with him in fact if not always in spirit.  His talk was mostly a warning about thinking you are an expert on much of anything without being very careful about your knowledge and qualifications - especially if your audience is a hard science crowd - or you will be dismissed as an ignorant idiot.  I definitely agree with that part… he also said that combing through the literature to find studies that support the evolutionary medicine hypothesis is biased and therefore unscientific.  As a factual matter I do agree.  As a practical matter, the  literature is so vast and the confounders and physiology as yet not fully understood, that our comprehension and understanding of the vastness is only possible by using context.  We have to interpret the facts, and we must interpret them within a framework.    Again, as a practical matter - we have two methods for determining context for further study - epidemiologic studies showing that people who do this or eat that or take this pill are healthier than those who don't.  As we know, epidemiologic studies have major weaknesses that can make even the best of them unreliable for establishing context.     The other method is to use common sense (which includes using evolutionary theory as a basis).  The main danger of bias must be taken on by accepting and analyzing negative as well as positive studies with regards to evolutionary medicine theory, but I do not think we should throw out the context altogether.  I'm fairly certain he has the same thoughts with respect to taking care and bias, but I just wanted to put up my thoughts on the subject, as it is important to the accuracy and meaning of my blog.

After Lalonde I saw Denise Minger - who was delightful (more about her in the "people" post).  Then I went to Melissa McEwan and John Durant, who between had some of the most factually interesting and provocative talks of the entire conference.  Andreas Eenfeldt, the Diet Doctor from Sweden, did a great job at his talk about Low Carb High Fat diet success in that country.  He included the amazing fact that if the obesity trend in America continues, we will all be obese or overweight by 2048.  My tweet of this fact prompted Dave from ThriveNaturally to respond thusly in what I considered to be the best tweet of the event :-)  I was sitting behind the Drs. Eades at that talk and it was gratifying to see the solidarity.

By this point in the afternoon, I wasn't as focused, and the exercise talks aren't as interesting to me as the biochem, anthropology, and science… but I did truly enjoy Erwan Le Corre's MovNat talk, and I will have a lot more to say about it in my third post of this series.

I missed the last hour of talks as I was milling around the poster presentation and chatting with people, but I'm sure my blood would have boiled in either one - the last one apparently had a random slash at SSRIs while promoting statins (both have serious problems and both have some modest usefulness in the right setting, frankly).  The other talk was about the modern healthcare system, and no matter what the context, I find such talks infuriating :)

SO… if you have made it this far, I would have to say my very favorite talks/speakers were:

Day 1: Lindeberg, Wolf, Dr. BG, Masterjohn

Day 2: Lustig, Lalonde, McEwan, Durant, Eenfeldt, LeCorre

Talks I'm sorry I missed and am looking forward to watching online:

Day 1: Stephan Guyenet, Bastos, Stanford

Day 2: Seth Roberts and Tucker Max (would have liked to have seen Nikoley and Naughton but I am told Naughton's talk was similar to his "Low Carb Cruise" presentation, which I saw and enjoyed very much online.  Nikoley's talk on self-experimentation I imagined would be similar to his blog, which I have read most of the posts from the last year or so, and I was very anxious to see Eenfeldt.  So will catch online!  Also would have enjoyed Sisson, of course - and apparently people were playing with beach balls in the audience for that one!)

All right.  Now I'm ready for the people post - which will probably be written during the interminable airport/airplane gauntlet tonight.  Today - hiking in Malibu!

3 comments:

  1. Thanks for the recap! There are really only two reasons I held this conference. 1) so I could get all of my paleo/primal books autographed in one place (at the party Thursday evening), and 2) so that I could finally convince my wife (who attended both days) why I've been acting like this crazy, monkey-foot shoe wearing, sunbathing, rid-the-pantry-of-all-our-kids-favorite-foods freaking dad/husband. I'll admit, both plans worked! :) Oh, it was also fun seeing you and the Jaminet's again, though I wish I had more time to chat with you and Jamie. Have fun in the Malibu hills. They are beautiful.

    ReplyDelete
  2. Thanks for the repot.

    SSRIs bad and statins good? I thought it was the other way round.

    ReplyDelete
  3. @Aaron - I love your second reason for organizing AHS - I think my husband and friends see me the same way. Should have got them all tickets to AHS!

    @Emily - Looked at your slides and wish I could share them with our HR dept! Esp. the fluorescent lighting vs natural sunlight. Would you believe I have to sign a form saying I cannot safely perform my job in order to get a sit/stand workstation. Apparently it is a job requirement to be able to sit at a desk for 8 hours a day!

    ReplyDelete