The Food Issue
In the last two years, the annual Ancestral Health Symposium has become a gathering point for a group that could loosely be called the paleo crowd. This past year’s event, held at Harvard Law School August 8-11, included presentations by icons in the movement like Robb Wolf, Mark Sisson, and S. Boyd Eaton, who co-wrote a 1985 article in the New England Journal of Medicine that, by most accounts, got the paleo ball rolling.
With that being said, a good percentage of those I spoke with at the event would object to being called paleo. Many have ditched a strict adherence to the Paleolithic era in particular in favor of their own custom-mixed paleo/primal/ancestral hybrid lifestyle. Others think paleo, in its many flavors, is partial or complete bullshit.
The Ancestral Health Society, which orchestrates the event, describes itself as a group of “scientists, health care professionals, and laypersons who study and communicate about health from an evolutionary perspective.” It seeks “...to develop solutions to our modern health challenges,” including the many so-called diseases of civilization.
It was, largely, a fit-looking and likeable group of idiosyncratic nerds getting nerdy together about health and evolution. Many a conversation was embellished with personal “n=1” research data.
There were carnivores, crusaders, academics, bloggers, booksellers, barefoot runners, a lot of skeptics, hardly any reporters, and about as many opinions on carbohydrate and starch as there were attendees. Based on a casual survey of T-shirt messages, there were a surprising number of Mixed Martial Arts enthusiasts. I spoke to a bearded fighter from Quebec who told me “there is a philosophical crossover between paleo, MMA, and libertarianism.” Another fighter explained that fighting, like hunting, is in our DNA.
EVOLUTIONARY HEALTH IS A broad framework. It encompasses exercise, mental health, social interactions, medicine, and, of course, diet—an area where, at least at the Ancestral Health Symposium, people were the most focused, and often most heated.
“Paleo, primal, ancestral, let’s call the whole thing off,” joked Mark Sisson, author of The Primal Blueprint and the Mark’s Daily Apple blog. He, along with Robb Wolf, author of The Paleo Solution: The Original Human Diet and co-producer of the Paleo Solution podcast, was part of a two-man “Paleo Q&A” panel one morning.
Despite their competing books, buzzwords, and online niches, the differences between Sisson’s and Wolf’s responses to the questions were often technical and nuanced, like two descriptions of the same mountain by climbers on different routes.
Both men are athletes—Sisson a former elite triathlete, Wolf a former power-lifting champion—and both have active consulting businesses. The paleo/primal/ancestral kool-aid drinkers were in heaven. The discussion included diet questions, of course, as well as topics like icing vs. heating, sleep, and dietary supplements.
A woman asked about the fact that females seem to hold more fat on their bodies than males. “Should we be trying to be as lean as the men?” she asked.d
“Women tend to hit a plateau before men,” Sisson said. “You’re not happy because you’re not Victoria’s Secret cover material, but that plateau is your body’s way of saying, I like what you’ve done with the place. It’s about reclaiming health more than looking good naked.”
“Give your scale to someone you hate,” Wolf added. “The scale tells us nothing.”
ALL THINGS PALEO HAVE ballooned in recent years, and both Wolf’s and Sisson’s services are in high demand, even as the theoretical underpinnings of the basic concept they built their empires upon have been eroded by the genetic record. Wolf told me by phone after the symposium that the human genome has changed rapidly since the Paleolithic Era, perhaps as much as 100 times faster than it was changing prior, according a widely respected 2007 paper by Dr. John Hawks, “Recent Acceleration of Human Adaptive Evolution.” This acceleration of genetic change was largely in response to the complexities that the Neolithic era brought to human life, Wolf said. We aren’t, it turns out, simply unfrozen cavemen.
On the other hand, Wolf continued, just because our bodies have adapted—or have started to adapt—to new foods like cow’s milk and various grains doesn’t mean we’re better off eating them. Some of us are clearly better than others at handling various Neolithic foods like grains, dairy, and legumes. In the end, he said, it’s about figuring out what’s right for an individual now, not then.
A FREQUENT TOPIC AT AHS was the metabolic state known as ketosis. Being in ketosis means the body’s cells are running primarily on ketones— small, water-soluble compounds created in the breakdown of fat—rather than glucose. Pursuing a ketogenic state, as it’s called, for weight-loss purposes was long ago dubbed the “starvation diet.”
To a community that generally prefers to get its calories from fat, rather than starch and sugar, getting your body into “fat-burning” mode has obvious appeal.
Nora Gedgaudas, author of Primal Body, Primal Mind, calls ketosis “the Holy Grail of primal health.” In her presentation at the symposium, she likened starch and sugar consumption to keeping a fire going with paper, kindling, and lighter fluid, rather than slow-burning logs. “You could heat your house that way,” she said. “But you’d have a constant preoccupation with where your next twig is coming from.” And that is exactly what we see with carbohydrate addiction, as she calls it.
Many, both within and outside of the AHS community, have told me they think that ketosis—at least as a dietary ideology—is ridiculous, that zero-carb diets are dangerous and unhealthy, that you will lose muscle mass, and that going ketogenic should only be considered for the handful of diseases that it has been shown to treat effectively.
Fat burning aside, some of the more promising applications of a ketogenic diet are in the treatment of chronic diseases. Dr. Elizabeth Thiele, director of the Pediatric Epilepsy program at Massachusetts General Hospital, said that nearly all child epilepsy patients respond well to a ketogenic diet, with one-third going into full remission. Terry Wahls, a professor of medicine at the University of Iowa Carver College, has been treating her own degenerative multiple sclerosis with a nutrient-dense ketogenic diet that includes rarely cooked meat and sprouted nuts. Five years into her n=1 research, Wahls is out of her wheelchair, riding her bike to work and practicing Taekwondo kicks. It’s only when sugars and starch tempt her off of the ketogenic wagon, she said in her presentation, that things go awry.
Several cancer researchers presented on the effectiveness of a ketogenic diet on various tumors. Ketogenic diets were also mentioned as being effective in treating Parkinson’s and Alzheimer’s, as well as metabolic syndrome, the feedback loop of high blood pressure, obesity, high blood lipids, and diabetes.
Stephan Guyenet, a neurobiologist at the University of Washington who presented at AHS, told me he thinks there’s promise in some therapeutic uses of ketosis, but is far less convinced it should be everyone’s metabolic goal. For that matter, he’s not convinced of many of paleo’s sacred cows. He even eats grains, while respecting the energy-dense flours they can be processed into.
Being anti-grain and anti-starch is pretty much the first rule of paleo/primal/ancestral living, but, paradoxically, despite this and other glaring infractions, Guyenet is somehow widely liked and respected in AHS circles. Except, as we found out in Los Angeles two years back, when he’s not.
Guyenet’s research looks at the neurologic roots of hunger and fat regulation. It’s a much different approach than obsessing over macronutrient categories like carbohydrates, and led to a showdown at AHS2011 against none other than Gary Taubes—a hero to many for his takedown of the dietary fat theory of heart disease. Taubes took the mic during the Q&A portion of Guyenet’s talk on food palatability and satiation, and went on the offensive.
This year, Guyenet was again challenged in the Q&A portion of his talk, and again by a lion in the AHS movement. Despite having chosen what seemed a relatively non-inflammatory topic—the role microbial balance in your gut plays in obesity and digestive health—the mild-mannered potato-eater nonetheless found himself facing Robert Lustig, perhaps the world’s leading anti-sugar advocate.
Lustig had given his (convincing) talk earlier in the day on just how awful and toxic sugar is. He praised Mayor Bloomberg’s soda ban in New York City, and pined for more intervention. “All you libertarians out there, eat my dust,” he had thundered.
Lustig—being Lustig—took the mic after Guyenet’s talk on microbes and chided him for not mentioning the role of fructose in gut microbial ecology. Later, Guyenet told me he thought Lustig’s point was fair, as was his call for government intervention. “The paleo crowd is dominated by libertarians,” he said. “I think people who are willing to break with conventional ideas on diet are also people who want to be self-directed in other areas of their lives. But honestly, I agree that we need regulation, because the fact is, if you rely on personal responsibility to change this, it ain’t gonna happen.”
THERE WERE A LOT of different dietary opinions presented at AHS2012, but one creed with no visible followers was vegetarianism. The vegan holdout Denise Minger, whose appearance at AHS 2011 left many confused, no longer avoids eating things with faces. In fact, the face is now her favorite part.
In light of the ancestral health community’s love of flesh, Chris Kresser used his presentation to emphasize that roughly 20 percent of humans are genetically prone to accumulate excess iron in their bodies, which can lead to serious health concerns. So it’s worth being tested for high iron, he said. And if your iron panel or ferritin comes back high, consider blood-letting (a.k.a. donating).
Along with meat, fat and vegetables form the core of the typical diet (the Saturday lunch was a bun-free burger bar). This core, coupled with the general longing to be as earthy, clean, and natural as possible, has created an alliance between the ancestral health community and small, locavore-oriented farmers and livestock growers. These types of farms happen to supply what the paleos want—animal products and vegetables—and not what they don’t want, like fields of wheat or corn. To put it bluntly, someone’s got to make the bacon, and the bacon has to be good. This paleocavore synergy was evident throughout the symposium, starting with the opening day’s keynote address by Joel Salatin, rock star farmer.
Judging by the blog posts and tweets (#AHS12), perhaps the most popular event of the symposium took place at a farm in Carlisle, outside of Boston. There, in a rustic barn, a contingent from the symposium enjoyed pickle juice martinis, grass-fed lamb, and vegetables raised by local farmers.
While the paleocavore alliance is a natural evolution, it also seems to be another nail in the paleo coffin—at least in terms of a literal interpretation of paleo. After all, agriculture is what brought the Paleolithic Era to an end. By embracing this most Neolithic of practices, perhaps the ancestral health community’s center of gravity is shifting. It’s a greener shade of paleo, but still paleo—largely because nobody’s been able to come up with a catchier name.