NPR’s health blog SHOTS posted an article about the Paleo Diet: The Paleo Diet Moves From The Gym To The Doctor’s Office. I’ll summarize and offer my thoughts below.
Randolph Nesse, a professor of psychiatry and psychology at the University of Michigan, could be called the father of “evolutionary medicine.” He co-authored an influential paper in 1991 called “The Dawn of Darwinian Medicine,” which made the case for researching how an understanding of human evolution by natural selection can explain what’s making modern humans so sick today. Enter the paleolithic diet movement. It’s basically on solid ground, because the diet directs people to swear off anything that was not readily available before agriculture: sugar, dairy, grains, beans, and artificial chemicals. Not a bad start.
Nesse now says there’s even an evolutionary flaw in the paleo diet: “…every single diet you pick as had advantage of some sort. Humans have lived in all kinds of places and we have adapted to all kinds of diets.” I agree with Ness: We are a diverse and adaptable species, and there is no “one size fits all” prescription for diets or evolutionary medicine. Still, it got me thinking…
The correct application of evolutionary medicine will need to do three things:
- Accurately define the dietary and environmental conditions under which Homo sapiens (and our hominid progenitors) evolved. Easier said than done.
- Consider human diversity. Although all of humanity is 99.9% genetically identical, we are genetically different in important ways. Many of the genetic differences in humanity are how our bodies handle nutrients. (Google: nutrigenomics). Significant genetic selection and evolution has occurred in the ~500 human generations since the dawn of agriculture (and the grain based diet).
- Consider and respond to the virtually inescapable differences in the modern world. Unless you are going to put on a loin-cloth, sharpen a stick, and start running after wild, grass-fed ungulates for your protein you can not actually simulate the hallowed “evolutionary” conditions that the Paleo-camp suggests.
Like anything modern, people take shortcuts with going paleo. Overcooking vegetables, and pounding down piles of factory-raised, corn-fed meat while driving to work at a stressful office job is *not* “going paleo” or evolutionary medicine.
As modern humans, we are exposed to a completely different set of stressors. We are not particularly challenged by infectious disease, starvation, exposure to the elements, and tiger and mammoth attacks. We also tend to expect to live well past the 40 years—which would have made you a very successful grandparent 10,000 years ago.
In contrast, we *are* challenged by the “modern predators”: living indoors, relatively sterile environments, sedentary lives, processed and refined food gluttony, and the constant stress of commercial media marketing, email, cell phones, traffic, the search for meaning, and modern relationships.
Add to this situation, that we have chronic exposure to (and accumulation of) tens of thousands of modern chemical pollutants (i.e. xenobiotics) that are connected to the modern epidemics of cancer, diabetes, obesity, and endocrine & autoimmune disease. This means that even if you improve your diet, that chemical exposures may foil your health and body composition goals. (google: obesogens & metabolic disruptors).
Here’s My (not so easy) Ten-Step Evolutionary Medicine Prescription for Patients:
- Live on land with soil and work from home (less than 30 hours a week).
- Grow your own vegetables: water them with rain water, fertilize them with your own compost and manure from your chickens.
- Eat a moderate amount of wild fish and fully-grass-fed meat and eggs. Skip the dairy unless it’s full-fat, un-pasteurized, and un-homogenized. No factory or feed lot animal products, ever. Eat minimal to no grains—especially avoid the American, high-gluten, Frankenstein wheat.
- Cook minimally and eat the good food with people you care about.
- Exercise with friends every day.
- Unplug from modern media as much as possible.
- Employ (other) stress-reduction measures (Yoga, Tai Chi, Qigong, Meditation, etc.)
- Directly support your adrenal glands with specific botanicals and nutrients.
- Go to sleep and rise early.
- Avoid chemical exposures at work and home and directly support your detoxification organs (Liver, Kidney, Colon, Skin, Lungs) with targeted nutritional and lifestyle measures. Because the worst toxins are fat-soluble, especially support your phase-II detoxification systems, your liver and other detoxification organs (intestines, kidneys, lungs, skin) any time you attempt to burn fat.(And because this one goes to eleven…)
- If you feed badly or can’t loose weight with a good diet and regular exercise, get tested by a good naturopathic doctor (or a “functional medicine” practitioner) that will look at the results carefully *without* shuttling you into oversimplified gimmicks. Tests I consider important are: blood glucose, liver enzymes (including GGT), key nutrient levels, thyroid, & adrenal function, hsCRP (inflammation), and fractionated lipid panels (beyond LDL and HDL). Traditional MDs usually won’t order the right tests and wont look further if the results fall in the “normal range” which is far too broad and thereby makes “medical refugees” out of patients with easily treatable underlying problems.
As always, your thoughts and comments are welcome.
Dr. T.R. Morris is a licensed naturopathic medical doctor (ND). He is currently serving as faculty and consultant to the Institute for Functional Medicine (IFM). The IFM mission is to revolutionize medicine by teaching the latest genetic, nutritional, hormonal and other biochemically-based integrative medicine techniques to MDs and other practitioners looking for new tools to prevent and treat chronic disease. In the past, T.R. served as the medical director of a large integrative clinic and taught (genetics, physiology, biochemistry, microbiology, cellular & molecular biology) for 10 years for various medical programs in the Puget Sound. He sees patients in person (or long-distance via Skype consultations) from his home office in Seattle.
Contact Dr. Morris