Top Ten Problems With Applying The Paleolithic Diet Principles: Number 9

9. Eating too much fruit

Due to unwarranted fears of saturated fats, and unwarrant beliefs in the healthfulness of fruit, would-be paleo dieters may replace the agricultural carbohydrates (cereals, legumes, etc.) with fruits. They may take a lead from Katherine Milton, Ph.D., who has proposed that high fruit consumption promoted human brain evolution and thus that fruit formed the main food in human ancestral Paleolithic diets.

This hypothesis has many counts against it, among which is evidence that humans do not have dental enamel well adapted to high consumption of the acids present in fruit. Grobler et al showed that just 6 minutes of exposure to fruit acids in the form of whole fruit caused enamel erosion on human teeth. West et al showed that orange juice erodes dental enamel in humans. Kunzel et al showed a positive correlation between degree of dental erosion and proximity to citrus plantations in Cuban children.

Cordain et al reported that among the Aussie Aborigines fruit appears to have supplied the bulk of energy from plant foods consumed. This supports optimal foraging theory, which indicates that animals including people will seek to get the maximum caloric return for foraging energy expenditures. Fruits are relatively easy to collect compared to digging up underground storage organs (USOs) like roots and tubers so we would predict foragers to prefer collecting fruits to digging up roots.

However, fruit did not supply the bulk of the total energy in their diet. Cordain (Table 1) reports that Aborigines obtained 77% of their total energy from animal food, only 23% from plant foods. About 41% of the plant food energy in Aborigine diets came from fruits, which means only about 9% of total energy in Aborigine diets came from fruit. Assuming a 2000 kcal diet, this would mean about 180 kcal from fruit daily, or about two pieces of modern fruit amounting to ~45 g carbohydrate.

Most of the wild fruits eaten by most hunter-gatherers did not provide the abundance of sugar supplied by modern hybridized fruits. Modern fruits supply large amounts of fructose, which Stanhope and Havel report can cause dyslipidemia, insulin resistance and hyperinsulinemia, which perpetuate a metabolic state dependent on sugars.

So it appears humans do not have a high tolerance or adaptation to diets containing large amounts of fruit. This again indicates that humans adapted to a diet built on fat and protein from hunted animals. A successful modern version of the paleodiet should put fruit in a minor, supporting role.

Grassroots Health Vitamin D Study Seeks Participants

Before I get on with the other nine problems people have when implementing paleo diet, I wanted to pass along a link to the website of Grassroots Health, an organization that has organized an open study of vitamin D and health under the auspices of leading vitamin D scientists. From the site:

GrassrootsHealth has launched a worldwide public health campaign to solve the vitamin D deficiency epidemic in a year through a focus on testing and education with all individuals spreading the word.

Everyone is invited to join in this campaign! Join Daction and test two times per year during a 5 year program to demonstrate the public health impact of this nutrient.

$40 and a quick health survey allows everyone to

• get a vitamin D blood spot test kit to be used at home (except in the state of New York)
• have the results sent directly to them
• take action to adjust their own levels to get to the desired ranges with whatever help is needed from their healthcare practitioners.

With only 100 people joining up today, and getting 2 friends to join in 2 weeks (and those 2 friends getting 2 more), by week 42, there could be 400,000,000 people who are vitamin D ‘replete’! (more than the United States population)

I signed up. As a participant, you pay $40 every 6 months to receive a vitamin D lab test delivered to your door, and you agree to fill in some surveys along the way, over a 5 year period. You can't beat the price for the vitamin D test, and your participation will contribute greatly to our understanding of the health protective effects of vitamin D.

Top Ten Problems With Applying The Paleolithic Diet Principles: Number 10

When I wrote The Garden of Eating (hereafter GOE), I still had not totally gotten past all the false beliefs I held about dietary fats and the benefits of eating lots of fruits and vegetables. Since publishing The Garden of Eating, I have continued to learn and refine my understanding and practice of Paleolithic diet, and along the way I have discovered a number of ill-founded mistakes I made and that I think others make in applying paleo diet principles to modern life. Rectification of these errors in my own practice have resulted in improvements in my health and body composition. So, in the next 5 to 10 posts I will report and explain the most important errors that create problems for would-be paleodieters, and how to correct them.

10. Eating on an agricultural schedule

In the GOE, we laid out meal plans that suggested three to four meals daily. Like many people, at the time I still believed that research had shown that people need to eat every four to five hours to prevent a decline in metabolism, stabilize blood sugar, and maintain a supply of amino acids to prevent loss of lean mass. Since then, I have learned otherwise. We have no scientific support for frequent eating, especially not in the context of a Paleolithic diet.

When I attempted to eat palediet four meals daily, I frequently found that I simply did not have an appropriate hunger for each meal. Also, I intermittently had bouts with indigestion, abdominal bloating, and constipation triggered by eating foods rich in fat. At times, I literally felt fed up with eating protein and fat, and would gravitate toward eating more tubers and fruits.

So I started questioning. My experience suggested that either people aren’t physiologically adapted to eat a diet high in fat and protein, or that my application of paleodiet principles contained some error. Ethnographic, archaeological, anatomical, and clinical trial evidence all ruled out the former alternative, so I figured the problem lay in my application of the diet.

What did I do wrong? Recent hunter gatherers typically consumed only one or two main meals in a day, often after spending a morning and early afternoon hunting or gathering mostly on an empty stomach. At these meals, H-Gs ate large amounts of animal protein and fat. The human gut has several characteristics indicating adaptation to intermittent feeding on high caloric density foods:

1. A relatively small stomach (only about 20 percent of total gut volume) despite large energy requirements, indicating adaptation to consuming high energy density, i.e., high fat foods.
2. Most (about 65 percent) of gut volume in the small intestine, a characteristic which seems more appropriate for prolonged inter-meal digestion and absorption periods than for frequent feeding.
3. A well-developed gall bladder, which stores bile for intermittent use on demand to emulsify fats for enzymatic digestion, and which only empties efficiently with large doses of dietary fat (See Barry Groves’s good discussion of how low-fat diets cause gallstone formation).

Three meals or more in a day developed only after the rise of agriculture and the adoption of high carbohydrate diets. A constant high meal frequency requires constant presence of stored food, which requires either non-perishable staple foods like grains or a ready refrigerator, neither available to hunter-gatherers.

If you eat a low-fat, high-carbohydrate diet, you will very likely be driven to eat frequently by the insulin response to the high-carbohydrate intake, which locks up your fat stores and drives down your blood sugar, putting you in the constant pincer grip of hunger. Frequent eating and its attendant fluctuations in blood sugar and insulin surges also promote daytime fatigue as energy goes into digestion, activating the parasympathetic—rest and digest—nervous system.

However, if you eat a paleodiet based largely on fat and protein, eating too frequently will not give your liver adequate time to produce sufficient bile for smooth digestion of fats, and you may get the kinds of digestive problems I mentioned above, along with the impression that you don’t or can’t tolerate a high fat diet. It could cause you to question or abandon paleodiet.

Of interest here, eating too frequently could also promote colon cancer by prolonging the colon’s exposure to bile acids. Wei et al did a case-control study (correlation, not causation) found a 50% lower risk of colon cancer among men, but not women, eating fewer than three meals daily. This weakly supports the hypothesis that humans are adapted to eating fewer than 3 meals daily.

Further, if you eat animal protein in Paleolithic quantities, this will by nature reduce your appetite for many hours, which signals that your body is not ready to eat. During this period your liver works intensively converting amino acids to glucose. Naturally, this would tend to reduce your appetite for animal protein.

Finally, a reduced carbohydrate intake reduces your insulin level, and this allows the body to mobilize fat stores so that you can go longer between meals. In other word, if eating paleo, you will have a low normal blood sugar level (due to low carbohydrate intake) and you will run on fat, not sugar, so you won’t have eat to “stabilize your blood sugar.”

We have no evidence that anyone must eat every few hours to avoid a depression of metabolic rate. Studies of fasting have shown that people can go at least 72 hours without food with no decline in metabolic rate, and no loss of lean tissue, and, once the fat starts flowing, no loss of energy. Webber and McDonald even found an increase in metabolic rate after 36 hours of fasting [Br J Nutr. 1994 Mar;71(3):437-47].

We also have no evidence for the claim that you must eat protein several times daily to prevent loss of muscle, or promote gain of muscle. In fact, Stote et al showed that when people ate all their daily caloric requirement in one meal (in a four hour period) daily for eight weeks, they gained muscle and lost fat, whereas when they ate the standard three meals daily they did not experience this body recomposition. The infrequent feeding regimen also reduced cortisol levels, suggesting a reduction in physiological stress.

During a 24 hour fast GH output increases markedly; the frequency of GH pulses increases by 25%, the peak amplitude of GH pulses doubles, and the interpeak serum GH levels quadruple [read this and this]. A study by Norrelund et al indicates that the protein-retaining effects of GH inhibit muscle-protein breakdown during fasting. Fasting-induced increases in GH may therefore account for the increase of lean mass found in the Stote et al study mentioned above.

Since the release of GOE, I have reduced my own meal frequency to not more than thrice daily, most usually eating only twice daily, with both meals consumed in a 6-8 hour window, so that I now fast 16-18 hours daily. This has improved my digestion and elimination, my energy level, my mood, and my body composition (less fat, more muscle). My next book will explain how to adopt this intermittent fasting schedule in a systematic fashion.

Stay tuned for the next installment, we have nine to go.

Perils of Indoor Living: Skin Cancer

Aaron Hicks just sent me a copy of this paper from Medical Hypotheses:

Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma

This paper may enlighten, or upset, dermatologists mired in the "sunlight causes cancer" myth. It also has the potential to damage the sunscreen industry, also based on the myth that sun exposure causes skin cancer.

The authors, Dianne E. Godar, Robert J. Landry, and Anne D. Lucas propose that intermittent, intense exposure to UVB initiates cutaneous malignant melanoma (CMM), but that promotion of CMM requires increased UVA exposures and inadequately maintained cutaneous levels of vitamin D3.


Some interesting facts cited in support of their hypothesis:

• "Although outdoor workers get much higher outdoor solar UV doses than indoor workers get, only the indoor workers’ incidence of cutaneous malignant melanoma (CMM) has been increasing at a steady exponential rate since before 1940."

• "Outdoor workers have a lower incidence of CMM compared to indoor workers."

• People who use UVB-absorbing sunscreens have a significantly increased risk of melanoma and these sunscreens promote the growth of melanoma in mice.

• People who maintain an all-year-tan have a reduced risk of melanoma, and outdoor workers, who receive three to nine times the erythemally effective UV dose of indoor workers have a significantly lower incidence of melanoma.

• Excluding sunburns, outdoor activities in childhood decrease the incidence of melanoma and research has failed to find a ‘‘critical period,” such as childhood, where intense exposures contribute more towards the induction of melanoma.

• Sunburns throughout life increase the risk of melanoma, while low level solar UV exposures reduce the risk.

• Melanoma patients who receive regular sun exposures live longer than those who do not.

• UVA not only promotes skin tumor growth in mice after initiation by artificial sunlight, but also causes twice as many tumors to form .
  

• UVA increases melanomas in a mouse model after initiation by UVB.

• People can get considerable UVA exposure from windows, but windows do not allow passage of adequate UVB to stimulate vitamin D production.

• UVA exposure, absent UVB exposure, leads to degradation of vitamin D; and UVA also causes DNA damage.
  

• "High-rise office buildings, needing many large windowpanes, became increasingly popular around the mid 1910s, about 20 years prior to the first observed increase in the incidence of CMM. The time-line for the industrial revolution fits the CMM observations, unlike the introduction of fluorescent lights in the mid-1940s [80] or any other events that occurred after the mid- 1930s. Thus, the industrial revolution caused many workers to stay indoors during the day reducing their cutaneous vitamin D3 levels and, the UVA entering their offices caused photodegradation of vitamin D3 and mutations to the DNA of their skin cells."

Finally:

"In the early 20th century, people went against evolution by going indoors during the day to work, which drastically decreased their daily amount of cutaneous vitamin D3 and, along with it, their blood levels. With the addition of larger buildings and sky scrappers, people created an unnatural UV barrier when windows were developed and used in abundance. The UV barrier created by window glass divided UVB from UVA, so that the vitamin D making UVB was excluded from our indoor working environment; only the vitamin D-breaking and DNA-mutating UVA was included. Because this unnatural UV environment existed for decades in buildings and cars, CMM began to steadily increase about 20–30 years later in the mid-1930s."

In short, a boat-load of evidence that avoiding the full-spectrum UV light provided by old Sol and hiding inside drives the production of CMM. This paper shows how elegantly the theory of evolutionary adaptation can explain all of the known facts about CMM and provide the basis for uncovering the cause of a degenerative process.

Dr. McDougall on B-12: A study in vegan thinking?

In his November 2007 Newsletter, Dr. John McDougall, a tireless advocate of a strict vegetarian (vegan) diet, writes the following:

“Since the usual dietary source of vitamin B12 for omnivores is the flesh of other animals, the obvious conclusion is that those who choose to avoid eating meat are destined to become B12 deficient. There is a grain of truth in this concern, but in reality an otherwise healthy strict vegetarian’s risk of developing a disease from B12 deficiency by following a sensible diet is extremely rare—less than one chance in a million.”

Dr. McDougall apparently has not read the scientific literature on B-12 deficiency in vegans and vegetarians. In 1999, Haddad et al reported a study that included 25 vegan participants. Of these, “2 had macrocytosis (mean red cell volume 398 fL), 3 had circulating concentrations of vitamin B-12<150>376 nmol/L, which is the critical cutoff point that represents
3 SDs above the population mean.” Macrocytosis represents gross vitamin B-12 deficiency, which in this study occurred in 2 of 25 vegan individuals, or 8% -- an 80,000 times greater incidence than “one-in-a-million” (i.e. 0.0001%). Three of 25 or 12% had low VT-B12 concentrations, and 5 of 25 or 20% had elevated methylmalonic acid concentrations, which most experts consider the most sensitive indicator of vitamin B-12 deficiency.

Furthermore, the Haddad et al reported that “Although the average time subjects consumed a vegan diet was 4.2 y in this study, the data showed that 10 of the 25 vegans had at least one indicator of vitamin B-12 deficiency, either macrocytosis, low serum vitamin B-12, or elevated methylmalonic acid concentration (Table 4).” Therefore, this study alone suggested that approximately 40% of vegans may suffer from some degree of vitamin B-12 deficiency. In other words, this study recorded an incidence of B-12 deficiency 400,000 times as high as McDougall claims. Meanwhile, not one of the non-vegetarians had any of the indicators of B-12 deficiency.

Of interest, in table 2 of this paper, Haddad et al report that average intakes of B-12 from both food and supplements did not differ much between the vegans and nonvegetarians. This suggests strongly that B-12 supplements and fortified foods (the only significant sources of B-12 in vegan diets) do not prevent B-12 deficiency in long-term vegans. This could occur because the form used in supplements and fortified foods, cyanocobalamin, differs from the form supplied by animal foods.

This deficiency also affects lacto-vegetarians. In 1999 Hokin and Butler reported a study of 340 Seventh Day Adventist Vegetarians, 245 of which were lactovegetarians or vegans. In the vegetarians, 53% had serum B-12 levels below the laboratory reference range of 171 pmol/L, and 73% had levels below 221 pmol/L, the level identified as normal for an individual with adequate production of the intrinsic factor required for vitamin B-12 absorption. By conducting the Schillings test for intrinsic factor activity, Holin and Butler determined that dietary inadequacy caused the B-12 deficiency in 70% of the vegetarian subjects in this study.

In 2003, Herrmann et al conducted a study of 66 lactovegetarians or lactoovovegetarians
(LV-LOV group), 29 vegans, and 79 omnivores. This team tested three indicators of B-12 deficiency in all subjects: holotranscobalamin II, methylmalonic acid (MMA), and homocysteine levels. Low serum B-12 or holotranscobalamin II, or elevated MMA or homocysteine, indicate B-12 deficiency. They reported:

“Irrespective of vitamin usage, low vitamin B-12 concentrations (<> 271 nmol/L) was found in 5% of the omnivores, 61% of the LV-LOV subjects, and 86% of the vegans.”

Again, the facts dispute McDougall’s claim. In this study, signs of B-12 deficiency appeared not only in up to 90% of vegans, but also in up to 73% of LV-LOVs, and this despite use of vitamin B-12 supplements among the vegetarians.

In table 2 of this study they report the following findings among subjects not using vitamins:

• Normal B-12 status occurred in 78% of omnivores, 11% of LV-LOVs, and only 8% of vegans.
• Stage I or II B-12 deficiency occurred in 10% of omnivores, 21% of LV-LOVs, and 8% of vegans.
• Stage III B-12 deficiency occurred in 3% of omnivores, 60% of LV-LOVs, and a disconcerting 83% of vegans.

McDougall also claims that vegan diets work the best for reduction of homocysteine because of their high levels of folate and low levels of methionine—an amino acid abundant in meat but not plant proteins. But in this study, vegans and LV-LOVs, not omnivores, had the highest homocsteine (tHcy) levels, due to their B-12 deficiency. Herrmann et al wrote:

“We found tHcy concentrations <> 7 nmol/L). In contrast, hyperhomocysteinemia occurred in the LV-LOV subjects and vegans when serum folate was as high as 42.0 nmol/L.”

In other words, high folate and low methionine intakes do not protect against elevated homocysteine. High homocysteine appears linked to heart disease, cancer, osteoporosis, and many other common degenerative conditions, none of which occurred in healthy hunting and gathering groups.

So McDougall doesn’t have his facts correct about the incidence of B-12 deficiency or elevated homocysteine levels in vegetarians. But he goes on from that error to add:

“Take a moment to compare the possible consequences of your dietary decisions. You could choose to eat lots of B12-rich animal foods and avoid the one-in-a-million chance of developing a reversible anemia and/or even less common, damage to your nervous system. However, this decision puts you at a one-in-two chance of dying prematurely from a heart attack or stroke; a one-in-seven chance of breast cancer or a one-in-six chance of prostate cancer. The same thinking results in obesity, diabetes, osteoporosis, constipation, indigestion, and arthritis. All these conditions caused by a B12-sufficient diet are found in the people you live and work with daily. How many vegans have you met with B12 deficiency anemia or nervous system damage? I bet not one! Furthermore, you have never even heard of such a problem unless you have read the attention-seeking headlines of newspapers or medical journals.”

This paragraph contains several fallacies. First of all, he asserts a false dilemma: Either eat no animal foods and court a miniscule risk of B-12 deficiency, or eat “lots of B12-rich animal foods” and incur a high risk of heart attack, stroke, breast cancer, prostate cancer, obesity, diabetes, osteoporosis, constipation, indigestion, and arthritis.” This dilemma is false in several ways:
• He suggests falsely that you have only two choices, either eat no animal foods, or eat an undefined “lots” of them, when in fact a diet can vary from 0% to 100% animal food.
• He has not defined what percent will constitute “lots” of animal food, and though it refers generally to large amounts, by contrasting it with “no” animal food, Dr. he implies without evidence that eating any amount of any kind of animal food will put you at high risk for the listed diseases
• He implies that eating “lots” of animal foods will put anyone or everyone at risk for the listed diseases, and conversely that eating a vegan diet will prevent all these diseases in anyone or everyone.

Traditional Eskimos eat a diet composed of up to 90% animal food, and on their traditional diet, they had a low risk of heart attack and no cancer, no obesity, no diabetes, and no constipation. I do not think the Eskimo diet is ideal, but traditional Eskimo dietary experience certainly disproves McDougall’s implied claim that eating “lots” of animal food causes all the disorders he listed.

Dr. McDougall goes on to cite one study finding that “The human gut also contains B12-synthesizing bacteria, living from the mouth to the anus.” Although apparently true, he fails to mention that in order to produce true vitamin B-12 (cobalamin), these bacteria would need a source of cobalt, since a functional B-12 molecule contains this mineral.

Foods can supply cobalt, either as B-12 or in elemental form. A study by Hokin et al found that in Australia meat and potatoes are the main dietary cobalt sources. Comparing cobalt intakes of 10 omnivores, 10 lacto-ovo-vegetarians, and 10 vegans, Hokin et al found that lacto-ovo-vegetarians had the lowest cobalt intakes, that vegans who ate large amounts of potatoes had cobalt intakes similar to omnivores, and that vegans who did not eat large amounts of potatoes had cobalt intakes similar to lacto-ovo-vegetarians. Hokin et al found no correlation between dietary cobalt intake and serum B-12 concentrations in any of the dietary groups.

Hokin et al reported both vegans and vegetarians had mean serum B-12 levels of 175 pmol/L, compared to 366 pmol/L in omnivores. (As noted above, levels below 221 pmol/L are considered deficient and are associated with macrocytosis and elevated homocysteine in vegetarians.) Hokin et al noted that even the lowest cobalt consumption in the groups studied (6.67 mcg/d) would support the production of 165 mcg of B-12, about 80 times the RDA for B-12 – but that did not happen in the vegans, indicating that human gut flora does not produce significant or adequate amounts of B-12 from dietary cobalt.

Dr. McDougall goes on to discuss the fact that the intestinal flora of ruminant animals (such as cattle, sheep, deer, bison, giraffes, and goats) produce vitamin B-12. These animals ingest cobalt, carbon, hydrogen, phosphorus, and nitrogen by eating grass, a food inedible to humans, and their intestinal flora use that material to produce B-12. They absorb and use some of that B-12, so that the B-12 appears in the meat and milk of these animals, but they also pass much out in their feces.

McDougall goes on to say:

“The [human] colon contains the greatest number of bacteria (4 trillion/cc of feces), and here most of our intestinal B12 is produced. However, because B12 is absorbed in the ileum, which lies upstream of the colon, this plentiful source of B12 is not immediately available for absorption—unless people eat feces (don’t gasp). Feces of cows, chickens, sheep and people contain large amounts of active B12. Until recently most people lived in close contact with their farm animals, and all people consumed B12 left as residues by bacteria living on their un-sanitized vegetable foods.”

Why shouldn’t we gasp? Is he suggesting that it is healthier to eat feces than to eat meat or milk? I venture to say without any scientific reference that people all over the planet feel revulsion at the idea of eating feces, and that no successful culture has failed to recognize the need to take steps to remove fecal matter from foods before consumption.

Moreover, every culture that keeps farm animals does so to have access to meat, milk, and eggs, not so as to have vegetables contaminated with fecal matter. But McDougall writes as if he wants us to believe that in the old days people avoided eating animal products and only kept farm animals so they could have access to vegetables contaminated with fecal matter.

I don’t know of any human group that has a tradition of keeping farm animals just for the purpose of eating unwashed vegetables contaminated with feces. I find his insinuation insulting to the intelligence of the reader and the human race in general. In case the reader or McDougall does not know, consumption of fecal matter can kill by ingestion of deadly coliform bacteria or protozoans. Yet McDougall appears to think it is better to eat vegetables contaminated with fecal matter than to eat animal flesh.

McDougall goes further to say: “Why would a plant-food-based diet, heralded as a preventative and cure for our most common chronic diseases be deficient in any way? Such a diet appears to be the proper, intended, diet for humans, except for this one blemish.”

Okay, one thing at a time. First, here he clearly uses the phrase “plant-food-based diet” to refer only to a vegan diet. But in fact the phrase “plant-based” does not mean plant-only. Any diet that provides more than 50% of its bulk or energy from plant foods can legitimately be called plant-based. What else would you call a diet that provided 75% of its energy from plant foods and 25% from animal foods? I certainly would not call that diet “animal-based.”

A vegan diet is not only plant-based, it is plant-only. Vegans quite commonly apply the concept of dietary base inconsistently. They commonly call the omnivorous diet “animal-based” when in fact the majority of modern omnivores eat plant-based diets, i.e. the bulk of the diet of omnivores comes from plants, not animals. If a diet contains any animal foods at all, vegans call it “animal-based,” but will call a diet “plant-based” only if it is 100% plant food.

Moreover, B-12 deficiency is not the only “blemish” on plant-only diets. Plant-only diets may fail to meet human needs for taurine, DHA, zinc, iron, vitamin B-6, and vitamin A.

Further, what does he mean when he says a plant-only diet is the “proper, intended” diet for humans? Who does he think “intended” for humans to eat a plant-only diet? Does he opine that some supernatural creator “intended” for humans to eat vegan diets? I find this sudden reference to an “intended” diet creepy.

I know many readers may believe in a god, but no one has ever produced any scientific evidence that any of Nature or human physiology occurred as a result of the “intention” of any supernatural entity. In addition, various human tribes have claimed to “know” the existence, will, or intent of many different gods– the Judeo-Christian God, the Islamic Allah, Vishnu, Brahman, Zeus, Poseidon, Buddha, etc. The opinions as to what these entities supposedly “intended” for humans appear quite contradictory. Compare the dietary proscriptions of Islam and Hinduism, or of Seventh Day Adventists and Jews, etc., and you will quickly see that the experts on the gods’ wills for human diets have major disagreements. Even within cults there appears dispute about what the god wants. Some Buddhists claim Buddha prohibits meat-eating, some say not. Some Christians say their God allows meat-eating, some say not.

Discussions of human nutritional requirements require evidence from scientific research, not vague references to the “intended” diet of man without reference to any entity that could have intent (such as humans). Certainly rice did not “intend” for humans to eat its seeds; apple trees did not produce apples for humans; soybean plants do not intend for humans to eat their seeds; and so on.

Nature did not “intend” for humans to eat any diet; rather, humans adapted to eating what Nature provided in the ecological niche humans chose to inhabit. All the scientific evidence indicates not only that humans have always eaten omnivorously, but in fact that prehistoric humans depended primarily on animal-source foods for millions of years during the ice ages.

In fact, humans could not have spread from Africa to inhabit Europe, starting 50, 000 years ago, unless they heavily utilized meat, poultry, fish, and eggs as staple foods. From that time until about 10, 000 years ago, an ice age gripped the planet, and humans moved out of Africa into Central Asia, and from there eventually to Australia, Europe, China, Siberia, and North America. The climate did not allow the earth to produce sufficient quantities of edible plant foods along many of the routes of migration humans followed. So they lived on meat and fish of whatever type they could find.

What every vegan needs to know about B-12: http://www.veganhealth.org/articles/everyvegan/

Another study showing low B-12 levels and elevated homocysteine in vegans and vegetarians:
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=12827&Ausgabe=224621&ProduktNr=223977

Notes

Haddad et al, Dietary intake and biochemical, hematologic, and immune status
of vegans compared with nonvegetarians, Am J Clin Nutr 1999;70(suppl):586S–93S.

Hokin and Butler, Cyanocobalamin (vitamin B-12) status in Seventh-day Adventist
ministers in Australia, Am J Clin Nutr 1999;70(suppl):576S–8S.

Herrmann et al, Vitamin B-12 status, particularly holotranscobalamin II and
methylmalonic acid concentrations, and hyperhomocysteinemia
in vegetarians, Am J Clin Nutr 2003;78:131–6.

Albert MJ, Mathan VI, Baker SJ. Vitamin B12 synthesis by human small intestinal bacteria. Nature. 1980 Feb 21;283(5749):781-2.

Hokin et al, Comparison of the dietary cobalt intake in three different Australian diets, Asia Pac J Clin Nutr 2004;13 (3):289-291.

Everything I know about the dreaded Cold Sore

Cold sores are an outbreak of the herpes virus. The sore begins with a hint of a tingle or itchiness and, if not treated, will turn into a painful blister that usually takes about a week to heal. This virus strikes after prolonged exposure to the sun, or a dip in the immune system at times of stress or sickness. I used to get cold sores more often, and now, only seem to get them when sick. They are the first thing that I started treating herbally years ago and I have found several effective ways of dealing with them. If you are hoping to stop a cold sore from erupting, the trick is to treat it aggressively, both liberally and frequently at the very first tingling. Once the cold sore breaks the surface, the best you can do is treat the pain, although steadily taking anti-viral and immune supporting herbs may shorten the duration of the outbreak.

I contacted cold sores when I was 16 and was so horrified I didn't go to school for a week until my lips were back to normal. At that time I really struggled emotionally with having the herpes virus. Although I certainly don't relish getting cold sores now, I have come to recognize them as a teacher of sorts. If I am getting too stressed, run down, anxious, etc., then my teacher the cold sore will pop up to remind me to take better care of myself. So besides the herbs listed below, proper rest, nutritious food, and calm state of mind can all be helpful in preventing cold sores and helping them to heal more quickly.

Because of their highly contagious nature, proper hygiene is crucial when dealing with an outbreak. Washing your hands after touching the cold sore is important as is refraining from wiping the area with any towel or cloth that will be re-used. A friend of mine told me she chewed on her thumb cuticle while she had an outbreak and her thumb started having outbreaks as well. Another friend contracted the virus into her eye. Obviously not kissing anyone, or placing the cold sore on any other place of the body is good practice as well.

St. John’s Wort Oil or Tincture (Hypericum perforatum)
I apply this oil or tincture topically and take the tincture internally at the first sign of a cold sore. St. John’s Wort has strong anti-viral properties that go straight to where the virus hangs out, in the nerve endings. This is probably my most tried and tested way of preventing outbreaks. St. John’s Wort has the potential to interfere with prescription medications and may cause photosensitivity in some individuals, so this is an herb that you should know well before ingesting.

Tea Tree Oil
This potent oil can be a little too much on the lips, so I like to dilute it in olive oil (or some other carrier oil), or I add tree tea oil to the St. John’s Wort Oil and apply them together with a Q-tip.

Lemon Balm (Melissa officinalis)
Herbalist Jill Stansbury says the tannins in lemon balm are what make it effective against the virus, so a water extract as a tea or infusion is best for use against cold sores. Herbalist Heather Nic an Fleishdier reports having completely gotten rid of the herpes virus from her body by taking daily infusions of lemon balm and St. John’s Wort.

Amino Acids:
Although not an herbal remedy, taking lysine pills at the beginning of a cold sore can stop the outbreak altogether. I take as many as 4,000 mcg at the first tingle of a cold sore, and continue with 2,000 mcg every hour. Trust me, you'll get nauseas if you take too much. Conversely avoiding foods high in arginine can be helpful during an outbreak or to prevent an outbreak. (A listing of foods with a lysine arginine ration can be found here.)

Tulsi (or Holy Basil):
Highly regarded in India, this potent plant related to basil is considered by many as a cure all wonder. Among its many attributes, are anti-viral properties. A warm cup of tea or a dropperful of tincture made from the fresh plant can stop or shorten the duration of a cold sore. Taken over time Tulsi also has the ability to help your body deal with stress better (adaptogenic). Large amounts of Tulsi should not be taken when pregnant.

Hyssop (Hyssop officinalis)
I used to think of hyssop as a “coughing” remedy and have only recently begun using the tea or tincture for cold sores. It tastes great and is very effective.

Elderberry (Sambucus spp. - blue berried varieties)
In the past year I have used elderberry tincture for cold sores a couple of times with mixed results. One thing is for sure it's easy to get this medicine down the trap.

Garlic (Allium sativum)
I haven't tried this myself but have heard from several people that place a raw slice of garlic on the site of the cold sore (again at the first sign of tingling), will help keep it from erupting.



Once the cold sore has erupted there are a few things that can help it to heal more quickly and reduce pain.

Ice
Sometimes I get monster cold sore outbreaks where my lip swells enormously and is so painful I can barely eat. Ice is certainly my friend. It dulls the pain and decreases the swelling.

Herbal bandaid
One time I had such an oozy outbreak that I wanted some kind of bandaid on the sore. I started experimenting with different herbal powders.

Mix together some variation of:
Powdered rose petals, powdered licorice root, powdered hyssop, and powdered lemon balm with kaolin clay. Mix it with a little water and a little St. John's Wort oil. You can also add tea tree oil or lavender EO to the mix. It should form a sticky clay like mixture that will stick to the desired area.

This is especially nice for night time application.

Lip Balm
For applications on the go I've made several variation of a cold sore care lip balm. My favorite herbs to use are St. John's Wort, Lemon Balm, and Hyssop with tea tree oil in an olive oil, coconut oil, and beeswax base.

The Digestive System: An Herbalist's Perspective

Here's an article I wrote for www.herbmentor.com as part of a new anatomy and physiology section. This series of articles were written for someone new to A&P and are meant to give a general understanding of how these different systems work and are not necessarily all encompassing. There is a suggested reading list located at the end of the article for those of you interested in pursuing these topics more in-depth.

Why is digestion important?

Unless something goes wrong it’s easy to stop thinking about the food that goes into your mouth until it comes out the other end, hopefully 12 – 24 hours later. Digestion is largely involuntary, meaning that, after you’ve done the conscious act of chewing and swallowing, your amazingly intelligent body takes over.

We can’t necessarily say that one system of the body is more important than the other, as we need all of them to operate optimally. However, special props can be given to the digestive system. In this set of organs, mucosa, secretions, and nerves lies the ability to turn nutritious food, which is completely unusable in its whole form, to molecules tiny enough for the body to assimilate and use for various functions. I’ll say it here, and probably a 100 more times before I am done with this series, the body is absolutely amazing.

Herbalist, Michael Tierra, says that in the Ayurvedic system, digestion is the key to overall health. He continues further to say that, in Traditional Chinese Medicine, disease is said to begin in the stomach.

As important as the digestive functions are, herbalist David Winston reports that up to 2/3 of his clientele show signs of impaired digestion. You can probably imagine that if a body is not digesting food properly then it’s not getting the essential nutrients the whole body needs for vibrant health throughout the whole body. But before we explore sluggish systems and various pathologies in the digestive system let’s expand on how exactly it works.

The Digestive Process (Or A Day in the Life of Your Food)

As stated above, the digestive process starts with the voluntary action of the intake, chewing, and swallowing of food. Normally your salivary glands produce just enough saliva to keep your mouth moist, but even before the food hits your tongue, your salivary glands are ideally secreting extra saliva. About 1 to 3 pints of saliva a day is produced in the mouth and yes, you can have too much or too little. Saliva is mostly made up of water but also includes special enzymes used to break down starches and sugars. The salivary reflex is started when you smell delicious food or eat sour or bitter foods.

We’ve all heard that we need to chew our food well (so you do right?). Chewing is important as the first step in changing the food into smaller molecules. It also allows for the mixing of saliva with the food to further break down starches and sugars. Besides saliva, your tongue, teeth, and gums all play an important role in this process.

Once you’ve swallowed your hopefully well-chewed food (called the bolus), it enters the esophagus. The esophagus is lined with muscles and the involuntary muscle action of peristalsis helps to move the food down to your stomach. This means that you could hypothetically eat while standing on your head, although such an action is not advised or endorsed by this author. The voyage from being swallowed to entering the stomach takes about 2 to 3 seconds.

At the bottom of the esophagus is the lower esophageal sphincter, which is a ring-like muscle that creates a barrier between the esophagus and the stomach. This sphincter relaxes when food enters the stomach, and tightens up again once the food has passed. Problems arise when this sphincter remains relaxed, allowing for the gastric juices of the stomach to rise into the esophagus, creating what you think would be called esophageal burn but, instead, somebody named it heartburn, overlooking the fact it has nothing to do with your heart. (I admit, however, that heartburn is much easier to say.)

Heartburn is often treated allopathically with antacids, which neutralize the acids in your stomach. Taking antacids may alleviate the pain for the time however they also severely hamper digestion, creating even more problems down the line. Herbalist David Winston says it’s important to determine the cause of the heartburn, whether from too much stomach acid, or from a relaxed esophageal sphincter, and then work to find a solution from there. His CD on digestion is very illuminating and is referenced in the suggested readings at the end of this article.

The Stomach

Once your food has made it to your stomach it may be there for up to a couple of hours. The stomach has three important physical functions. It stores consumed food and liquid, it mixes this with gastric juices to further break it down into a liquid, and, lastly, it slowly empties the food (now called chyme) into the small intestine (which is by no means small by the way).

The stomach is lined with mucosa that helps to protect it from the intense acids it produces to break down food. This specialized mucosa does not allow for much absorption of nutrients although it does break down some water, some electrolytes, certain drugs (especially aspirin), and alcohol. (This is why tinctures act on the body so quickly.)

Much of the digestive system is made up of mucosal tissue. When inflamed due to chronic inflammatory processes (Crohn’s disease, ulcers), or acute inflammation (diarrhea, heartburn), demulcent herbs such as marshmallow root, comfrey, and slippery elm can be used to soothe the irritated tissue. (Please read up on the controversial comfrey before taking it yourself.)

How much time your food stays in the stomach depends a lot on the type of food that you ate. Carbohydrates stay in the stomach for the least amount of time, followed by proteins, and then fats. (Knowing how fast your body metabolizes food is part of what can help you to determine which foods work best for you. For example, if your body has a fast metabolism, eating too many carbohydrates can leave you with frequent hunger and on a roller coaster of fluctuating energy. If, on the other hand, you have a slower metabolism, eating too much fat can leave you feeling too full and heavy long after you’ve eaten.)

Small Intestine

Once your stomach has finished processing the chyme, it slowly enters it into the small intestine where 90% of the digestive function takes place. This hollow organ is an average of 22 feet long in an adult and is from 1.5 to 2 inches wide. It is covered in a mucosal lining along with small villi that all help to absorb the nutrients that will be assimilable by the body with the help of several digestive juices from the liver, pancreas, and the small intestine.

Bile

Bile is produced by your liver and stored in your gallbladder between meal times. When you start to eat, especially if there are bitter tastes in your food, the liver produces bile and the gallbladder squeezes out bile through ducts that enter into the small intestine. The bile has the specific action of breaking down fats.

Pancreatic enzymes

The pancreas produces a wide range of enzymes that further break down the carbohydrates, proteins, and fats in your food.

As your food changes into smaller and smaller molecules with the help of these various digestive juices it becomes ready for absorption through the small intestine.

Absorption

With the help of these digestive juices the chyme is broken down into smaller and smaller molecules and then finally absorbed into the circulatory system. Fat-soluble vitamins are stored in the liver and adipose of the body, while extra water-soluble vitamins are excreted through the urine. Water is also absorbed through the walls of the small intestine. Twenty two feet later it begins a slow entry into the large intestine.

Large Intestine

The large intestine has several roles. It absorbs most of the remaining water as well as a few vitamins and electrolytes. It also holds the chyme until ready for evacuation.

One interesting thing about the large intestine is the ascending colon. As the name suggests, it literally travels up your right side before becoming the horizontal transverse colon, and then finally the sigmoid portion which travels down and ends at the anus. In view of this anatomy, it makes sitting on a toilet to defecate a very unnatural phenomenon because it forces your body to work against gravity. Much more appropriate is to squat, which arranges your large intestine in a way that facilitates defecation. If you look around the world, squatting is much more common than our more modern, and supposedly superior, porcelain thrones.

The large intestine (and small intestine) is home to an amazing amount of bacteria that participate in further fermenting and breaking down your food. (Herbalist Chanchal Cabrera says that the bacteria in your colon could weigh as much as three pounds!). It is this fermentation that causes gas and flatulence. Gas can be an annoying nuisance or even extremely painful. Carminatives such as mints, fennel, chamomile, cardamom, and thyme are aromatic herbs that help to expel gas. Cooking with these herbs can help a problem before it starts. (This practice is inherent in some cultures, which is why you always find fennel candy as you walk out of the Indian restaurant after eating a meal; wonderfully spiced with carminatives.)

In a healthy person these bacteria are varied and abundant. Bacteria can become easily imbalanced with the use of antibiotics, diarrhea, poor food choices such as an abundance of sugar, and extreme colon cleansing programs. Traditional cultures around the world ate small amounts of fermented foods with every meal. This wisdom can be employed today to create and maintain a healthy balance in your colon. Some examples of fermented foods are kim chee, sauerkraut, miso, kefir, beet kvass and many more.

Appendix

When researching for this article I ran into several references amazingly still referring to the appendix as useless. (I have a hard time believing that this incredible human body contains useless organs.) In fact recent research suggests that the appendix plays a huge role in the immune system. Herbalist Jim McDonald says there’s research showing it may also repopulate the bowel with healthy bacteria after it has been purged.

After the remaining nutrients and water are absorbed, the same peristalsis action that moved the food down your esophagus pipe now acts in the large intestine, moving it closer to the exit hole and creating the reflex to defecate. All that remains is some water, indigestible food, bacteria, products of bacterial decomposition, and inorganic salts.

Diarrhea happens when the food is moved through the system too quickly and water is not properly absorbed. This can happen because of irritants in the intestines. Astringents like blackberry and raspberry leaves can be taken to tone the tissue for better absorption, although for the most part it’s a good idea to initially let your body expel whatever it is trying to get rid of. The focus should be on staying hydrated and getting electrolytes.

Constipation, on the other hand, is when the fecal matter stays in the large intestine too long. Most commonly, this can happen from both hyper or hypo tonic tissue, lack of fiber in the diet, dehydration, lack of exercise, or excess mucous. Addressing these issues is much more effective in the long run than laxatives, herbal or otherwise.

David Winston recommends that transit time, the time food enters your mouth to the time it leaves your body, is around 12 to 24 hours. To determine your transit time eat a nice serving of cooked beets and then record the time until you notice them on the other end. A nice bowl of borscht should do it.

What controls all these processes?

Although I have tried to mainly focus on the organs of digestion, it’s impossible to cut the digestive system out of the body without at least acknowledging some other important roles. The nervous system, hormones, and the circulation system administer different actions in harmony with the digestive system, leading to the stimulation of digestive juices, reflexes to keep things moving, and then carrying the digested nutrients to the various parts of the body. In-depth discussion of these tasks could last another fives pages, and I am already feeling your waning energy. Please just take note of these forces and we’ll end the article with some suggestions on healthy digestion as well as further reading.

Ideas for healthy digestion

1. Eat healthy food according to your constitution. To determine which foods work best for you I highly recommend the book Metabolic Typing. Rather than proclaiming dietary dogma it teaches self awareness to help a person actually figure out which foods, what size of meals, the best times of day for eating, etc, work for them.
2. Eliminate food that you are allergic or sensitive to. Common sensitivities are wheat, dairy, and soy.
3. Chew your food well. There’s no need to count to 100, just be sure that your food is well mashed before swallowing.
4. Stay hydrated, but limit large amounts of liquids before, during, and after meals. This can dilute your digestive juices, impairing the breakdown of your food.
5. Avoid extreme physical activity directly following meal times.
6. Avoid frozen and iced beverages and foods at meal-time. The digestive process needs warmth, and is hampered by excessive coldness.
7. Eat until you are only ¾ full.
8. Eat fermented foods with your meal. Miso, sauerkraut, kefir, beet kvass, etc.
9. Eat your bitters. Bitter foods and herbs stimulate the salivary glands and the expulsion of bile, all facilitating digestion. Bitters include dandelion leaves, orange peels, gentian, yellow dock, and hops.
10. Eat sitting down. Avoid watching TV or reading while eating.
11. Don’t eat when tense, angry, or fearful. These emotions have direct effects on your nervous system, which in turn affects digestion.
12. Avoid harsh cleansing programs like gall bladder flushes and colon cleansing.
13. Enjoy your meal. In Ayurveda it’s said that singing before and after a meal promotes digestion.

Suggested Reading

David Winston, Digestion CD from the Herbal Therapeutics Library

Metabolic Typing, William Wolcott. This book helps you to determine which foods work best for you.

Herbs for the Digestive System, article by Jim McDonald

Jim McDonald’s Article Index. I used this resource extensively for the article. Here you will find many articles related to specific pathologies of the digestive tract. Many thanks to Jim for putting together such quality articles in one easy-to-locate place.

I particularly referenced the following from this index:

Phytotherapeutic approaches to lower bowel disease Pt1 and Pt2 by Chanchal Cabrera. Great look at digestive health and many chronic issues.

Herbalist's View - Digestion by 7song

Principles of Anatomy &f Physiology, Tortora, Grabowski. For an in-depth look at the digestive system.

Thanks to http://eatwellgetwell.wordpress.com/ for the image.

This article was written to give you a brief view of the digestive system interspersed with herbalists’ perspectives on digestive health and digestive pathologies. It is not meant to treat, diagnose, or cure.