I recently blogged about the discovery of Dr. Mary Newport, a Florida doctor, that her husband’s Alzheimer’s got better when he ate coconut oil. Dr. Newport now has a website devoted to the subject.
Category: nutrition
What Did Eskimos Eat?
In the early 1900s, the anthropologist/explorer Vilhjalmur Stefansson, after living with Eskimos for a long time, returned to tell Americans what he had learned about nutrition. Eskimos ate meat almost exclusively, he said, which contradicted the usual emphasis, then as now, on diversity and fruits and vegetables. Yet Eskimos were healthy. Eskimo diet became even more fascinating when it was realized they had very low rates of heart disease — much lower than Danes, for example. In the 1970s, two Danish doctors, Bang and Dyerberg, found that Eskimos had large amounts of omega-3 fats in their blood, much more than Danes; that was the beginning of the current interest in omega-3 and the idea that fish and fish oil are “heart-healthy”.
As I pointed out earlier, discussions of the Eskimo diet have ignored the fermented food they ate. Here’s what Stefansson said in 1935:
I like fermented (therefore slightly acid) whale oil with my fish as well as ever I liked mixed vinegar and olive oil with a salad. . . .
There were several grades of decayed fish. The August catch had been protected by longs from animals but not from heat and was outright rotten. The September catch was mildly decayed. The October and later catches had been frozen immediately and were fresh. There was less of the August fish than of any other and, for that reason among the rest, it was a delicacy – eaten sometimes as a snack between meals, sometimes as a kind of dessert and always frozen, raw. . . .
[At first, Stefansson didn’t want to eat decayed fish.] While it is good form [in America] to eat decayed milk products and decayed game [well, well], it is very bad form to eat decayed fish. . . . If it is almost a mark of social distinction to be able to eat strong cheeses with a straight face and smelly birds with relish, why is it necessarily a low taste to be fond of decaying fish? On that basis of philosophy, though with several qualms, I tried the rotten fish one day, and if memory serves, liked it better than my first taste of Camembert. During the next weeks I became fond of rotten fish.
So Eskimos ate fermented whale oil and a lot of rotten fish. (“A lot” because if they didn’t eat a lot of it, Steffanson wouldn’t have felt pressure to eat it.) I had no idea that Americans used to eat decayed game.
Oral Health, Heart Disease, and Fermented Foods
From the abstract of a 2007 paper about oral health and heart disease:
The high prevalence of cardiovascular diseases (CVD) and infections of the mouth has led to the hypothesis that these disease entities [are] connected. Oral biofilms contain numerous micro-organisms with more than 700 identified species. . . . These micro-organisms cause dental caries and periodontal disease of which the majority of humans suffer during their life. Oral bacteria are presumed to gain access to the blood circulation and are postulated to trigger systemic reactions by up-regulating a variety of cytokines and inflammatory mediators. Infection and inflammation play a role also in atherogenesis. Furthermore, traces of oral micro-organisms, such as the gram-negative anaerobic bacterium Porphyromonas gingivalis, have been detected in atheroma plaques. This bacterium seems to be potentially atherogenic in animal models. Epidemiologic data have shown a statistical association between periodontal disease and coronary heart disease and stroke. In a meta-analysis, the odds ratio increase for CVD in persons with periodontal disease was almost 20%. Poor oral health also seems to be associated with all-cause mortality.
Emphasis added. As I blogged earlier, during my last trip to the dentist I was told my gums were in great shape, better than the previous visit — and the only intentional change since the previous visit was a huge increase (a factor of 50?) in how much fermented food I eat. So perhaps fermented foods improve oral health. A reason to suspect that fermented foods reduce heart disease is that Eskimos, with very low rates of heart disease, eat lots of fermented food. If both these ideas are true — fermented foods improve gum health and reduce heart disease — it would explain the observed correlation between gum disease and heart disease.
A vast number of people believe that sugar and refined flour are bad for us. In large amounts, sure, because they cause so much dysregulation (e.g., high blood sugar) and in ditto foods cause obesity. But what about average amounts? Here I’m not so sure. The shift to a diet high in sugar and refined flours has usually happened at the same time as a shift away from traditional diets. In other words, the increase in sugar and flour wasn’t the only change. I suspect there was usually a great reduction in fermented foods at the same time. Maybe the reduction in fermented foods caused the trouble rather than the increase in sugar and flour. The reduction in fermented foods is almost always ignored – for example, by Weston Price and John Yudkin (author of Sweet and Dangerous).
Probiotics and oral health. An experiment about probiotics and oral health.
Salt, Fermented Food, and Black-and-White Speak
In an informative op-ed piece in the New York Times, Michael Alderman, an epidemiologist, questions a government campaign to reduce salt in processed food. His piece raises two (wildly different) questions.
1. Several studies have correlated less salt with worse health. Why? Alderman writes:
Nine [observational] studies, looking at a total of more than 100,000 participants who consume as much sodium as New Yorkers do, have had mixed results. In four of them, reduced dietary salt was associated with an increased incidence of death and disability from heart attacks and strokes. In one that focused on obese people, more salt was associated with increased cardiovascular mortality. And in the remaining four, no association between salt and health was seen.
And in the one experimental study that Alderman knows of, “the group that adhered to a lower sodium diet actually suffered significantly more cardiovascular deaths and hospitalizations than did the one assigned to the higher sodium diet.”
Those are useful facts. Alderman gives a few possible explanations. Here’s another one: Several popular fermented foods, including sauerkraut, buttermilk, miso, and cheese, are high in salt, and fermented foods protect against heart disease. I haven’t read the experimental study Alderman describes but it is unlikely that the two groups in that study ate food that was the same in every way except for salt content. What probably happened is that one group was instructed to choose a low-salt diet and the other group wasn’t. The low-salt group ate less salt in part by avoiding high-salt fermented foods (such as cheese).
2. Alderman writes:
[Observational] research can justify action only when multiple studies produce consistent, robust findings across a wide range of circumstances, as the research on tobacco and lung and cardiovascular health has done.
The puzzle is why he writes like this, which I find irritating. Most of the editorial is good, which makes this lapse especially interesting. I call this black-and-white speak, talking as if something complex was black and white and — always associated with this — people on one side are better than people on the other side. In my professional life, I hear black-and-white speak from some statisticians, who divide analyses into “correct” and “incorrect.” According to them you should analyze your data by following a set of black-and-white rules. Here is a less-irritating version of Alderman’s statement:
Successful public health campaigns have been built on observational studies but in the best-known case — the danger of smoking — the findings were consistent and robust across a wide range of circumstances.
See: no need to moralize. Alderman’s statement, of course, is just one example of something very common.
Ben Casnocha on another example of moralizing in the Times.
Pagophagia and the Umami Hypothesis
Pagophagia is an eating disorder where you chew a lot of ice. A friend of mine had it. After she discovered she loved crunching ice cubes, she started going through several trays of ice cubes per day. A trip to Russia, where ice cubes were unavailable, was highly unpleasant. Eventually my friend learned that pagophagia is caused by iron deficiency. When she started eating more iron, her ice craving went away.
Why do we work this way? The evolutionary reason, I think, is that in the ancient world where this tendency evolved, a desire to crunch something was usually satisfied by crunching bones. After you discovered how pleasant it was to crunch bones, you sought them out. Bone marrow is high in iron. Crunching those sought-out bones increased your iron intake.
The umami hypothesis says that we like umami tastes, sour tastes and complex flavors so that we will consume more harmless-bacteria-laden food (which keeps our immune system on its toes). In the ancient environment where these tendencies evolved, in other words, a desire to eat food with these characteristics led us to eat bacteria-laden food. At the Fancy Food Show, I met a maker of sparkling tea who was unable to get enough complexity without using bacteria.
Just as a person with pagophagia chews ice, most of us do one or more of these:
- add monosodium glutamate (e.g., Accent) for umami taste
- add vinegar for sourness (I put a few drops of vinegar in coffee-like drinks)
- add many spices for complexity
The result, I suspect, is that most of us have immune systems with plenty of room for improvement. I stopped getting easy-to-notice colds when I started sleeping better so the high frequency of reported colds (the average American adult gets about three per year) may be a sign that this is true.
Aaron Blaisdell Recommends
I like to think that Aaron Blaisdell, a friend of mine who is a psychology professor at UCLA, has been influenced by what he has read on this blog. Maybe not. In any case, he has an interesting story to tell:
I noticed an increase in energy when I began taking fish oil capsules about a year ago, but it seemed to fade after the birth of our second child (and thus a large drop in amount of sleep at night).
In early November I began taking 1/4 teaspoon each of high-vitamin cod liver oil and high-vitamin butter oil (a la Weston Price’s findings) purchased from Green Pastures. I noticed a large increase in energy and alertness afterward that continues to this day. I didn’t start incorporating raw milk, cheese made from raw milk, yogurt, and kefir in my diet until late December. What I’ve noticed the most after incorporating fermented dairy into my diet was the drop in the amount of gas I produce and in how good my stomach feels. I used to frequently get a little bit of indigestion or an “empty stomach” feeling, even a few hours after a meal. That is, my stomach would churn, make noises, and sometimes I’d have light cramps in my stomach or intestines. Since taking the lactofermented dairy all of those symptoms have virtually disappeared. In fact, my GI track has never felt so good!
I’ve also been eating more kimchi and fermented tofu over the last few weeks, but haven’t noticed any additional benefits likely because the effects on my health are already at ceiling. I also have switched from regular whole wheat bread to sprouted wheat bread, which I eat only in moderation (about a slice every day or two). Thus, my consumption of grains, particularly wheat, is way down compared to a few months ago.
In January I also started taking about 4k IU of Vitamin D3 (after reading discussions on the topic of Vitamin D deficiency at Stephen’s blog, Wholehealthsource.blogspot.com).
I also have noticed beginning in January that my skin looks very supple and clear. My visual acuity has always been better than 20/20 (all of my family but me need glasses), but also since January I’ve noticed my eyesight to be even more keen than ever. And my libido has increased as well.I really should keep a journal documenting all of my dietary and health changes. But with a 5-month old and a 3-year old at home, it’s enough just to try to stay on top of my work!
What to Do about Beijing Air
Beijing’s dirty air is easily the worst thing about living there. You might think what to do about it is obvious. Many people do, including this man who wants to sell the expensive air filter he bought:
I remember the day IQair Sales Rep Justin Shuttleworth came to my place [in Beijing] to give me a demo. This guy has the easiest job in the world. All he does is come with his little air quality measuring device, show you how bad the air you are breathing is in your apartment (indoor air is sometimes worse than outdoor air for those who don`t know), and as the minutes go by, you literally see the amount of particles in the air go down, until it’s basically nil. This was the first time that I could actually smell the difference.
This is from an email list I’m on.
I got the same demo. But it had the opposite effect: It made me not want to buy the IQair filter.
The air coming out of the IQair filter was very clean, yes. But there was only so much it could do. More dirty air was always coming into my apartment and no matter how high (= noisy) they ran the machine the overall level of dirt was no more than cut by 2/3rds. I already had an air filter. The air it produced wasn’t quite as clean as air from the IQair filter but it was still much much cleaner than the intake air. The IQair machine cost about 11,000 RMB. My filter had cost about 1,000 RMB. For 1,500 RMB I could buy a bigger version of what I already had, an air filter that cleaned twice as much air per minute as the IQair machine while producing roughly the same amount of noise. Its output was slightly dirtier than the output of the IQair machine but the overall cleaning effect — the reduction in dirt — was much greater. I ended up getting two of the 1,500 RMB filters.
I think of this demo when I hear someone talk about how this or that traditional diets is better than our modern diet. They make a simple point: People who eat the traditional diet are healthy, people who eat the modern diet are unhealthy. Just as the IQair demo guy has “the easiest job in the world.” They inevitably conclude: Eat the traditional diet or at least closer to it. Just as the conclusion of the demo is supposed to be: Buy an IQair filter. It seems so simple.
But it isn’t so simple. Eating the traditional diet isn’t easy, just as the IQair filter isn’t cheap. Maybe their abstraction — their description — of the traditional diet leaves out something important. Just as the IQair people do not measure cleaning power per decibel, which turns out to be what matters. (I traded air pollution for noise pollution. I wanted the best deal possible.)
If you read Good Calories Bad Calories you may remember the Canadian anthropologist Vilhjalmur Stefansson who spent many months with Eskimos eating what they ate. He came back and told the world “you can eat only meat.” In his conclusions and subsequent field experiment, he ignored the fact that the Eskimos ate a lot of fermented meat.
The Inuit Paradox
The Inuit Paradox is that the Inuit eat lots of fat and hardly any vegetables or fruit yet are much healthier than groups who follow conventional dietary guidelines. In particular,
In the Nunavik villages in northern Quebec, adults over 40 get almost half their calories from native foods, says Dewailly, and they don’t die of heart attacks at nearly the same rates as other Canadians or Americans. Their cardiac death rate is about half of ours, he says.
Likewise, the fact that Greenland Eskimos had very low rates of heart disease led to the discovery of the importance of omega-3 fatty acids. If you read anything on this subject you will come across the concept of “healthy fats”. Sure, some fats are good for you, no doubt about it. Weston Price was the first of many to make this point. But is it the whole story? Attempts to reduce heart disease by giving people fish oil have had disappointing results. Perhaps they got the dose wrong. Or perhaps they missed something crucial. Here is what the Inuit eat:
Our meat was seal and walrus, marine mammals that live in cold water and have lots of fat. We used seal oil for our cooking and as a dipping sauce for food. We had moose, caribou, and reindeer. We hunted ducks, geese, and little land birds like quail, called ptarmigan. We caught crab and lots of fish—salmon, whitefish, tomcod, pike, and char. Our fish were cooked, dried, smoked, or frozen. We ate frozen raw whitefish, sliced thin. The elders liked stinkfish, fish buried in seal bags or cans in the tundra and left to ferment. And fermented seal flipper, they liked that too.” [emphasis added]
In the rest of the article and in all discussions of the subject I have seen you won’t find a word about fermented food. Yet I believe that was crucial. The fermented food had lots of harmless bacteria that caused the immune system to stay awake; heart disease is caused by infection too slowly fought off. Why do the French have low rates of heart disease? It’s not only the wine, it’s also the stinky cheese they eat. Why do the Japanese have low rates of heart disease? It’s not only the fish, it’s also the miso and natto. I’ll be blogging more about this — stay tuned.
Not the Same Study Section: How the Truth Comes Out
In the latest Vanity Fair is a brilliant piece of journalism, Goodbye to All That: An Oral History of the Bush White House by Cullen Murphy and Todd Purdum. In a fun, easy-to-read format, it tells some basic truths I had never read before. Here are two examples:
Matthew Dowd, Bush’s pollster and chief strategist for the 2004 presidential campaign: When Abu Ghraib happened, I was like, We’ve got to fire Rumsfeld. Like if we’re the “accountability president,” we haven’t really done this. We don’t veto any bills. We don’t fire anybody. I was like, Well, this is a disaster, and we’re going to hold some National Guard colonel responsible? This guy’s got to get fired.
For an M.B.A. president, he got the M.B.A. 101 stuff down, which is, you know, you don’t have to do everything. Let other people do it. But M.B.A. 201 is: Hold people accountable.
David Kuo, deputy director of the White House Office of Faith-Based and Community Initiatives: There’s this idea that the Bush White House was dominated by religious conservatives and catered to the needs of religious conservatives. But what people miss is that religious conservatives and the Republican Party have always had a very uneasy relationship. The reality in the White House is if you look at the most senior staff you’re seeing people who aren’t personally religious and have no particular affection for people who are religious-right leaders. Now, at the end of the day, that’s easy to understand, because most of the people who are religious-right leaders are not easy to like. It’s that old Gandhi thing, right? I might actually be a Christian myself, except for the action of Christians.
And so in the political-affairs shop in particular, you saw a lot of people who just rolled their eyes at everyone from Rich Cizik, who is one of the heads of the National Association of Evangelicals, to James Dobson, to basically every religious-right leader that was out there, because they just found them annoying and insufferable. These guys were pains in the butt who had to be accommodated.
This is related to the Shangri-La Diet. In these two excerpts, the speakers were (a) close to the events they describe but (b) not so close they are in any danger from the people they tell the truth about.
In science the same thing happens. Saul Sternberg and I could tell the truth about Ranjit Chandra’s research not only because (a) we were fairly close to that research (which involved psychology, even though Chandra was a nutritionist) but also because (b) not being nutrition professors, Chandra couldn’t harm us. Those closer to Chandra, professional nutritionists, had plenty of doubts as far as I could tell but were afraid to say them. Hal Pashler and I could criticize a widely-accepted practice among cognitive modelers because (a) we were in the same general field, cognitive psychology, but (b) far enough away so that the people we criticized would never review our grants or our papers. (Except the critique itself, which they hated. After the first round of reviews, Hal and I requested new reviewers, saying it was inevitable that the people we criticized wouldn’t like what we said.) Likewise, in the case of voodoo correlations, Hal is (a) close enough to social neuroscience to understand the details of the research but (b) far enough away to criticize it without fear.
In the case of the Shangri-La Diet, I was (a) close enough to the field of nutrition that I could understand the research but (b) far enough away so that I could say what I thought without fear of reprisal. Nassim Taleb is in the same relation to the field he criticizes. Just as Saul Sternberg and I knew a lot about the outcome measure (psychological tests) but were not nutritionists, Weston Price, a dentist, knew a lot about his outcome measure (dental health) but was not a nutritionist.
It’s curious how rarely this need for insider/outsiders (inside in terms of knowledge, outside in terms of career) is pointed out. It’s a big part of how science progresses, in small ways and large. Mendel and Darwin were well-educated amateurs, for example. Thorstein Veblen wrote about it but I haven’t read it anywhere else.
Butter: Bad or Good?
At the Fancy Food Show, I heard someone say that the better a food tastes the worse it is for you. “What’s an example?” I asked. “Butter,” he said. “It goes straight to your arteries.”
What a choice. I have three pounds of very expensive butter in my freezer, purchased from an Amish farmer who raises grass-fed cows. I eat it as often as possible. I believe butter may have fat-soluble nutrients we need to be healthy, nutrients that are found in high concentration in growing plants (such as grass) but not in ordinary animal feed. In the Swiss Alps, in the 1930s, Weston Price found small communities that produced almost all the food they ate. Because of the altitude, they couldn’t produce much. They did have grass-fed cows and prized the butter from those cows. They were in much better health, especially dental health, than their neighbors who ate mostly industrial food.
There was a time, long ago, when exactly the opposite of the overheard statement was true: The better a food tasted the better it was for you. Now it is complicated.