The Growth of Paleo: Patrick Vlaskovits Interview

I wondered if Patrick Vlaskovits, who runs the question-answer site PaleoHacks, could shed some light on the recent growth of interest in a Paleo approach to health. So I asked him a few questions.

SETH What have you learned from PaleoHacks about the growth of the Paleo movement during the last year?

PATRICK Well, one thing is certain … the Paleo movement IS growing. One can look at various proxies for this — Google Trends – for example – https://www.google.com/trends?q=paleo+diet — or more frequent mentions in the mainstream media. But your question is about what I have learned from PaleoHacks.com with regard to growth. PaleoHacks.com’s traffic is definitely growing and my sense is that Paleo (by that I mean eating in an evolutionarily appropriate manner) is about to cross the chasm into the mainstream.

A few interesting measures of growth vis-a-vis PaleoHacks are:

1) The increasing frequency of meta-discussions on PaleoHacks –people who have been eating Paleo for some time are now looking to the future about what it means to be “Paleo” and how long-time Paleo eaters are changing their Paleo diets. This is, IMO, is a good thing as Keynes said: ”When the facts change, I change my mind — what do you do, sir?” We are learning more about how our health changes after some time eating Paleo – and what needs to be fine-tuned when it comes to things like bacterial/gut health (probably the most important thing to worry about) and hormonal changes relative to our environment, e.g. cortisol levels increasing due to lack of sleep which can result in unwanted/unhealthy weight gain or weight loss.

2) More people are blogging about Paleo and also more people are trying to monetize Paleo and I see them on PaleoHacks. (For the record, I have no problem with anyone trying to monetize Paleo as long as they are responsible about it as I feel that anyone monetizing Paleo should also be a good steward of Paleo.)

SETH How much has PaleoHacks traffic grown over the last year?

PATRICK Short answer: A lot. Longer answer: Depends on which metric you use — but still a lot. Ranges from 6x to 8x YOY increase in visits, uniques and page-views. Currently, PaleoHacks gets +500k page-views a month. [I double-checked my internal stats with public information on Compete.com & Quantcast – and it looks like they undercount (BTW this is a well-known and hotly debated topic).]

SETH What do you think is causing such fast growth? The broad idea is really old. Even the details are old — Weston Price wrote in the 1930s, for example. The Weston Price Foundation, which was started many years ago, is growing much more slowly.

PATRICK Cutting to the chase: no idea. Some thoughts:

Paleo’s growth appears highly correlated with CrossFit — but what has caused CrossFit’s growth? Not sure. It too has been around a while.

Social media have certainly accelerated/lubricated Paleo’s growth but I don’t if social media actually *caused* Paleo’s growth. What causes memes like Paleo to spark, and then die out or go dormant and then spark again to grow into a raging wildfire? I wish I knew.

Getting a little meta and perhaps off-topic — my assumption is that is true for most “Big Ideas”. We rarely recognize or know of their true “discovery” because for-whatever-reason the implications are not fully, if at all, appreciated at the time of discovery. For example, I believe this was the case with penicillin. A French medical student discovered it 1896, Fleming re-discovered it in 1928 and then it lay around until 1939 when Florey fully appreciated it.

I certainly didn’t put two and two together when I read Why We Get Sick back in 2000-ish. I thought it a fantastic book (and still do)– but I didn’t think of applying the evolutionary lens to diet/nutrition, even though in retrospect, it seems obvious.

Evolutionary Health Journal to Start

Building on the success of the Ancestral Health Symposium — it will be in August, but it’s already a success — Aaron Blaisdell is planning to start a scientific journal on the subject.

It will be an historic thing. The notion that ancient lifestyles are especially healthy has been around, and taken seriously, for at least a few hundred years. Serious data began to be gathered in the early 1900s. Weston Price is an example. For a very long time this idea seemed to go nowhere, or at least the mainstream ignored it. In the 1970s there began a small irregular stream of publications (e.g., a book called Western Diseases edited by my friend Norman Temple) but again the mainstream ignored it.

But mainstream medicine doesn’t work very well. The notion that when you get sick you should take a dangerous expensive drug doesn’t make a lot of sense. You didn’t get sick because you lacked the drug. More plausible is that when you get sick you should reverse the environmental conditions that caused the sickness and find out if your body can heal itself. Even more, you should prevent disease from starting. Along with mainstream medicine’s implausible intellectual foundation has come pathetic results. Robin Hanson has emphasized the RAND experiment that found that a large fraction of medical spending produced little benefit. Tyler Cowen has pointed out that Americans spend far more than other countries on health care with no better results. A doctor at a county hospital once told me, “The truth is that we can’t help most people that come in.” They come in with diabetes, obesity, and so on. Why don’t you do something that does help? I asked. Because when you do prevention research, she said, you don’t get people thanking you. She was describing a protection racket: make people sick — if only by failing to tell them how to be healthy — so that they will come to you for help.

An academic journal with a steady stream of articles and supporting evidence is a big step toward getting the paleo alternative taken seriously. It will help researchers who take paleo ideas seriously publish their work, of course, but it will also help them get feedback. Because it will help them publish, it will help them get research support. Because the journal (like any new journal) will be open access, it will help those who want to learn about those ideas. When ideas about health are forced to compete on their merits (such as cost, safety, effectiveness, and quality of the supporting evidence) and becoming an M.D. confers less of a monopoly (on information and treatment), a great change will come. Richard Nikoley recently posted an example of what a difference this can make.

Effect of Animal Fat on Sleep?

Recently I listened to Robert Spector discuss his book The Mom & Pop Store: How the Unsung Heros of the American Economy are Surviving and Thriving. He had a personal connection to the subject: His father was a butcher. “As I watched him trim the meat . . . ” he said at one point. I thought: Oh-oh. To “trim” meat is to cut fat off of it.

Last spring, I bought $80 of organic grass-raised pork from a farmer near Berkeley. My order included a variety of cuts. I cooked the ones I was familiar with, leaving one I’d never seen before: pork belly. Pork belly is used to make bacon. I’ve never seen it for sale in America. Ugh, I thought. Fat. It’s 80-90% fat. I too trim the fat off meat. It sat in my freezer for a long time. Finally I decided I shouldn’t waste it. I cut it into chunks which I put in miso soup and had for lunch.

That night I slept much longer than usual (8.3 hr) and woke up feeling unusually well-rested. Here is a graph that shows my sleep duration for that night and several preceding nights:

Sleeping 8.3 hours was less common than this graph may suggest. I’d moved back to Berkeley in January and from then until the miso soup had measured how long I slept on 130 nights. I’d slept more than 8.3 hours on 2 of them (2%). Even rarer was how energetic I felt the day after the miso soup. I couldn’t quantify it, but it was very rare — once in 10 years?

Was it a coincidence — that on the very day I ate far more animal fat than usual I also slept much longer than usual and had much more energy than usual the next day? Or was it cause and effect? Here’s why the second explanation — which implies that for best health I need much more animal fat than I usually get — is plausible:

1. As Spector said, butchers cut the fat off meat. The odds that our Stone-Age ancestors, living when food was sometimes scarce, did the same thing: Zero. Perhaps our meat is unnaturally low in fat. If for a long time in our evolutionary past we ate a lot of animal fat it makes sense that our bodies would be shaped to work best with that much fat.

2. Many video games, which boys enjoy, resemble hunting. I think this reflects an evolutionary past in which men hunted. If so, for a long time humans ate meat. That they ate a lot of meat is suggested by the fact that when big game went extinct (probably due to hunting) human health got worse.

3. American culture demonizes animal fat. The conclusion that animal fat is bad rests on epidemiology. Once something becomes heavily recommended or discouraged, a big problem for epidemiologists arises: the people who follow the advice are likely to be different (e.g., more disciplined, better off) than those that don’t (the healthy-user bias). As I blogged yesterday, an example is vaccine effectiveness: Those who get vaccinated are different than those who don’t.

4. Fat tastes good. Which implies we need it. We like whipped cream, butter on toast, milk in tea, and so on. Butter vastly improves toast even with my nose clipped. Long ago, when this fat-pleasure connection evolved, dietary fat was mostly animal fat and fish oil.

All this makes it plausible that animal fat is good for us. That’s not surprising. Based on Weston Price’s observations plus these four arguments, I already believed this. Many people believe this. The interesting idea suggested by my data is the possibility of measuring its benefits quickly, by measuring brain function. My experience suggested that animal fat improves brain function quickly. Brain function is easier to measure than the functioning of other parts of the body. By measuring my sleep, my energy, or something else controlled by the brain, maybe I can figure out the optimal amount of animal fat. This is what happened with omega-3. The idea that omega-3 is good wasn’t new; the novelty was the ability to measure its benefits quickly. (At first I measured my balance, later other things controlled by the brain.) With a fast measure I could determine the optimal amount. It’s likely that what’s optimal for the brain is optimal for the rest of the body, just as all the electric appliances in your house work best with the same house current. If you figure out the best current for one appliance, you are probably simultaneously optimizing all of them.

Did Genghis Khan Read Weston Price?

In Genghis Khan and the Making of the Modern World (2004) by Jack Weatherford, I read this (p. 87):

Compared to the Jurched [Chinese] soldiers, the Mongols were much healthier and stronger. The Mongols consumed a steady diet of meat, milk, yogurt, and other dairy products, and they fought men who lived on gruel made from various grains. The grain diet of the peasant warriors stunted their bones, rotted their teeth, and left them weak and prone to disease. In contrast, the poorest Mongol soldier ate mostly protein, thereby giving him strong teeth and bones.

To tenderize meat a Mongol would put it under his saddle while riding. I was pleased to read this because I eat a lot of meat and yogurt (but not milk). The source of this information is unclear but it’s a surprisingly modern comparison. Good Calories Bad Calories (2007) by Gary Taubes says much the same thing (minus the yogurt — the part that most interests me). Weston Price wrote many similar passages comparing people eating traditional food (= Mongols) with people eating modern food circa 1930 (= Chinese). Long ago, grain was modern food.

Thanks to Tucker Max.

The Experts Speak: Nutrition

I have nothing against a paleolithic diet, but I think its advocates, like many experts, are overconfident. It’s not easy to know which features of a diet that varies in 20 ways from modern diets are the crucial ones. I came across this while reading about paleolithic diets:

The general gist of eating like a caveman—namely, focusing on foods in their whole, natural state, is not going to get much argument. “It comes down to the advice your mother gave you,” says Leonard [William Leonard, chair of the anthropology department at Northwestern University]. “Eat a balanced diet and a diversity of foods.”

I beg to differ.

1. Whole, natural state. I find flaxseed oil very helpful. It supplies omega-3 missing from my diet, but presumably present in diets that contained lots of seafood or vegetation-fed meat. Flaxseed oil is not food in a whole and natural state.

2. Whole, natural state . I find fermented food very helpful. Bacteria break down food, making it less whole. Modern food of all sorts is unnaturally low in bacteria (due to refrigeration, food safety laws, shelf-life requirements, etc.), just as modern meat is unnaturally low in omega-3. Fermented food is unnaturally high in bacteria, correcting the deficit.

3. The advice your mother gave you. Traditional diets, yes, what your mom thinks, no. When I was growing up we ate margarine instead of butter — poor choice. We had skim milk, not whole milk — poor choice. The absence of butter and whole milk is, if Weston Price is right, why my teeth are slightly crooked. We ate almost no fermented food — very poor choice. (Which I suspect is why I had mild allergies.) We rarely ate fish — poor choice. And yet we didn’t have a TV — very good, very unusual choice. Even my mom, who thought for herself far more than most moms, had serious misconceptions about nutrition. Given the epidemic of childhood obesity, not to mention less visible increases in autism, allergies, and ADHD, I am very skeptical that the average kid’s mom knows what to eat.

4. Eat a balanced diet. Plenty of communities in excellent health eat diets that American experts would describe as not balanced at all — no fruit for example, or too much dairy. Eskimos and the Swiss in isolated villages studied by Weston Price are two examples. Price found that a wide range of diets, most violating one or more popular nutritional precepts, produced excellent health.

5. A diversity of foods. Several healthy communities studied by Price did not eat a wide range of foods. The human diet became a lot more diverse around the time of the “ broad-spectrum revolution” — broad-spectrum meaning wider range of food. Around that time human height decreased. Apparently the new, more diverse diet was less healthy than the old diet. An anthropology professor might know this.

The title of this post comes from the book The Experts Speak which is full of examples of how experts were wildly wrong.

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.

Probiotics and Your Immune System

At the Fancy Food Show, five or six booths sold probiotic foods, usually yogurt. At each booth I asked what they could tell me about the health effects of probiotics. Mostly the question seemed to annoy them — especially the employees hired for the event.

But at the Oixos booth — Oixos is a Greek yogurt made by Stonyfield Farm, an organic dairy in New Hampshire — Amy Plourde, a graphic designer at Stonyfield, told me that for a long time she was “always sick” with sinus infections, colds, and even mononucleosis. During that time, she ate yogurt once/week. When she started working at Stonyfield she began to eat yogurt once/day (6 oz. at breakfast) and her health got much better. Stonyfield yogurt has relatively high amounts of live bacteria. Their website has a list of scientific papers about yogurt and the immune system.

My take is that our immune systems need a steady stream of foreign pathogens (e.g., bacteria) and pieces of pathogens (e.g., bacterial cell walls) to stay “awake”. When your immune system is working properly you fight off all sorts of bacteria and viruses without noticing. When your immune system isn’t working properly it overreacts (allergies) and takes too long to react (infectious diseases). Weston Price found twelve communities eating traditional diets whose health was excellent. Their diets varied tremendously but one thing they had in common was daily consumption of fermented foods, including cheese, kefir, sauerkraut, and fermented fish. This supports Amy’s story right down to the dosage. If you don’t eat fermented foods, you might use hookworms, which excrete a steady stream of foreign substances into the blood. (Thanks, Tom.) Hookworms definitely reduce allergy symptoms; I don’t think anyone has asked if they reduce colds and other infections.

The hygiene hypothesis.

Weston Price and the Olympics

I was surprised how much I liked the Olympics opening ceremonies on Friday. I hadn’t been so transfixed by an Olympic event since Joan Benoit won the first woman’s marathon, leading the whole way. At one point during the opening ceremonies a young girl in a red dress sang a Chinese song. Or so it seemed:

The girl in the red dress with the pigtails, called Lin Miaoke, 9, and from a Beijing primary school, has become a national sensation since Friday night, giving interviews to all the most popular newspapers.

But the show’s musical designer felt forced to set the record straight. He gave an interview to Beijing radio saying the real singer was a seven-year-old girl who had won a gruelling competition to perform the anthem, a patriotic song called “Hymn to the Motherland”.

At the last moment a member of the Chinese politburo who was watching a rehearsal pronounced that the winner, a girl called Yang Peiyi, might have a perfect voice but was unsuited to the lead role because of her buck teeth.

Weston Price’s research, described in Nutrition and Physical Degeneration, implies that buck teeth are caused by too little of a dietary growth factor, which a commenter described as “the menaquinone-4 form of vitamin K2.”