In the mainstream scientific community there is a consensus that there was a major dietary shift that occurred in our evolution which allowed us, as humans, to have the large energy-hungry brains we have now. The most largely accepted theory is that it was hunting down large predators on the savanna. The Wrangham hypothesis that it was cooked tubers is getting press lately because he has a book out. But there is another theory that I think deserves a look: that our move from chimpanzee-like primate to humans was when we started living by the waterside. That would account for why the human brain seems to run on omega-3 fatty acids that are so abundant in seafood.
Anecdotal, but the diet I have settled on is most like what early humans dwelling by the waterside might have eaten. I personally gravitate towards water: I'm a good swimmer and when I think about processing a rabbit or digging in the ground for tubers vs. grabbing a fish and a coconut....well I think most early humans would have picked the latter. Note that I'm not advocating the discredited aquatic ape theory, which theorized an ape ancestor that had gills and fins.
While we fully agree that the structural, cognitive and visual development of the brain requires adequate amounts of certain nutrients including DHA (Crawford and Sinclair 1972), we think the initial shift might have included more abundant and easily obtainable DHA-rich sources such as shellfish, crayfish, fish, turtles, birds and eggs (Broadhurst et al. 1998). Since the primary source of DHA is algae and plankton, it is abundant in the marine and lacustrine food chains, but almost absent in the meat, fats and offal associated with carnivore remains (Broadhurst et al. 2002). Other brain-selective nutrients are also more abundant in aquatic than in terrestrial milieus. This is notably the case for brain-selective minerals such as iron, copper, zinc,selenium, and iodine (Table 5). Of all the major food groups, shellfish requires the least amount (900 grams) to meet the minimum requirement for all five minerals, and is also the food group for which these requirements are most evenly distributed. Eggs (2500 grams) and fish (3500 grams), both more abundant at the waterside than in terrestrial environments, are next, while 5000 grams of meat, five times more than shellfish, would be needed to meet the minimum daily requirements for all five minerals (Table 5). Iodine especially is more abundant in littoral food chains than terrestrial food chains, and before the iodinisation of drinking-water and salt, hypothyroidy caused by iodine deficiency resulted in mental retardation and cretinism in millions of humans who lived away from the coasts....
Humans have about ten times as much subcutaneous fat as most terrestrial mammals and non-human primates including chimpanzees, and in this respect they approach ‘lean’ aquatics such as fin whales
Whenever an article about the paleo diet is published in a major newspaper, at least one commenter expresses dismay that paleo dieters don't realize that humans are adapted to grains and milk. That's a misconception on several levels. First of all, plenty of us are educated enough to know that genetic adaptations can occur rapidly. I remember in high school when I first read The Beak of The Finch, which is about the finches in the Galapagos islands and how their populations genetically respond rapidly to changes in the environment. It takes down the myth that evolution is slow and can't be observed.
In that case, why are we still talking about what our ancestors eat as if it matters? Well, so far the evidence is that some adaptations have occurred in some populations response to neolithic food. Genetic evidence shows that most of the population in modern societies is descended from agriculturalists who had been farming for several thousand years. Clearly, our ancestors were very much able to survive on diets of grains and dairy.
I was just reading this scientific paper, Demeter's Legacy, which is free online and a fascinating read. Yes, there are two major genetic adaptations in agriculturalist populations. One improves the digestion of starch and the other of dairy. Great, we can eat these foods and reproduce. Yay, but it doesn't mean that we are completely adapted to them. There are plenty of foods that are digestible for everyday needs, but damaging in the long term. It's up to us to do the research and figure out if foods are really worth it. I ate bread for most of my life and felt OK, but life for me is not just about surviving, but about thriving. It's important to remember that even though adaptations have occurred, the vast majority of our genes were forged before agriculture.
And for people descended from more recent hunter-gatherers, neolithic foods are even more devastating.
I created a list that I am currently still adding foods to which outlines some pros and cons of various foods from the paleo viewpoint. I think foods should be judged on their merits and there is no "one true" paleo diet...there can't be, since last time I checked I couldn't get wild antelope at the grocery store. It's about learning from the wisdom of the past and choosing food based on those principles, not reenactment.
My story about healing GERD was featured in Marks Daily Apple last year and received a very positive response, but also some comments from people who tried eating paleo for GERD and did not have success. So I thought I'd do a post discussing my experiences further, in the hope that people suffering from GERD can have the same success I did.
I can't really remember a time growing up when I didn't have stomach problems. My diet then was full of Kraft Mac & Cheese, Reeses Cups, and McDonalds. When I got to college it got even worse as I reveled in the dining hall's smorgasboard of ice cream, nachos, fries, and cake. It was that first year of college when I first experienced a terrible unsettling pain radiating from my stomach up into my chest. I stocked up on antacids, but found that they provided only temporary relief. My mother chided me for eating unhealthy and I tried to reform my diet by eating vegetarian and low-fat. I ate Special K with soy milk every day for breakfast, a sandwich on whole wheat bread for lunch, and a pasta salad for dinner. But the pain continued. I booked an appointment at the school doctor and was diagnosed with gastroesophageal reflux disease (GERD).
In many ways I was very unlucky. GERD is among the most common diseases of civilization, but it typically does not strike until people are much older. My father was also struggling with GERD at the same time, so perhaps I have some sort of genetic predisposition to it. Both my parents, who have always been suspicious of medications, discouraged me from treating my GERD with the Prilosec pills my doctor prescribed me.
Prilosec is just one of several proton pump inhibitors on the market, which is a very lucrative market considering the vast numbers of people who are diagnosed with GERD. Proton pump inhibitors function by drastically reducing stomach acid. They are widely considered safe for long term use by doctors. One of my doctors told me I would probably be on proton pump inhibitors for the rest of my life, but assured me that was OK.
At first I was ecstatic that I could enjoy food again, but as time wore on I developed other stomach problems. My doctor said it was just IBS, but one morning I collapsed from dehydration. A test at the hospital revealed I had been harboring salmonella chronically for quite some time. Salmonella is among the most common types of food poisoning, but most infections last only a few days. Apparently my body had been unable to clear my infection, which is not usually the case in most teenagers.
Stomach acid is there for a reason and why doctors prescribe medications that pretty much get rid of it is beyond me. Acid kills germs and while I don't have concrete proof, it's possible my lack of stomach acid predisposed me to food poisoning. They have found in studies that PPIS predispose people to pneumonia and I hope someone will study food poisoning and PPIs in the future.
As I recovered my stomach was pretty battered and my GERD returned with a vengeance. I was lucky enough that I encountered Jared Diamond's The Worst Mistake in Human History in class and also heard a lecture by an anarcho-primativist. At first I was quite offended by both. As an agricultural economics student I viewed agriculture as the cornerstone of man's greatest achievements and that hunter-gatherer life had been "nasty, brutish, and short." Raised to believe in conservative ideals, I had been taught that the "noble savage" was a myth popular among liberals who refused to accept man's true nature and the glories of classical civilization. Turns out that the truth is somewhere between. Hunter-gatherers, both modern and paleolithic, were and are as diverse as any other humans. They tend to have relatively high infant mortality and succumb to accidents and diseases that modern humans rarely encounter. But they live and lived longer and better lives than most people expect, with plenty of leisure time and without modern health problems.
So when I encountered Art De Vany's writings and Gary Taubes though one of my favorite economics blogs, Marginal Revolution, I was ready for a change. The idea that fat was good and that modern foods might be the culprit for modern diseases was new to me and it took me a long time to learn how to eat paleo. I had no idea how to cook meat, I had never eaten fish, and bagged baby spinach was the only sort of vegetable I'd really dealt with. Candy and ice cream were also my essential study buddies and I felt pretty proud about my soy milk and Special K habits.
So things certainly did not get better overnight. I tried to eat healthy and would succumb to eating junk, but over time I learned how to buy and prepare good food and became educated enough about science and my own body to have more incentive to avoid junk.
In the future I think scientists will look back on PPIs as a huge mistake. They are already finding out that GERD is about more than just heart burn, that adysfunctional immune system plays a role. I have a feeling that's just the tip of the iceberg. GERD is not just run of the mill heartburn and it's not just about repairing an injury to the esophagus. Real solutions should address why the heartburn occurs in the first place rather than masking symptoms.
In the past, studies about diet and GERD have been mired in simplistic dietary dogma, typically measuring total fat and fiber intake. Newsflash, there are many ways to get both fat and fiber, and many types of both. Some are probably good, others are bad. A bright spot in the research is this study: A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms.
It took a long time for me to finally rid myself of all symptoms, but it was very much worth it. I'm very happy to be both pain and medication free now. I worry people will think I adopted the paleo diet to lose weight when I mention the word "diet." While I did lose weight, it was about being healthy and the paleo diet isn't a temporary fix, you have to stick with it. I got off the bandwagon last year while traveling and had GERD symptoms for the first time in a long time. It was not pleasant. Besides that, while eating paleo I experienced a cessation of problems I took for granted as just part of life, but which I now recognize as food related, such as heavy periods, constant bloating, headaches, and asthma.
My father is also a follower of the paleo diet now and has also experienced relief from GERD.
Here are my tips for combating GERD
- Don't expect GERD to go away overnight. It took me over six months to completely reduce symptoms.
- Learn how to eat wild fish. Omega-3 fatty acids can combat inflammation very effectively. Farmed fish are unfortunately too high in omega-6 fatty acids to be of much use.
- Buy quality meat and animal fats. Factory farmed meat is much too high in omega-6 fatty acids, which can cause inflammation. Eating out only at restaurants that serve pastured meat and getting to know the farmers at your local farmer's market is a good way to accomplish this.
- Eat nose to tail. I grew up thinking that chicken breasts and steak were all that animals had to offer. I was missing out on the vital nutrients present in the whole animal. Bone marrow, lard, tallow, liver, and all the "nasty bits" should become part of your diet.
- Learn how to prepare nutrient rich stock and make healing soups. GERD can make eating uncomfortable, but nutritious soups usually go down well and provide healing nutrients. I will write many posts in the future about stock, but it's mostly just about putting bones in the crock pot overnight. The resulting stock can be pureed with your favorite vegetables.
- Eat greens and seaweed. These fight inflammation and provide healthy fiber without the carbs.
- Educate yourself both by reading more about the paleo diet and health, and by learning to listen to your own body. I did lots of research about different aspects of diet and trial eliminations for questionable foods like nightshades and dairy to figure out if they had a role in my problems.
- Indulge carefully. Find out by trial and error which foods irritate your gut and look to adopt new occasional indulgences that have at least some nutrients, like coconut milk with berries, coconut water, and raw dairy-free chocolate.
- Fermented foods are a bone of contention in the paleo community. They really aren't paleo, but eating paleo isn't about food reenactment, it's about looking to the wisdom of the past and finding what works now. The problem with life today is that we are exposed to so many antibiotics and an artificially sterile environment. Most of us probably have inadequate bacteria to assist with digestion. Probiotic fermented foods can help augment your own body's bacterial colonies while you heal. I consumed apple cider vinegar tonics, kombucha and probiotic pills while I was recovering. I have since phased them out since my bacteria seem to be doing the job fine on their own now.