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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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February 22, 2016

Dear Mark: Paleo Diet Fattening?

By Mark Sisson
62 Comments

Fattening finalFor today’s edition of Dear Mark, I’m answering one question. It’s a burning one, though, judging from the deluge of emails I’ve received in the past few days. A new study has just come out purporting to show the deleterious effects of a “paleo diet” on weight gain, fat gain, and glucose tolerance in type 2 diabetics. It sounds alarming, so today I’m going to explore just how relevant this study is for you guys following a Primal eating plan. Should you be concerned with the results? Is it time to start radically restructuring the way you eat? I’ll evaluate the study, and its larger implications, to let you know.

Let’s go:

Mark,

The media is abuzz with reports of a new study claiming to show that the paleo diet leads to rapid weight gain. Care to respond? It’s getting hard to ignore my skeptical friends’ chorus of “I told you so”s.

Oh, man. The lead author of the study, one Associate Professor Sof Andrikopoulos, makes some of the most amazing quotes I’ve ever read. I can’t single out any single quote, so let’s examine them all one by one.

He claims that a low-carb, high-fat diet is especially risky in people with diabetes or pre-diabetes. “There is no evidence they work.”

LCHF diets are risky for diabetes or pre-diabetes, meaning they put your diabetes at risk of disappearing outright or never showing up at all. But for diabetics or pre-diabetics, it’s risky not to try a low-carb diet. Here’s one recent study of Japanese men with pre-diabetes in whom a low-carb diet normalized blood glucose and prevented the progression into full-blown type 2 diabetes. Those were human men, by the way, not mouse men.

More quotes:

“We are told to eat zero carbs and lots of fat on the Paleo diet.”

No, we aren’t. I don’t know anyone saying that.

“Our model tried to mimic that, but we didn’t see any improvements in weight or symptoms.”

They didn’t try hard enough, because they managed to slip 6% of calories as pure white sugar into the diet. Funny how that stuff just has a mind of its own. Nope, totally impossible not to add that sugar in. Completely out of their hands.

“The bottom line is it’s not good to eat too much fat.”

Well, okay. It’s not good to eat too much of anything. It’s not good to eat so much that you gain weight and body fat. It’s not good to eat too much fat in the context of a refined diet of isolated ingredients, pure table sugar, and a genetic propensity to get severely obese on such a diet. Don’t believe me?

Just look at the diet composition for the low-carb group.

Cocoa butter—Cocoa butter is a legit fat, particularly combined with cocoa fiber and polyphenols. In other words, chocolate.

Casein—Hmm. An isolated dairy protein wouldn’t be my first choice when constructing a wholesome paleo diet, but I’m not the scientist!

Sucrose—Table sugar, eh? I’ll allow it. You need to make this refined slop palatable enough to get the mice to eat it.

Canola oil—Hold on a minute. Canola oil doesn’t belong in my idea of a paleo diet.

Ghee—Interesting choice. I love me some ghee.

Cellulose—Okay, stop right there. You’re basically feeding these mice paper. What’s going on here? I’m sure there’s a more prebiotic type of fiber coming next. Right?

Calcium carbonate—You do realize you could have simply omitted the isolated, refined casein, ghee, and calcium in favor of some actual whole food dairy.

AIN-93G vitamin mix—You could give them vitamin pellets, or you could give them actual food. That’s just me, though. I’m weird.

Potassium dihydrogen phosphate—If you wanted the mice to get potassium and phosphate, you could have given them a little meat and banana.

DL methionine—An essential amino acid that appears frequently in animal foods. It’s important for health but must be balanced with adequate glycine to reduce inflammation. No glycine appears in the study diet, though.

Sodium chloride, potassium citrate, potassium sulfate—More minerals.

Choline chloride—At least they added choline in there. It’s very important for maintaining liver health, particularly in the context of high fat diets.

AIN-93G trace mineral mix—In the absence of food, you need to add these back in.

Delicious, right? I’m salivating just typing this.

So the experimental diet was made up entirely of refined, isolated “ingredients.” Not even foods, but ingredients. Its sole carb source was white sugar. Meanwhile, the control group got an actual real-food diet consisting of wheat, wheat germ, fish meal, soybean meal, beef fat, vegetable oil, molasses, milk powder, yeast, and added trace vitamins and minerals. Not the “best diet,” but way better than the experimental diet. The two are not comparable. We already know that the refinement of a rodent’s diet determines in part how that diet will affect its health and cognitive abilities, irrespective of that diet’s macronutrient ratios.

In reference to the Mediterranean diet: “It’s backed by evidence and is a low-refined sugar diet with healthy oils and fats from fish and extra virgin olive oil, legumes and protein.”

Reduce/drop the legumes, and what diet is he really talking about? Sounds pretty familiar to me.

Other niggles: These weren’t humans. These weren’t even normal “wild-type” mice, who are already bad proxies for studying the effects of high-fat diets in humans. They were New Zealand Obese (NZO) mice, a type of mouse genetically-engineered to get quickly and severely obese on high-fat diets. That makes them useful for studying obesity.

The good doctor has made questionable recommendations in other venues, like if you’re going to eat fast food, make sure you have a sugary soda with it.

But perhaps the most egregious and pernicious aspect of the doctor is his penchant for Hellenic nationalism. There’s his last name. There’s the fact that he concocts imbalanced study designs to promote the Mediterranean diet. What next, Sof? Will you stop at nothing until Greek war chariots pound the streets of every city across the globe and boys and girls have bowls of kalamata olives (pit-in) with red wine instead of cereal for breakfast?

I jest, of course…

But next time, design a study that actually mirrors a Paleo diet. Then we’ll talk.

So if you’re eating Primally and you’re not getting fat (or you’re actively losing fat), the results of this study do not apply to you. The study displays the negative health effects of getting really fat really quickly. That the diet used to get the mice fat was a bastardized version of a high-fat, low-carb diet has little bearing on how we eat around here.

Thanks for reading, everyone. Take care!

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62 Comments on "Dear Mark: Paleo Diet Fattening?"

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barry
barry
9 months 11 days ago

I’m glad to see you write about this. I figured there was a angle somewhere, but didn’t know where. Thanks for clearing that up for us Mark! Why the high fat group gets picked on more then any other I’ll never know.

BJJ Caveman
9 months 8 days ago

Seriously! Do you know what else, if anything, this author has tried to pull? Mark makes it seem like he’s a repeat offender.

Wenchypoo
Wenchypoo
9 months 11 days ago

So they’d rather see more of Pizza Rat and Doughnut Rat antics in the subways of NYC? THAT’S an acceptable diet to them? This goes to show you who is in real need of the diet, and it ain’t the mice!

grey
grey
9 months 11 days ago

Not that I had any doubts that Mark’s our best health writer, but, you know…I was already pretty happy with this even before the war chariots showed up. Well, this old man’s getting on his longboard, going down the hill, and is going to eat some real food, real viscera, topped with a little war-chariot evoo.

nutrivore
nutrivore
9 months 11 days ago
Each year my husband and I spend 3 to 4 weeks travelling in India eating lots of carbs (easily 70-80% of total calories), dubious oils, street food, not much protein – what one would consider the standard Indian diet. Erratic sleep, hardly any exercise. Then we get back home and revert back to a primal diet (still with a decent amount of carbs – about 20% of total calories) and activity regimen. For the past three years we’ve tried to track our lipid panel numbers. When we go to India, our triglycerides are in the high 20s/low 30s, HDL in… Read more »
Chris
Chris
9 months 11 days ago
Just to play devil’s advocate here: overall good health is not all about lipid numbers, and there are a lot more to lipid panels than just tri and HDL (particle size, ratio, etc). And depending on age, higher total cholesterol can actually be *beneficial* for many, especially as we age, and genetics play a role in specific diet that works for you. I’d like to know what your version of primal consists of? I went from vegetarian to primal many years ago and my total cholesterol hovers around 220, with HDL often as high as 95 and triglycerides at 30… Read more »
Clay
Clay
9 months 11 days ago

The India diet is pretty bad. Maybe it wasn’t a hundred years ago, but the modern India diet is terrible. Eating for a longer period of time would only cause more problems not less. You don’t adapt to a bad diet. It just makes things worse. If it we could adapt to a bad diet, then Americans would do just fine, if not improve, the longer they ate the standard America diet.

And the numbers do matter. No matter how you slice it, an increase in TG and a drop HDL is a worsening of your health.

Chris
Chris
9 months 11 days ago

Oops! I misread her cmoment! I thought she was saying the reverse, that her triglycerides dropped upon going to India and continuing the Indian diet. Sorry about that. Disregard my reply.

Shobhit Choudhary
9 months 11 days ago

What’s your activity level when you are traveling and when you are at home ? Larger than that it depends on the food choices you make. Do you eat street food at home ?

nutrivore
nutrivore
9 months 10 days ago

No street food in the U.S. High quality fat and protein with some rice, teff, fruit, potatoes and sprouted beans/lentils for carbs.

I have a moderate to high activity level in the U.S. – taekwondo, crossfit, swimming, kettlebells. In India not much other than walking around.

ShaSha
ShaSha
9 months 11 days ago

Yes!!

Jack Lea Mason
Jack Lea Mason
9 months 11 days ago

There is too much junk science spewed by the general media. Thank you Mark for simply seeking the truth and sharing your research.

Aaron
Aaron
9 months 11 days ago

What about the fact that the LCHFD contained almost twice the “digestible energy”, 24 MJ/kg vs. 13.5 MJ/kg. Talk about stacking the deck!

Brian
Brian
9 months 11 days ago
This is what I like about the primal diet, it makes me sleep better. I believe a lot of the fat or weight gain comes from running with a cooler body temperature. This can happen from a number of things but the main one being not sleeping enough or having poor quality sleep. In almost all the cases I see from people whom make diet switch from SAD to primal all stated they sleep better, which in turn from my belief, would cause someone to drop weight and in turn increase insulin sensitivity. No where does it ever state that… Read more »
LoriK
LoriK
9 months 11 days ago

Ah, I understand now. Next time I go to set mouse traps, I’ll be sure and bait them with AIN-93G. And to think I’ve been using peanut butter all this time. Silly me!

Emily
Emily
9 months 11 days ago

Haha good one! 😀

Groktimus Primal
9 months 11 days ago

Until they can line their pockets with it. Paleo will never be accepted no matter what the evidence.

investigator
investigator
9 months 11 days ago

There’s a saying that just because something is published in Nature doesn’t mean that it’s wrong. And the conclusions in the study are supported by data: the mice on the diet that was higher in fat did indeed get fatter. But let’s give the journal a little credit here: despite journalistic reports of the author’s anti-paleo rhetoric, and despite the extra attention that such rhetoric would garner, the word paleo does not appear in the journal article itself. My guess is that peer review prevented such claims from publication because they cannot be supported by this data.

TF
TF
9 months 11 days ago
How these are called ‘scientific studies’ is beyond me… On another note… I’m newly pregnant with my second baby, and I’m still breastfeeding my first one almost exclusively who just turned 1. I was wondering if you could do a post on any specific things to consider concerning nutrition/fitness/general health while pregnant and nursing. I’ve been really lethargic (starting full on primal/paleo today because I just found out I’m pregnant this morning and it was the motivation I needed), and I’m hoping that’ll fade a little with healthy eating, and I think eating too much fruit makes me more tired,… Read more »
barry
barry
9 months 11 days ago
unfortunately the craving for fruit is actually a craving for carbs, and this craving will likely not subside for a week or so. under normal circumstances I’d say drop your carbs to 50 or below for a week to initiate ketosis but considering your pregnant you just need a well rounded diet. substitute the fruit for something lower in carbs and sugars like parsnips, beets, carrots, butternut squash. also unless you are trying to lose extreme amounts of weight 1 or 2 servings of fruit a da is perfectly acceptable. your lethargic could be coming from not enough fat in… Read more »
TF
TF
9 months 9 days ago

Thanks for the advice. I eat lots of fat though, I’ve never gone fully primal yet, but adding in more fat is something I’ve pretty much mastered (love me some fat). I don’t have any weight to lose, but I can’t seem to eat *just* one or two servings of fruit a day. If I eat one it’s like a chain reaction and I want to eat all the sugar… I’ll try replacing the fruit with vegetables as you suggested.

Kelda
Kelda
9 months 11 days ago

Use the google search button top right for pregnancy, Mark’s covered the topic a number of times.

TF
TF
9 months 11 days ago

Thank you for the advice, I have already read all of his pregnancy posts. I was wondering if he had any specific suggestions for pregnant women who are also breastfeeding. I feel like that’s quite a bit different from pregnancy alone.

Stephanie
Stephanie
9 months 11 days ago
I too have been pregnant and nursing a couple of times. Your lethargy could just be due to the fact that you are pregnant and your body is transitioning into a human making machine. It requires a lot of energy and I think it’s natures way of telling you to slow down and take a nap and really take care of yourself. Plus, this isn’t like your first pregnancy. Your nursing and taking care of a one year old. Your craving for fruit might have something to do with a vitamin deficiency. During my pregnancies which resulted in 5 healthy… Read more »
Jennifer L.
Jennifer L.
9 months 10 days ago
Breastfeeding while pregnant won’t change the dietary tips as much as you’d think. I’ve been pregnant while breastfeeding twice and early fatigue was a bit to be expected. It’s usually my only pregnancy symptom, and I’ve had it with all three. Thankfully it disappears completely by 12 weeks. Sleep more and rest more–especially while you are still comfortable and not too big to get a good night of sleep without a run to the bathroom every 3 hours. That sounds kind of idealistic with a one year old though! You do need carbs. I usually add in more squash, sweet… Read more »
TF
TF
9 months 9 days ago
Stephanie – Thank you for sharing your experience. I think I need to rest more. I don’t do any heavy exercise, but I’m still ridiculously tired anyway, so I should probably nap when my baby naps, and go to sleep earlier… I too love seeing healthy breastfed babies! My sister has an almost 4 year old who was formula fed, but she has a 5 month old now who she has been breastfeeding almost exclusively with the exception of some formula when she wasn’t producing enough milk. That’s awesome that your son has only been to the doctor once. My… Read more »
TF
TF
9 months 9 days ago
Jennifer – I remember being fatigued last pregnancy, but not to this extent. I guess it should be expected, and maybe mine’ll clear up by 12 weeks too. It didn’t last too long last time. I’ll definitely make a note to take it easy and get more sleep. I know I’ve needed it, I just have this tendency to want to enjoy my free time whenever I get it (when baby naps and for the first few hours he sleeps at night). I think my body does best on a low carb lifestyle, because anything carb heavy seems to make… Read more »
Julie
Julie
9 months 11 days ago

I’m so glad you addressed this. Just as I’m getting back on my bandwagon personally, the news personalities are salivating about yet another useless diet article. And they know, THEY KNOW, that next week they’ll get another contradicting one. They can’t even fake taking it seriously anymore. They start to chuckle as soon as they lead into one (cf. KTLA-5).

Becky D
9 months 11 days ago

Ugh, I hate seeing these studies. How can anyone compromise their ethics far enough to provide “absolutist” statements like that off an obviously biased study on rodents?
The canola oil adds an interesting spin based on Dr. Mike Eades’ recent post on vegetable oil and insulin sensitivity.

jack
jack
9 months 11 days ago

So all that weight I lost in the last six years eating high-fat low-carb didn’t really happen. Funny stuff.

Jan James
Jan James
9 months 11 days ago

Right, and my A1C (I’m T2 Diabetic) that has been below 5.4 for 8 years solely on HFLC didn’t really happen, either.

Tuba
Tuba
9 months 11 days ago

Topic-ignorant researchers create a topic-ignorant study and get topic ignorant results.

Kelda
Kelda
9 months 11 days ago

Ahhhhhh the voice of reason, as ever.

Long live Mark Sisson

Janet
Janet
9 months 11 days ago

Indeed.

Time Traveler
Time Traveler
9 months 11 days ago

This type or so called research, plays into the hands of naysayers (opposing Paleo) and naive readers, who take everything they read in the paper, as the words from god if there was one.

It reminds me of article I ran into recently, that also claimed that families switching to gluten free diet gained weight. But the researchers played down the fact, that the participants were guzzling down gluten free snacks, bars and other foods, that were loaded with carbohydrates and sugars.

maidel
9 months 11 days ago

Love the way you eviscerated this guy. He really had it coming.

peter mason
peter mason
9 months 11 days ago

The scariest part of the study Associate Professor Sof Andrikopoulos is president of The ‘Australia Diabetes Society’!!

David John
David John
9 months 11 days ago

Mark, thanks for looking at this study. This study led to several articles in the papers in the UK yesterday. The most damaging thing I find, is that these types of headlines discourage people from trying Paleo even though the studies may be questionable at best. People who don’t prioritise food won’t dig deeper to find out. Sometimes to me (without meaning to sound superior) Paleo feels like an informational advantage when it comes to choosing food, I just feel lucky to have the mindset in my life to help make choices.

HealthyHombre
HealthyHombre
9 months 11 days ago

I sometimes don’t want to get into a detailed discussion with people I don’t know that well when they make a comment along the lines of “boy it looks like you eat pretty healthy, what kind of a diet are you on?”. I basically tell them I’m on a Mediterranean diet but no beans and a tad more protein.

MIssJelic
MIssJelic
9 months 11 days ago

Hilarious! Thank you, Mark! Love the humour, and of course, the common sense.

Shary
Shary
9 months 11 days ago

There are no doubt people who claim to have gained weight rapidly while eating a Paleo diet. In all likelihood they either didn’t have a good handle on what Paleo actually is, or they tried to combine high fat with high carb, which would definitely pack on the pounds.

ob
ob
9 months 11 days ago

This study was done in Melbourne where I live has been big “news” here. People in media etc are quoting the results like it was a human clinical trial. Mice are designed to eat grain. Experiemental mice in study were actually on a low carb and low protein diet due to the amount of fat in the mice chow. The authors in interviews etc support a Mediterranean like diet as that has been shown to be healthy…….. Tweak up the Mediterranean a bit and voila…. primal – paleo like diet there you are.

Graeme
Graeme
9 months 11 days ago

This is the same guy that said that we should all have a soft drink with our burger instead of water. Research at its finest!
http://www.heraldsun.com.au/news/victoria/how-sugar-with-a-burger-could-be-healthier/news-story/b806e60ee1ded5da9b1c248a498c3a0a

Ziva
Ziva
9 months 2 days ago

From theheraldsun article:

“They found that those that had coke instead of a healthy drink with their meal were more likely to feel fuller for longer and perhaps stop them from over-eating later on.”

I’m not sure if it’s possible to headdesk so hard that you knock yourself unconscious, but I’m pretty sure I just did it.

Joshua Hansen
Joshua Hansen
9 months 11 days ago
I almost look forward to the day where I read a study that seems to fly in the face of reality and find out that it isn’t totally flawed from top to bottom. These sorts of “studies” are one of the biggest problems in health and nutrition (and probably everything else). You have a title that has nothing to do with the actual content and you provide rigged data that isn’t even meaningful. However, this has turned into such a contentious issue where factions are more interested in their diet being blessed as the best that media outlets pick up… Read more »
ben
ben
9 months 11 days ago

Great explanation, Mark. I thought it a bit unnecessary though. Surely anybody familiar with your blog is aware of the hundreds of success stories all because of eating and living primal.
No need for a battle of wits with an unarmed person.

Alex
Alex
9 months 10 days ago

The protein content of the LCHF group was quite low as well, only 13 % which hardly imitates a primal diet of meat, fish, eggs, etc, the control group had a somewhat more reasonable 20% protein, I assume mostly from the fish meal.

hh45
hh45
9 months 10 days ago

I love MDA and the primal lifestyle, but the part on carbs should be modified, I think it’s best to do a primal lifestyle + diet PLUS pasta, noodles, rice, bread… Otherwise the info provided here is just gold

Paleo4life
Paleo4life
9 months 10 days ago

One of the things that I love most about the primal/paleo lifestyle is that the focus is on health, not weight. Other than grains and legumes, I was a pretty clean eater and had lost excess weight, and then some, in my pre-paleo days. In my case the paleo diet did lead to a 20 lb. weight gain, but that weight has come with denser bones, stronger muscles, and the leanest and healthiest body I’ve ever had. So much for “rapid weight gain.”

George Henderson
George Henderson
9 months 10 days ago

There was one interesting result – despite the high fat diet causing weight gain and increasing glucose and insulin, there was no deterioration in beta cell morphology.
I wonder, if these results had been achieved by overfeeding refined carbs, would the beta cells still look pristine?
Whatever happened to these mice, which are designed for it, the diabetes looks reversible with weight loss.
I’d like to suggest a ketogenic diet for that, it’s something that does work in obesity mice.

AG
AG
9 months 10 days ago

This scientist is calling for retraction of the paper – https://www.facebook.com/richard.feinman.7/posts/959579280793676

Myles
9 months 9 days ago

“Will you stop at nothing until Greek war chariots pound the streets of every city across the globe and boys and girls have bowls of kalamata olives (pit-in) with red wine instead of cereal for breakfast?”

That’s a freaking glorious breakfast if you ask me. Add in some feta stuffed grape leaves and some bacon/eggs and I’m in. That being said, thanks for dissecting this used toilet paper (err…. research).

Ziva
Ziva
9 months 2 days ago

“bowls of kalamata olives (pit-in) with red wine instead of cereal for breakfast?”

That’s a freaking glorious breakfast if you ask me. Add in some feta stuffed grape leaves and some bacon/eggs and I’m in.”

I’ll happily join in, that sounds divine! (Signed, the person who recently discovered feta…)

Rose
Rose
9 months 9 days ago

Ah, Mark, I knew I could count on you to write an intelligent rebuttal to this study – thanks for giving me fuel for my arguments to defend Paleo!

Patricia
Patricia
9 months 9 days ago
This was an encouraging read for me. My motto since 2012 has been, “If it does not make since, then there is money involved somewhere”. I know that sounds jaded, but after following the medical “rules”, I have Type II Diabetes, had stage 2 uterine cancer, and had a quadruple by-pass in May of 2014. I met a doctor of pediatric oncology over a communal dinner table, heard about his success with Paleo, found your blog, and never looked back! I take no statins, eat a LCHF diet, work full time and my cardiologist cannot believe my numbers. I have… Read more »
Amazon07
Amazon07
9 months 9 days ago

Hey! Have you had your thyroid tested? It sounds as if you might have hypothyroidism. Get your doctor to test not only your TSH levels but your T4 and FT3 levels too! The latter two should be in the top 1/3 of the reference range! Make sure to actually get your test results with the reference ranges and take a look, do t just let the doctors tell you that it’s all ‘OK’!

Amazon07
Amazon07
9 months 9 days ago

Hahahaaaa great response Mark! I just *love* it when some idiots who have absolutely ZERO idea about what paleo is, carry out experiments and try to prove that paleo doesn’t work! Maybe they should read some of your books first and try it for themselves…

Elsie Harrington
Elsie Harrington
9 months 8 days ago
Dear Mark, thank you for defending the paleo/pre-mesolithic diet. Besides the offensive national slurs about names, Kalamalata olives (naturally fermented, BTW), etc, There is a skewed vision of the Mediterranean diet. Growing up all over rural Europe and North Africa (Archaeology research) we found that subsistence “peasant” diet is more “Paleo” than you would expect, plus a lot of fermented dairy, eggs from their own animals if lucky to have them, plus loads of veggies and mushrooms, roots, either foraged or cultivated. We were often offered simple fare of yogurt, stewed or preserved fish or meat, vegetables and fresh or… Read more »
K W
K W
9 months 6 days ago
There’s an easy explanation for his theory about drinking soda with fast food, and it has nothing to do with the actual nutrition of any of it. We’re raised drinking soda with fast food, so we have that psychological association of fast food and soda. Much like willpower is a finite resource, if you expect to have a certain combination of foods and don’t get what you expect, you’re likely to overeat to compensate later. So, maybe he was onto something, but not for any nutritional reason. Sugar and fats eaten together are a powerfully addictive combination, so it makes… Read more »
gabriella kadar
gabriella kadar
9 months 6 days ago

That was nothing more than mouse abuse.

Lorie
9 months 6 days ago

My local hospital just posted a link to the referenced study on their Facebook page…I posted a link back here to your response. Thank you for picking this ‘study’ apart. I hope more people will come to their senses about how flawed medical testing is!

Bulls
8 months 11 days ago

Weston Price discovered, the ancient wisdom of fit survival was integrated into the invading cultures to preserve what worked, not replace it. Now all is different there, of course, thanks to “progress.”

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