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Alan Aragon's Argument against paleo/primal lifestyle (with slide show)

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  • #46
    Originally posted by stallion23 View Post
    You made some great points there. As always, there are good points on both sides of this argument. As an example, I can give you studies that refute your ideas that O6 oils are unhealthy:

    PLOS Medicine: Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    "These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD."

    I guess the most important study is your own personal n=1.
    That's a nice cherry-pick by either you or AA (not sure which) -- but it shows unfamiliarity with the body of research. It turns out that if you separate interventions that provide n-3 along with n-6, vs. interventions that only raise n-6, you find that raising n-6 alone increases risk of CHD and death:

    Br J Nutr. 2010 Dec;104(11):1586-600. doi: 10.1017/S0007114510004010.
    n-6 fatty acid-specific and mixed polyunsaturate dietary interventions have different effects on CHD risk: a meta-analysis of randomised controlled trials.
    Ramsden CE, Hibbeln JR, Majchrzak SF, Davis JM.
    https://www.ncbi.nlm.nih.gov/pubmed/21118617

    "For non-fatal myocardial infarction (MI)+CHD death, the pooled risk reduction for mixed n-3/n-6 PUFA diets was 22 % (risk ratio (RR) 0.78; 95 % CI 0.65, 0.93) compared to an increased risk of 13 % for n-6 specific PUFA diets (RR 1.13; 95 % CI 0.84, 1.53)."
    Strike one.
    "Risk of non-fatal MI+CHD death was significantly higher in n-6 specific PUFA diets compared to mixed n-3/n-6 PUFA diets (P = 0.02)."
    Strike two,
    "RCT that substituted n-6 PUFA for TFA and SFA without simultaneously increasing n-3 PUFA produced an increase in risk of death that approached statistical significance (RR 1.16; 95 % CI 0.95, 1.42). "Advice to specifically increase n-6 PUFA intake, based on mixed n-3/n-6 RCT data, is unlikely to provide the intended benefits, and may actually increase the risks of CHD and death."

    Strike three. And please note that n-6 was substituted for TFA (trans fats) as well as SFA, and TFA have strongly negative health effects even at a low % energy:
    https://www.ncbi.nlm.nih.gov/pubmed/19424218
    "A meta-analysis of prospective studies indicated 24, 20, 27 and 32% higher risk of myocardial infarction (MI) or CHD death for every 2% energy of TFA consumption isocalorically replacing carbohydrate, SFA, cis monounsaturated fatty acids and cis polyunsaturated fatty acids, respectively."

    Again, it's easy to cherry-pick one single study, or even one single meta-analysis. It takes a long time to become familiar enough with the research to get a bigger picture...much longer than it takes to justify a pre-existing prejudice with a few footnotes.

    EIDT TO ADD: Stephan Guyenet did a great debunking of the Mozaffarian paper back in the day:
    http://wholehealthsource.blogspot.co...rials-new.html
    Not only did it fail to distinguish n-3 from n-6 PUFA, it simply omitted several trials that found highly unfavorable results for n-6 interventions, like the Rose Corn Oil Trial and Sydney Diet-Heart Trial. Result: junk science.

    JS
    Last edited by J. Stanton; 08-25-2013, 06:42 PM. Reason: added one more link

    Comment


    • #47
      Originally posted by lea View Post
      OK, skimmed through the ppt.

      1. I didn't know paleo was anti-salt.
      Yeah, me either.

      Originally posted by lea View Post
      Some of the comments were just snotty in tone which turned me off. And half of the food he posted would be considered absolutely fine around here. So I don't know what to make of all this.
      Basically my take is that he is defining 'paleo' as being what Lauren Cordain says it is (or did, several years ago). And he's debunking that.

      And that's fine.
      Disclaimer: I eat 'meat and vegetables' ala Primal, although I don't agree with the carb curve. I like Perfect Health Diet and WAPF Lactofermentation a lot.

      Griff's cholesterol primer
      5,000 Cal Fat <> 5,000 Cal Carbs
      Winterbike: What I eat every day is what other people eat to treat themselves.
      TQP: I find for me that nutrition is much more important than what I do in the gym.
      bloodorchid is always right

      Comment


      • #48
        Originally posted by Neckhammer View Post
        I think you mean gout right? But yeah, neither of those are very comparable to the mechanisms associated with celiac disease or gluten intolerance. And yes you have to include gluten intolerance and gluten allergy in your projections. Like I said.... read my replies in the linked thread on this. I don't think you did, or you wouldn't had made that absurd comment on lactose intolerance. So in the case of grains that is my primary concern and as to the evidence to support it.... it is ample IMO.

        As to burden of proof.... the epidemiological data I asked you to look for doesnt count? I'll get you started.

        Cassidy CM. Nutrition and health in agriculturalists and hunter-gatherers: a case study of two prehistoric populations. in Nutritional Anthropology. Eds Jerome NW et al. 1980 Redgrave Publishing Company, Pleasantville, NY pg 117-145

        This study is blogged about here if you can't find the original:

        Nutrition and health in agriculturalists and hunter-gatherers » The Blog of Michael R. Eades, M.D.

        By no means is this the nail in the coffin on grains, but in combination with what I have already written on gluten and our problems with GMO dwarf, and other epidemiological evidence.... well make up your own mind as to if it is worth eliminating for 30-60 days and finding out if you are one of many that are affected.

        So thats grains for you. They exist on a continuum of least likely to be detrimental to most likely and you have to take into account cultivation and preparation. There is ample evidence that as humans they are not necessary for health, and in fact epidemiological evidence seems to support the concept that societies that do not include them are healthier than those that do.

        As to PUFA... this is getting long again and I'm now off for a hike, but lets just start with a point that SFA has for the most part been vindicated. So maybe the onus of this one is on the people stating that PUFA should need to replace SFA to make us healthier? I mean this is a concept born of the Key's crap 50+ years ago and the heart health hypothesis. We can pick this up in a bit though. BTW have you tried the search function at the top? Perhaps you can do some reading while I'm gone... this really has all been covered before, which is what makes the whole argument a bit redundant....here is a start for you again:

        Is It All Just a “Paleofantasy”? | Mark's Daily Apple

        Polyunsaturated Fats: Are They Healthy? | Mark's Daily Apple
        Yes, you are correct, I meant gout. Sorry for the misspelling. But regardless, my argument wasn't comparing the underlying pathological mechanisms of gout vs celiac disease. It was simply to show you that you can not make blanket recommendations for everyone based on the individual biology of those with a diagnosed medical disease.

        As for your study... I gave you a meta-analysis of several studies. You are giving me a case study...the lowest level of evidence second only to bench/theoretical research. Hardly proof of anything, wouldn't you say? You're talking about bias and all these other alleged weaknesses in the studies I gave you. But here you are giving me the weakest level of evidence to prove your point. That being said, I agree with you on the 30-60 day experiment. Individual results will vary and you should always listen to your own body regardless of what the evidence says. I have no issue with that. My only issue is when blanket recommendations are made such as "grains are harmful"...as if it applies to everyone.

        Look, I read the articles you linked to...but none of them address the elephant in the room: when you take a systematic review of the randomized control studies held under the process of scientific rigor to deem whether PUFAs are harmful or not....they are NOT harmful (as demonstrated by the link I gave you). All I'm seeing here is the blog posts where Mark writes his opinion on PUFAs...and that's fine, everyone is entitled to their opinion, but I'm presenting scientific evidence, not blog posts.

        Comment


        • #49
          Originally posted by J. Stanton View Post
          That's a nice cherry-pick by either you or AA (not sure which) -- but it shows unfamiliarity with the body of research. It turns out that if you separate interventions that provide n-3 along with n-6, vs. interventions that only raise n-6, you find that raising n-6 alone increases risk of CHD and death:

          Br J Nutr. 2010 Dec;104(11):1586-600. doi: 10.1017/S0007114510004010.
          n-6 fatty acid-specific and mixed polyunsaturate dietary interventions have different effects on CHD risk: a meta-analysis of randomised controlled trials.
          Ramsden CE, Hibbeln JR, Majchrzak SF, Davis JM.
          https://www.ncbi.nlm.nih.gov/pubmed/21118617

          "For non-fatal myocardial infarction (MI)+CHD death, the pooled risk reduction for mixed n-3/n-6 PUFA diets was 22 % (risk ratio (RR) 0.78; 95 % CI 0.65, 0.93) compared to an increased risk of 13 % for n-6 specific PUFA diets (RR 1.13; 95 % CI 0.84, 1.53)."
          Strike one.
          "Risk of non-fatal MI+CHD death was significantly higher in n-6 specific PUFA diets compared to mixed n-3/n-6 PUFA diets (P = 0.02)."
          Strike two,
          "RCT that substituted n-6 PUFA for TFA and SFA without simultaneously increasing n-3 PUFA produced an increase in risk of death that approached statistical significance (RR 1.16; 95 % CI 0.95, 1.42). "Advice to specifically increase n-6 PUFA intake, based on mixed n-3/n-6 RCT data, is unlikely to provide the intended benefits, and may actually increase the risks of CHD and death."

          Strike three. And please note that n-6 was substituted for TFA (trans fats) as well as SFA, and TFA have strongly negative health effects even at a low % energy:
          https://www.ncbi.nlm.nih.gov/pubmed/19424218
          "A meta-analysis of prospective studies indicated 24, 20, 27 and 32% higher risk of myocardial infarction (MI) or CHD death for every 2% energy of TFA consumption isocalorically replacing carbohydrate, SFA, cis monounsaturated fatty acids and cis polyunsaturated fatty acids, respectively."

          Again, it's easy to cherry-pick one single study, or even one single meta-analysis. It takes a long time to become familiar enough with the research to get a bigger picture...much longer than it takes to justify a pre-existing prejudice with a few footnotes.

          EIDT TO ADD: Stephan Guyenet did a great debunking of the Mozaffarian paper back in the day:
          Whole Health Source: Diet-Heart Controlled Trials: a New Literature Review
          Not only did it fail to distinguish n-3 from n-6 PUFA, it simply omitted several trials that found highly unfavorable results for n-6 interventions, like the Rose Corn Oil Trial and Sydney Diet-Heart Trial. Result: junk science.

          JS
          I didn't cherry pick you a single study. I gave you a systematic review which covered several randomised control trials- not just a single study that said "PUFAs are good for you".

          You actually are the first person here that presented a solid piece of research though. So I commend you on that but I can't actually see the entire article. Do you have a link to the actual study or is this just an abstract.

          Comment


          • #50
            Originally posted by J. Stanton View Post
            It takes a long time to become familiar enough with the research to get a bigger picture...much longer than it takes to justify a pre-existing prejudice with a few footnotes.
            JS, I'm a big fan of yours. But sentences like this are just an appeal to authority, reminiscent of Campbell's dismissal of Minder about the china study, since it's just 'too complex' for her simplistic analysis.

            I mean, couldn't adherents of any particular food philosophy make the same arguements in favour of their predisposed diet solution?
            Disclaimer: I eat 'meat and vegetables' ala Primal, although I don't agree with the carb curve. I like Perfect Health Diet and WAPF Lactofermentation a lot.

            Griff's cholesterol primer
            5,000 Cal Fat <> 5,000 Cal Carbs
            Winterbike: What I eat every day is what other people eat to treat themselves.
            TQP: I find for me that nutrition is much more important than what I do in the gym.
            bloodorchid is always right

            Comment


            • #51
              Yes, I've read the actual study. It's not free fulltext, but there are copies floating around the web that a quick Googling will likely reveal to you.

              Their demolishing of the Finnish Mental Hospital Study is priceless. They did a great deal of investigative work to figure out exactly what the dietary interventions in each study (some decades old) were doing to n-3 and TFA consumption...and the results are not kind at all to the Mozaffarian et.al. paper, which is clearly shown to have omitted the trials unfavorable to their predetermined conclusion for bogus reasons.

              Example: "Although STARS had three study arms and a pre-intervention drug trial, it was included in their meta-analysis(7) while the RCOT was excluded for containing ‘multiple interventions’, despite also having three study arms. Another n-6 specific
              PUFA RCT, the SDHS, was excluded because it reported only total death, which was considered a ‘non-CHD endpoint’(7). However, the vast majority of deaths (91 %) in the SDHS were attributed to CHD(38)."

              JS

              Comment


              • #52
                Originally posted by magicmerl View Post
                JS, I'm a big fan of yours. But sentences like this are just an appeal to authority, reminiscent of Campbell's dismissal of Minder about the china study, since it's just 'too complex' for her simplistic analysis.

                I mean, couldn't adherents of any particular food philosophy make the same arguements in favour of their predisposed diet solution?
                Not in this specific case. The paper I'm quoting (Ramsden 2010) specifically addresses Mozaffarian et.al. in great detail, which is why I quoted it above in message #51.

                Anyone who has spent meaningful amounts of time investigating the PUFA issue cannot fail to have encountered both papers, as they're both widely publicized meta-analyses published in high-impact journals.

                I don't make claims of that nature ("It takes a long time to become familiar enough with the research to get a bigger picture...much longer than it takes to justify a pre-existing prejudice with a few footnotes.") unless I believe them to be supported by the data. In this case, I feel justified in saying that anyone who cites Mozaffarian 2010 but not Ramsden 2010 either has an agenda, is quoting someone with an agenda, or simply hasn't done the work required to make categorical statements.

                JS

                Comment


                • #53
                  I think Alan makes some good points and he is at least basing it on research/science.

                  A paleo diet in any of it's incarnations is better than the typical standard American diet, but you could say the same thing about a vegetarian diet. I think the safe thing for most of us would be to eat real foods and eat lesss processed foods.

                  I followed a low carb paleo diet for a couple years. I lost weight and performed better, but eventually it ran me down. I was tired all the time and started having trouble with insomnia, etc.

                  I've noticed that more than one of the paleo gurus reports that they are run down or suffreing from "adrenal fatigue." Isn't your diet supposed to make you feel better? I find this interesting.

                  Comment


                  • #54
                    Alan has some great points. Th fact that he is taking the Cordain's paleo diet down on topics I have issues with supports my thoughts. I really think full Paleo is too limited. I have always been really interested in Human development and whetter the Paleo diet is really paleo or not we know a few things as fact:

                    - SAD isn't working.... too much sugar, too much salt and a lot of people are allergic or hyper sensitive to wheat. It gives to think that we aren't meant to eat wheat.
                    - High amounts of carbs isn't good for a body. you can look around and see it. people are fat, in pain and not moving well. the carbs in a SAD consist of a lot of refined sugar.
                    - There are so many people who are doing well on primal/paleo... there is some truth to it...
                    - nobody has died from eating whole, healthy foods... that's what Primal to me is all about.

                    last fact, we weren't made for being overweight and sitting on a couch... Paleo and Primal got that right, we are made to move forward...
                    My story, My thought....

                    It's all about trying to stay healthy!!!!

                    Comment


                    • #55
                      Originally posted by MarielleGO View Post
                      Alan has some great points. Th fact that he is taking the Cordain's paleo diet down on topics I have issues with supports my thoughts. I really think full Paleo is too limited. I have always been really interested in Human development and whetter the Paleo diet is really paleo or not we know a few things as fact:

                      - SAD isn't working.... too much sugar, too much salt and a lot of people are allergic or hyper sensitive to wheat. It gives to think that we aren't meant to eat wheat.
                      - High amounts of carbs isn't good for a body. you can look around and see it. people are fat, in pain and not moving well. the carbs in a SAD consist of a lot of refined sugar.
                      - There are so many people who are doing well on primal/paleo... there is some truth to it...
                      - nobody has died from eating whole, healthy foods... that's what Primal to me is all about.

                      last fact, we weren't made for being overweight and sitting on a couch... Paleo and Primal got that right, we are made to move forward...

                      Good points. Just a couple thoughts:

                      You mention that people may be allergic or sensative to wheat. The existence of true celiac disease is actually very low. I see MDs telling there patients to get off of wheat. The patients that do that sometimes see benefits, but was it due to giving up wheat or to giving up lots of processed food, which is invariably what happens when one gives up wheat.

                      Maybe it isn't wheat that makes people fat, but instead the processed foods. Look at the bread you get in a grocery store. It has a long long list of indgredients. I can make bread at home with 5 or less ingredients. It doesn't keep as long because it doesn't have all those other additives, but maybe that should tell us something.

                      You mention that too many carbs aren't good for people. We can actually find cultures that are very healthy on high carb diets. We can also find cultures that have maintained health on a very high fat diet. The one thing they have in common: no crackers, chips, twinkies, etc. I think that processed foods are making people sick and fat, not too much carbohydrate or too much fat.

                      Comment


                      • #56
                        Originally posted by squeally dan View Post
                        Good points. Just a couple thoughts:

                        You mention that people may be allergic or sensative to wheat. The existence of true celiac disease is actually very low. I see MDs telling there patients to get off of wheat. The patients that do that sometimes see benefits, but was it due to giving up wheat or to giving up lots of processed food, which is invariably what happens when one gives up wheat.

                        Maybe it isn't wheat that makes people fat, but instead the processed foods. Look at the bread you get in a grocery store. It has a long long list of indgredients. I can make bread at home with 5 or less ingredients. It doesn't keep as long because it doesn't have all those other additives, but maybe that should tell us something.

                        You mention that too many carbs aren't good for people. We can actually find cultures that are very healthy on high carb diets. We can also find cultures that have maintained health on a very high fat diet. The one thing they have in common: no crackers, chips, twinkies, etc. I think that processed foods are making people sick and fat, not too much carbohydrate or too much fat.
                        gluten, or specifically gliadin, has zonulin-signaling effects that have been observed in both celiac and non-celiac populations, hence increases permeability of the epithelial lining of the gut, allowing assimilation of things into the bloodstream that don't belong there. I find the argument that avoiding wheat and other gluten-containing grains is only beneficial to those with celiac disease or non-celiac gluten sensitivity to be really weak.
                        The Champagne of Beards

                        Comment


                        • #57
                          Originally posted by RichMahogany View Post
                          gluten, or specifically gliadin, has zonulin-signaling effects that have been observed in both celiac and non-celiac populations, hence increases permeability of the epithelial lining of the gut, allowing assimilation of things into the bloodstream that don't belong there. I find the argument that avoiding wheat and other gluten-containing grains is only beneficial to those with celiac disease or non-celiac gluten sensitivity to be really weak.
                          I agree. i don't have celiac but I do not want my immune system to be chronically activated, responding to things that have passed into my blood stream that do not belong there. My immune system should not go on high alert every time I eat something. I credit this diet for reducing generalized inflammation throughout my body, which has reduced and eliminated chronic joint pain I had before. I think eliminating wheat played a part. And if it did nothing? Well, the replacement foods have so much more nutritional content I think I'm ahead no matter what calculations you do.
                          Female, 5'3", 50, Max squat: 202.5lbs. Max deadlift: 225 x 3.

                          Comment


                          • #58
                            Originally posted by sbhikes View Post
                            I agree. i don't have celiac but I do not want my immune system to be chronically activated, responding to things that have passed into my blood stream that do not belong there. My immune system should not go on high alert every time I eat something. I credit this diet for reducing generalized inflammation throughout my body, which has reduced and eliminated chronic joint pain I had before. I think eliminating wheat played a part. And if it did nothing? Well, the replacement foods have so much more nutritional content I think I'm ahead no matter what calculations you do.
                            In terms of risk and reward eating paleo is all reward with no risks.

                            Comment


                            • #59
                              Originally posted by RichMahogany View Post
                              I find the argument that avoiding wheat and other gluten-containing grains is only beneficial to those with celiac disease or non-celiac gluten sensitivity to be really weak.
                              I would agree with this. When you look at the number of autoimmune disorders that are associated with celiac , it's clear we don't understand the full impact of gluten on the immune system. I would bet though, that for most people, simply moving gluten grains from the bottom of their food pyramid, to the very top, would have a significant impact on their health over their whole lifetime. And that sort of lifestyle is 1000x easier than that of an actual celiac, who has to worry about gluten contamination 24/7.
                              50yo, 5'3"
                              SW-195
                              CW-125, part calorie counting, part transition to primal
                              GW- Goals are no longer weight-related

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                              • #60
                                +1, +1, and +1 to the last 3 posts.
                                The Champagne of Beards

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