Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
20 Apr

Dear Mark: Primal Blueprint Superiority?

envelope 1Dear Mark,

If you’ll bear with me for 4 paragraphs, I’ll get to the question which is the purpose of this email!

My name is Greg, and I’ve followed your blog for a few months now. I’m grateful for the knowledge you’ve shared about nutrition. Thanks to you, I’ve eliminated virtually all white flour and processed sugar from my diet, and I’ve dramatically reduced my intake of carbs. I’m still relatively indiscriminate with fruits and dairy, so I wouldn’t say I’m a Blueprinter yet, but I’m significantly closer than when I first started reading your posts.

I came to your site with no “symptoms” from my previous lifestyle. I wasn’t carrying excess weight, my sugar intake wasn’t egregious, and I was a pretty fit 40-year old. Having said that, I was open to challenging my “default” food choices, and some of my fellow CrossFitters swore they saw performance gains after going Caveman (along with Paleo and Atkins).

My only reservation about the Blueprint was – and still is – the science. It’s not that I don’t appreciate the enormous lengths you’ve gone to base your system on above-board studies and peer reviewed literature. (I’m deeply impressed by the education you’ve amassed on your own.) It’s more that I wonder whether current science is sophisticated enough to unlock the potentially nuanced relationship between our bodies and our food. Yes, transfats are poison. And processed foods are certainly less nutritious/more harmful than whole foods. (Although no one seems to have a problem with supplements, which aren’t “whole”…)

But have we really unlocked the secret of how the body is “ideally” fueled? And is there only one answer? I don’t think so – but I do know that people thirst for the assurance that they are following “the one true way”. To me, that explains why certain diets attract cult/religious-like followings. For example, my wife works with people who swear by the blood-type diet. That’s absurd, right? But so is the literal narrative behind most religions – and that doesn’t stop people from having faith. As long as there’s no irrefutable way to isolate dietary choices from the myriad of other variables that affect a test population’s health, people will develop all sorts of (flawed) theories and support them with incomplete/misleading research. (I know how much that bugs you – since you love to tear apart poorly executed “academic” studies and papers.)

And this (finally!) brings me to my question: Why aren’t Italians all dying at 57? To be less cute: if the Blueprint is definitively superior to other modes of eating, why don’t we see populations that eat high levels of wheat-based carbs falling prey to illness and/or early death? We could single out Italians, Chinese (with their gluten), or many other long-thriving cultures that don’t eat Primal. My (totally unproven) hypothesis is that multiple foods interact with our system in ways we don’t fully comprehend. Maybe the dangers of that first plate of penne are counter-acted by the traditional second plate of animal protein. Or maybe it’s the salad, wine, olive oil, etc…

Anyway, I’m really interested in your reaction. (I’m not Italian, so don’t worry about insulting penne!) I find your Grok narrative/metaphor to be a very appealing and seemingly intuitive model for making food choices. But I can’t quite square that with counter-indicating models that don’t seem to be suffering from their “Grok ignorance”.

Thanks again for sharing your knowledge. I really appreciate the thoughtful and valuable contributions you make to this field of study.

Best regards,

Greg

Los Angeles, CA

______________________________________________________________

Greg,

1) There is no right answer – only choices. I just want to know the ramifications of my choices. That’s what drives me to look further.

2) Whether you eat Primally or Vegan, Mediterranean or SAD, you’ll still probably live a relatively long, relatively healthy life if you exercise. 80 years or 100. Who’s counting? The rest is more about nuances and small percentage changes in overall risk factors. Oh, and lean mass.

3) Italians may not eat as much pasta as you think (or as Italian Americans eat), they may eat more olive oil and healthy animal fats, they may walk more, they may handle stress better as a culture. Chinese don’t eat as much rice as you think. They eat a ton of vegetables and a fair amount of animal products. Having said that, they may both have a large percentage that react poorly to gluten, but who don’t report it. Who knows?

4) Anyone (including me) can find some research that supports their theory. Science is always full of holes. I love poking holes in other peoples’ science. Especially the China Study. Eat Right 4 was a neat concept that had no basis in reality after about 200 years ago. But it caught on with a bunch of people. Sometimes the scientists are so close to the method that they miss the big picture. Sadly, most of those who do the focused studies are not real visionaries. They are almost mutually exclusive concepts.

5) So MDA is my opportunity to put it all out there and see what people think. I may not be right (I think I am, though), but few people are in a position like me to combine solid experiences in endurance training, coaching, nutrition, research, drug-testing, supplement design and writing…and then synthesize those all into a world-view that makes pretty good sense in the context of evolution.

Take what you like from our posts, comment when you have a chance, disregard whatever doesn’t resonate with you, and tell your friends about MDA!!

Cheers,

Mark

I’d love to hear your thoughts on this, readers. Hit me up with a comment in the board!

Further Reading:

Dear Mark: Don’t Call It a Diet

Dear Mark: Ketosis

Dear Mark: Pondering Protein

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. To me, its not about surviving as much as it is about thriving. Although the two often go together.

    This is what makes the paleolithic diet so appealing to me. Giving my body what it needs to perform at its highest level, I really get to enjoy my life! Of course we all hear stories about someone’s grandfather who drank every day and lived to 98, but when I go to do my weekend warrior thing and run circles around my counterparts who are all flabby and lugging around beer/carb guts…I’m pretty sure I’m making the right choices. One of them may live to 100, but are they really “living”?

    Rick wrote on April 20th, 2009
  2. Just a thought. If you’ve watched Mario Battali cook on Food TV, there is much to Italian cuisine that isn’t pasta and red suace.

    JD wrote on April 20th, 2009
  3. Re the blood-type diet: I read about it briefly, and am not convinced. It may “work” because the people who adopt it are generally more diligent about their health. The same may apply to vegetarians. And any diet that focuses on whole foods is bound to be better than the S.A.D. pyramid and have beneficial results.

    In the end, I still think the primal diet is the way to go, because it was designed by nature, not by some doctor with a pet theory.

    Geekay wrote on April 20th, 2009
  4. Greg – intelligent letter. Personally, the thing I like about the Primal/Paleo way is that it cuts out the middle man – i.e. science – if you want it to. Sure, we look to science to validate/challenge our belief in the approach – but ultimately it is based on the principle that we are optimised based on history. If you accept natural selection as true and accept the analyses of ancient eating patterns as correct, then it makes sense that emulating them is optimal. Science is merely a luxury with which to explore what we already believe to be self-evident.

    Methuselah - Pay Now Live Later wrote on April 20th, 2009
  5. Greg that was a very nice letter. I don’t know how the primal diet will compare to other diets in the research in the long term. All I can say is that I did a single case study with myself and “black boxed” it just to see what would happen. The experiment was started about 2 years ago. I was already in very good shape but then I really leaned-out and got even stronger on the paleo/primal/weston price diet. I have no intention at this point of ever going back.

    The Italians do seem to be healthy, but I view it as being all relative. They may be healthy compared to Americans, but weak and slow relative to Grok’s family.

    I really like your comparison of diet to religion. Three topics I tend to stay away from during social gatherings are religion, politics and now diet. People hold very strong views on all 3 and I have found that it is just not worth talking about any of the 3 unless someone approaches who is genuinely interested in what I have to say about the topic.

    primalman wrote on April 20th, 2009
  6. I’ve been eating “primal”…one form or another…for over 5 years.
    This is what I always hear:

    “I can’t believe you are 55 years old”….

    You want proof? You want science?

    How about results!
    Dr. John

    dr john wrote on April 20th, 2009
  7. I think if there was a heealthy eating for dummies book making things very simple it would say : Eat lots of veggies, good fats, and protein. Don’t eat proccessed food! If you look at all of the highly successful ways of life/eating they include the above. Now there are differing opinions on carb amounts and types but in general I think that covers it. Then ad daily activity, enjoy life, and maintain a possitive aditude and your all set.

    I often hear ” Brad thinks all his excersise, and the way he eats is going to make him live forever.” and I always reply ” Not forever, and maybe not even longer, but definitly BETTER!”

    BradK

    Brad wrote on April 20th, 2009
  8. While I am from America, I lived in Italy for quite some time with my Italian family… therefore, I can say I was fully immersed as they are about as Italian as you get ;). JD and Mark’s #3 brought up good points – they don’t eat as much pasta as one may think. It isn’t the huge sized Olive Garden portions with the 4-inch thick garlic bread on the side. Yes, they eat pasta at many meals, but, relatively, very small portions. They walk… a lot. All of their food is bought and made fresh everyday. Dessert is generally a piece of fruit (particularly blood oranges from the spring!).
    I agree, Greg, sometimes I do wonder how other cultures, with their seemingly more carb-based diets, don’t blow up like most Americans. But then I realize Primal works for me and that is what matters.

    LivedinItaly wrote on April 20th, 2009
  9. Genetics may be a part of it. Before I started eating a paleo/primal type diet, I ate a typical western diet for most of my youth (about 18 years) and I was one of the healthiest people I knew. Of course, regular junk food intake may have been tempered by the fact that my family and I cooked most of our meals, even bread, ourselves, and ate copious amounts of fresh veggies, fruits, eggs, fish and olive oil. (Not to mention a daily helping of avocados, plain or in guacamole.) Still, all of that typically came with tons of pasta, bread, and potatoes attached. At the time we didn’t see them as negative for our health – or as filler, which is the true culinary function they seem to serve.

    So, some people, like myself, may be more or less tolerant of grains, or may be at less risk genetically for CVD, obesity, and diabetes. Those who DO suffer from such maladies, however, tend to seriously improve health living on a primal type of diet. My extended family has a history of both type-1 and type-2 diabetes, heart disease, and various cancers, and my mother, who has almost (but not quite – grains are deeply embedded in our culture and psyche, after all) converted to a paleo/primal diet, is the only one of my relatives who managed to recover from age-related health issues, namely weight and liver problems.

    Still, if I was basically healthy before, why do I feel the need to cut grains, beans, and potatoes completely from my diet? I look at them the same way I do cigarettes or alcohol: not harmful in small amounts, but why bother poisoning your body and risking a long-term addiction? Without them one can function perfectly fine and, in most cases, much, much better.

    In terms of science, paleo/primal has a simple evolutionary logic to it that I have found is its best selling point. With some variation allowed for healthy neolithic foods (like olives and their oil) and dairy (if one can tolerate it), this is the diet our bodies were designed to process. Remember, grains and beans (not sure about tubers, but their nutritional value is similar) were only introduced as part of the human diet 10 to 12 thousand years ago, and then only in parts of the Asian steppe as it took several thousand more years to trickle out to Europe, Africa, and the Americas.

    Icarus wrote on April 20th, 2009
  10. Ooops: meant to add that GBP were only introduced 10-12K years ago as part of the Agricultural Revolution.

    Icarus wrote on April 20th, 2009
  11. Greg,

    All I can say is that I ate the Standard American Diet until last year. If you ask, nobody would have said I was overweight. I love to cycle and could ride my bike 25-35 miles with no problem. And yet… I was developing blood sugar problems. My blood pressure has been in the 130′s over 90′s for years.
    Once I went paleo, my blood sugar problems vanished. Not only on a daily basis but when I had a glucose tolerance test done as well. My blood pressure dropped to 115ish over 68-74. I dropped 30 lbs. I have my high school body back, except BETTER!
    Since I eliminated so much garbage from my diet, it could be that there is one thing that was the primary causative agent. Maybe it’s high fructose corn syrup. But on the other hand, can a diet coke be good for you? I think not.
    My science is my results too.

    Dave, RN wrote on April 20th, 2009
  12. I have been following MDA for quite a while now. It took Greg’s letter to encourage me to post a comment, but hey, better late than never.

    First off, congratulations Mark. I’m a Biologist and it’s very refreshing to see a Darwinian approach to nutrition. The guidelines make a lot of sense to me.

    I do think it’s important to maintain a healthy dose of skepticism though, and like Greg I have some issues with completely embracing the Primal diet as well.

    In general, the Primal diet assumes all early men shared the same ecosystem. I would think the red/meat – white/meat – nut – vegetable ratios must have been consistently different amongst populations based on their geographical location.

    Also, coastal ecosystems appear to have played an important role in early human migration. If this is true, white lean meat might have played a bigger role in human evolution than we think, and might deserve to be prioritized.

    Race also seems to be neglected. There are big variations amongst lactose intolerance amongst different ethnic groups, for example. The same might apply to other dietary components.

    I do believe everything points out to pre-agricultural diets as the way to go. It makes a lot of sense. But I do frown upon an ideal Primal recipe for all. I would expect future research supporting more “tailored” dietary guidelines based on the ethnicity or even environmental variables, but only time will tell.

    Cheers,

    SS

    SerialSinner wrote on April 20th, 2009
  13. IMO genetics are a big part of it. We have weird familial genetics where we have the lipids, blood pressure and blood glucose of obese people while remaining slim: some twisted version of the Thrifty Gene.

    When I was young I ate a mix of fresh meat and veg and as I now realise too many carbs, especially wheat. When I was older I became vegetarian (well what did I know, I was still young!) with every meal based on starchy carbs just like they tell you.

    I was told categorically that I was “not diabetic” based on fasting BG or urine dips, plus the fact that I was a skinny bastard and quite fit and active. Still had gallstones in my twenties and (as I now find) severe “diabetic dyslipidemia” – low HDL, high LDL and sky high trigs, which they never bothered to tell me about. Then my blood pressure went south in my forties, and as a result I was put on a Heart Healthy High Carb Low Fat diet.

    This made things so much worse so quickly I was accused of noncompliance – and for the first time in my life I started putting on weight.

    It therefore seemed logical to my anarchic mind that I should do the exact opposite – and when I bought a BG meter and found my BG was heading into near-diabetic territory and then crashing into near-hypo territory several times a day, while my fasting glucose remained “normal”, and I read this

    http://loraldiabetes.blogspot.com/2009/04/test-test-test.html

    and put it into action, my “diet” built itself out of what I could eat without spiking my BG levels, and was fine tuned by the results of my BP and especially lipids.

    I ended up on something highly similar to a Primal diet by default. I suspect we are genetic throwbacks – but we may not be as uncommon as expected. I’m the exact opposite of the media’s potrayal of a Type 2 – fat, lazy and stuffing my face with fast food – I tried really hard to do everything right but what they were telling me was exactly wrong for my physiology.

    By dumping most of the carbs, especially wheat, and adding back those nasty dangerous saturated fats in place of those Healthy Omega 6 vegetable oils I have decimated my trigs (literally) and doubled my HDL. My LDL is none too special but that probably isn’t important – and even that improved with an increase in sat fats. The Horror!

    Yeah I’m not perfect, I sometimes eat bread and 85% chocolate, I drink red wine and sometimes I weaken and blow out – but I always suffer afterwards. I accept that I’m going to die young as a result of following dietary advice which was completely physiologically incorrect for most of my life and which has left me with some permanent damage (and some damage which appears to have reversed) but I’m going to go down fighting. And enjoying myself. And spreading the word to my fellow sufferers.

    The genes are still there but I am no longer expressing them (had a BG testing day Saturday and was nailed between 90 and 112 all day)

    Trinkwasser wrote on April 20th, 2009
  14. Long time no comment. . . . But I couldn’t help myself this time!

    A good read on the ‘perils’ of modern, industrial life is The Autoimmune Epidemic. I have rheumatoid arthritis, and my family has been hit by a tsunami of autoimmune disease in the past 20 years. I think we’re genetically susceptible to autoimmune problems, but I think the huge environmental, and particularly dietary changes over the past 20-30 years is what has tipped my family over the edge.

    To me, a ‘primal’ diet (and exercise) plan just makes sense! Our bodies certainly didn’t evolve on processed, sweetened, chemically ‘enhanced’ glop!

    Oh, and I really will get around to a testimonial some day, but in the mean time. . . I took my dogs to my breed national agility competition last week – and one dog was High In Trial the first day, and the other dog was High In Trial the second day! High in Trial is the dog with the best score/fastest time. Yeah, we kicked butt! And we’re all eating ‘primal’, taking long hikes several times a week, and doing sprint work outs several times a week. There was not a single dog/handler team out there that could hold a candle to our conditioning – while living with relatively severe rheumatoid arthritis!

    Jennifer (she of the ‘kitchen sink salad’)

    Jennifer wrote on April 20th, 2009
  15. Great letter Greg.

    I lived in Italy when I was young. Now age (almost) 42, I’m still in touch with many of the friends of my family. 95% of those people are overweight. They still dress well and have that “Italian thing” going on ;-) lol, but they are for sure not the thin people I remember growing up. I’m sure many of them are also taking regular meds (bp, cholesterol etc)

    so while they might not be falling dead at 57, they are not all that much different then their american counterparts.

    Thanks for sharing how well the primal approach works for you. I think the proof is as they say in the pudding….or should we say marrow? ;-)

    Marc

    Marc Feel Good Eating wrote on April 20th, 2009
  16. And what about the health conditions in the previous centuries? I think people were pretty healthy then. Correct me if I wrong. So you think the best way to eat is to eat like cavemans? Why isn’t enough to move back couple hundreds of years? Eating like the ancient greeks? Were there any diseases like today? Cancer, diabetes etc.

    Hermann wrote on April 20th, 2009
  17. Notice you mentioned the China Study. I actually read most of the book which was given to me by a vegitarian (almost vegan) relative.

    The thing that initially irked me about the book is that (imho) it never delivered its promise of explaining the variance in chd or cancer from one province to another.

    The wildly confounded first study can be simply explained: Mao Tse Tung (sp?) was firmly in control.

    Anyone who wants to know what happened to people who gave Chairman Mao answers he didn’t like needs to read up on him. Wikipedia’s a good place to start.

    Imagine your the health official in some obscure province of China and you get a request from the #2 leader asking if you have any cancer in your province. What would your answer be?

    Remember that somewhere between 30 and 70 million Chinese were starved to death deliberately by Chairman Mao. Yeah, a great diet we should emulate!

    I’m not trying to make a political statement, just throwing a little light on the subject.

    j d wilson wrote on April 20th, 2009
  18. Great post Mark. Greg certainly brings up good points.

    I really appreciate the fact that you reference all these “scientific studies”, and poke holes in them. When I first read the china study, I was sold. Then I started reading your blog, and started realizing all the things wrong with the china “study”. Let’s just say all my friends know me as a caveman now.

    Someone did mention family history (the family blueprint – FB), which is very valid. However, the FB is really just a small part of the all encompassing primal blueprint. Our FB has been slightly modified over the course of time, but as you have mentioned before with gene expression, the FB can become less of a factor!

    Scientific studies aside, your theories just makes innate, intuitive sense and that is something you *can’t* quantify, which IMHO, is something you don’t need to.

    Ryan Denner wrote on April 20th, 2009
  19. Great post, great questions, and great answers from Mark and all the commentors!

    One thing I’d add is that, in the famous China study which looked at the chinese diet, though they did eat plenty of Rice, they didn’t eat as much pasta/noodles as american ‘chinese food’ would lead you to believe.

    More importantly, they ate less sugar in a year than many Americans eat weekly. This lack of sugar, along with good animal fats, and unprocessed foods, is probably why they’re not dying at 57, I think.

    You can be “alright” on an italian/chinese style diet, and some can even remain thin on the Standard American Diet, but most people just don’t. Certainly, enough people suffer on these diets that a cultural shift could only benefit us, in the form of reduced health care burdens, and etc.

    Bryce wrote on April 20th, 2009
  20. Trinkwasser’s last line is the essence of the PB: “The genes are still there but I am no longer expressing them (had a BG testing day Saturday and was nailed between 90 and 112 all day)”

    I suggest that we are all genetically predisposed to obeisty, diabetes, heart disease, arthritis, cancer, etc when we send our genes the wrong signals. Yes, some are more predisposed to one or more of these conditions than others, but all that means is that when the red flag goes up in your family, you – more than most – need to start sending the right signals. The same signals our genes expect from us. The same ones that evolved to become the recipe for a healthy human during the 2,000,000 years we were subject to the laws of natural selection.

    SerialSinner, I agree that many subcultures were exposed to limited forms of foods for millenia. I do think today we are a complex mosaic of mixed tribes who all still process all foods pretty much the same way. And yes, many people call out lactose tolerance as an example of local adaptation. Alas, that is one of a small handful of genetic examples we can point to and even that is muted by the fact that everyone is originally born with the ability to thrive on lactose.

    Jennifer, congrats on your success (both you and your dogs). Keep up the great work and keep us posted on your progress.

    Hermann, ancient civilizations that ate grains all had health problems. The fact that many people exercised so much may have helped offset or delay health issues, but I for one would not go back a feww hundred years. Maybe 10,000 (in a time machine. If I could get home safely)

    Mark Sisson wrote on April 20th, 2009
  21. to address on the chinese concern…since I am one.

    before recent years, china was relatively quite poor, and to be honest not a lot of people could even stay out of starvation. having food on their plate was already hard, let alone having “refined carbs” such as white flour, and good rice.
    back in the old days, people ate a lot more veggies, and cheap grains that are rich in fiber, such as corn and beans. People had a lot more physical activities compared to now a days. Therefore they also had more muscles to compensate the glucose they had consumbed.

    having sad that, looking at china now, people have definitely grown richer and so have the rates of diabeties and heart diseases. I had always thought it’s b/c people could eat more meat now…but modern people have followed the american food pyramid and were so scared of being fat that they rarely do. All one could hear on TV or all what people talk about is to eat less fat. Yet the rate of diabetes has just soared. My dad had an heart attach last year and his cholesterole was still high even though my mom put him on a almost starving diet, feeding him almost no fat but congee and veggies(rice porridge). and she often said to me “I don’t understand why doesn’t his belly shrink, he’s been also walking every day now.”

    not until recently have I encountered the science behind low carb. hoping it could help my dad, I did some intensive readings on the scientific researches, of course MDA helped me a lot in understanding our diet from an evolutionary perspective. It all made sense.

    Now let’s look at China once again. Assuming the relationship between insulin response, carbs and diabetes are true, (especially after reading one study about mice and starches), I came with a hypothesis: People in north china should have a higher percentage of having diabetes than south. reasoning: people from north china eat mainly wheat and potatoes traditionaly. and people from south ate a lot more rice and veggies.

    even though rice is also carb, but it definitely has more fiber, and people from north china have potatoes as dishes on top of the “main food (rice/ bread)”, where that rarely happens in the south.

    I did a random google, typing in “diabetes, north, south”. and all the hits confirmed my hypothesis. People from north DO have a MUCH higher rate of diabetics. and before china has gotten richer, the difference was not as obvious.

    everything went in line with the evolutionary theory of our primal blueprint on diet.

    hope that helped with Greg’s question.

    and thanks Mark, for all your effort and valueble information.

    btw mark’s right. even though we probably eat rice with every meal, we never eat it alone. it’s always roughly a bow of rice and several plates of “side dishes” of veggies, and some meat.

    riceball wrote on April 20th, 2009
  22. oh…one more comment.

    in chinese, people call the ones who gets their big bellies in their 40s “fa fu”, which literally means “luck expansion”. But that didn’t happen often in the old days. especially people who were poor. hense the “luck” . and diabetes were said to be the “rich disease’ even some 30 years ago.

    but now, almost everyone “fa fu”, and diabetes finds almost most people who “fafu” a lot…rich or relatively poorer.

    I became more towards the idea that the reason people “fafu”, is not due to their slower metabolism, but their accumulated damage on their insulin response/sensitivities over the years. After some 40 years of too much rice/noodle eating, it finally became more resistance and more obvious.

    I think it really also explains why young people rarely become diabetics.

    riceball wrote on April 20th, 2009
  23. Great letter & question, great response, great comments.

    I think 57 yo Italians do drop dead of CVD, just not as many do as in the US, so their statistics look better. The way I look at is they are “less sick” than we are, though I noticed that they eat a lot more salami and cheese than the CW’s proposed “Med Diet”. But the salami and cure ham is so much better than the shrink wrapped posers in US chain supermarkets. Little delis carve off slices of rustic cured ham from the bone, the pig skin covered with a light mold that is cut off as the ham is used up (that would make the average US teenager gag). My 10 yo loved it the ham and wanted it at home.

    I’m no expert on Italian food, but I grew up in a predominately Italian-American community in the Northeast and spent two weeks in Italy (Tuscany and Rome) last summer – one week in a farmhouse rental where I bought and cooked most of our meals and one week in a Rome hotel, when we had to eat prepared foods from restaurants, cafes and take-aways. The Italian-American food is nothing like true Italian food. But my BG control was normal and steady the first week while I choose and prepared the food, but my BG was I consider terrible the second week because it was a constant strategy to avoid drowning in sugar and starch with the prepared foods. Like anywhere, if someone else makes your food, you have less choice and control.

    I saw plenty of people in Italy who were clearly suffering from poor diets (excess weight, acanthosis nigricans, leg ulcers, diabetic-related disabilities, etc.) and I don’t mean just the foreign tourists, I mean locals on the street.

    Maximo, the gregarious and handsome owner of the cafe where we had our coffee for three mornings in Rome, was fit and very buff, obviously a man who worked out and tried to take care of himself. I asked for his best health secret, and he patted his 6 pack abs and said, “no pasta”. I couldn’t agree more, but I couldn’t eat the breakfast our hotel ticket provided – he only stocked pastries and bread. Without kitchen facilities, I had to find a deli open nearby to buy some salami or cheese if I wanted protein for breakfast.

    And there is a LOT of gluten intolerance/celiac disease in Italy, in fact, if you lookup the most recent research, you’ll find much of the cutting edge findings on celiac disease is coming from Italy. Celiac/gluten issues are well known in Italy (despite what looked to me like “drowning in wheat”). You won’t hear much about that here unless you dive into the gluten oriented research papers.

    The younger Italians may not do so well as their parents as they age, either, as they were obviously very attracted to the fast food outlets and cheaper high starch, high sugar takeaway foods. Lots of Italian “muffin tops” exist, too, they aren’t all trim. When we wanted something fast and cheaper to eat, our best bet was to find a kebab shop, where they would sub salad for the bread and rice, with water to drink.

    Anna wrote on April 20th, 2009
  24. agree with serialsinner…there is no one best diet for every one it’s just that primal/paleo is an elimination diet omitting the foods that cause the most problems to the most people(though I personally have problems with nightshades).

    Human Evolution Speeding Up, Study Says:

    http://news.nationalgeographic.com/news/2007/12/071211-human-evolution.html

    Chris wrote on April 20th, 2009
  25. I have to say, I did have the same questions as Greg when I picked up this blog.
    I am in good shape, not overweight at all (size 2), and in perfect health. I’ve never had any health issues whatsoever in my entire life. And, I’ve never been on a diet. In fact, my diet consisted almost purely of sugar, wheat and processed foods. So in one respect, I agree with the primal diet philosophy that it makes the most logical sense to me. I’ve also tried the primal diet, and whereas it makes me feel better in that I’m being proactive with my health, I in truth felt no different phsyically/mentally than I had when eating a completely processed diet. I eat better because I feel I should and that the “science” of it makes the most logical sense, not because it makes me feel any better physically.

    yoork wrote on April 20th, 2009
  26. This being my very first comment on your site Mark, I would just firstly like to say how your site has really changed my life, well actually like a complete turnaround of what I had always believed in.

    I have been following your site on a daily basis and all the fantastic comments since November 2008 and really I am very hooked on all your info and many links that you provide to us readers.

    Greg’s letter is very interesting to read and for me personally, it aired many of the questions that I guess I had in the beginning. Just for a little history of myself, I was one of those firm believers of a low fat and high carb diet and I stood by that for many many years. Interesting enough I was never overweight or looked unhealthy as I always did some form of exercise too but maybe that might have been my genes that contributed to that. As I got a little older I started to put on a little weight here and there and couldn’t shift it. I was also starting to feel sluggish and tired and rundown. I would hear a lot about low carb and low GI etc and would just laugh really as I believed the best way was to go low fat etc. The turning point for me was when my partner was starting to follow the primal blueprint and I could see the results very noticeably. I was showed your website and when reading all the info I was instantly interested as it was just so different to my normal way of thinking. I realised it is just not only about the carbs but about the whole package of whole foods and goodness and really just simple food that haven’t been tampered with. I must say the comments of the readers here really intrigued me and still today their feedback speaks volumes!

    If I can share at all any advice seeing that I am really relatively new at this I would say that the results that we get individually of our commitment to the primal way through our appearance and just as importantly through our mind in respect to how we think and deal with the stresses of life in general is proof enough for me that I really have been doing the wrong thing for my health for about three decades!

    Just to end with a little note, how easily the mind can think that the word Fat was the culprit as it is the actual word that directly refers to overweight..any wonder many believed that eating fats was the cause…I WAS one of them.

    X LowFat wrote on April 20th, 2009
  27. Greg’s letter is a fascinating case study that mirrors some of my questions regarding the Paleo diet. I think Mark hit the nail on the head though, in that many “diets” will get the job done. The most successful “diets” are not really diets at all, but rather lifestyle choices. Furthermore, they all share very common themes. Eating large quantities of vegetables, lean meat, and small amounts of processed foods, whatever their source.

    Greg at Live Fit wrote on April 20th, 2009
  28. Hi Mark,

    Another lurker here, inspired to write something.

    My first exposure to this paleo/primal/caveman was via your interview with Grant Petersen in his Rivendell Reader.

    Coincidentally, I was reading this only a few weeks after being diagnosed with autoimmune hypothyroidism, and had been on a reading frenzy trying to assimilate a lot of information and understand what was going on with my health. A lot of the things you were talking about with Grant started clanging like bells, especially since I’d recently had blood work done and had noticed that my blood glucose was at the high end of the “normal” range (although my doctor said nothing about it).

    I’m also a keen cyclist (long distance brevets, loaded touring etc) so all the points you made about the damage done to us by the combination of high exertion and high carb intake started to make sense, and has probably made my adrenal/cortisol situation worse (a side effect of the thyroid problem).

    At first I was very sceptical about this style of eating. I’ve been a vegetarian for about 10 years (another thyroid side effect!), so the thought of eating meat all the time was almost impossible to contemplate. But then I started reading as widely as I could, and all the ducks just lined up. Autoimmune disease, insulin resistance, gut problems, fungal problems. Everywhere I looked all roads led to the paleo diet or variations upon it. There are differences in opinion of course, but Cordain, Weston Price, Audette, Mark Sisson etc all pretty much agree on the basics.

    A month later, I’m no longer a vegetarian. Who knows how much damage ten years of eating rice, oats, wheat and legumes every day has done to me? I’ve already lost all the fat around my torso that had slowly been building up despite lots of regular cycling, and I’m generally feeling pretty ok despite wildly fluctating thyroid/adrenal hormone levels. It will be interesting to see how I feel in six months time once I’ve got the hormones under control.

    I have to say, your passion for this subject and the way you write about it was the trigger for me exploring these issues. Thank you.

    Andrew wrote on April 20th, 2009
  29. Thanks for all the kind words, personal stories and fantastic insights, everyone. All you first time commenters and lurkers, please come back and express yourself more often! This is what I love about MDA; connecting with others about a topic I am so passionate about.

    Congrats on the changes you’ve made, Andrew. Please keep in touch. I’d love to hear how things go for you in 6 months.

    Mark Sisson wrote on April 20th, 2009
  30. Perhaps this sounds like a strange way to come from this, but while I think the PB has a lot scientifically going for it, I doubt some people are psychologically able to deal with it even if they believe the science. I know from my own experience, I have tried to eat meat and fish, but they truly are not appealing in the least. And I’ve tried to cut out grains completely, but that backfires as I merely binge and purge a whole load more grains and sugary things I don’t even like, when the whole thing could have been avoided by having the piece of whole grain toast I really wanted.

    It’s easy to say that certain things need to be cut out, but it’s a whole lot harder to do that in the context of the real world.

    Katie wrote on April 20th, 2009
  31. I think Riceball’s explanation is right on.

    There’s a great scientific explanation in Gary Taubes’s wonderful book, “Good Calories, Bad Calories” (www.amazon.com/Good-Calories-Bad-Gary-Taubes/dp/1400040787). Taubes cites research by Ahrens, who thought it was due to a relative lack of calories compared to high levels of physical activity found in these (typically, in the past) impoverished populations.

    I can’t recommend this book highly enough — Taubes is an award-winning science writer who has basically gone back and examined the research on diet over the last 100 years and assessed its quality, validity, etc.

    The book gives you the ammo to refute all those questions from the diet mainstream:

    – “But your brain needs [dietary] glucose.” – It can also run on ketone bodies, glucose synthesized from the amino acids in protein, and glucose synthesized from glycerol. You don’t need to eat starch.

    – “High-protein diets damage the kidneys.” That research was conducted on RABBITS.

    – “But how about the Chinese and their high-rice diet?” — see above

    The NY Times article by Taubes that started it all is here: http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html He is also a correspondent for the journal Science.

    Anne wrote on April 20th, 2009
  32. Interestingly enough, my experience with starting the primal blueprint has been the opposite of Katie’s.

    As a binge purger, eating more primally and cutting out grains has finally allowed me to let go of the “OMG, those 50 extra calories will go straight to my thighs!” mentality. Before pb, even when I ate what I wanted I till I felt full, 2 hours or so after a normal (carb-based) meal I would immediately get headaches, and hunger pains, which usually lead to more snacking on fruit/grain based snacks and eventually a massive binge.

    But by switching to a more pb regimen, I’ve managed to cut waaaay down on the binges. I find it near impossible to binge on hard cheese, the salty-ness and richness make you start feeling sick much faster. Also, since you don’t get to the accompanying sugar rush from carbs, it forces you to realise how pointless slf-medicating with food is and that it’d be more effective to deal with what triggered the binge in the first place.

    Went off on a bit of a tangent there, but that’s my two cents. I’ve been an avid reader of this blog for quite a while now, and love the clear cut explainations and accompanying pretty pictures :D

    Sarah wrote on April 21st, 2009
    • See, my problems are not generated by being hungry. I rarely binge when I’m hungry. And I can binge on anything: bread, cookies, donuts, deliciously salty cheese, scrambled eggs. It doesn’t matter what it is, because it never satisfies. And even knowing the science and my own experience, I have fewer problems when I say that having a piece of whole wheat toast is not going to hurt me. It’s the same reason that I smoke on occasion: the increased possibility of lung cancer or a rise in blood sugar/insulin and all that means, these are both preferable to the certain destruction of my teeth, fingers, and digestive tract.

      In addition, if the eating disorder is not driven by wild swings in blood sugar, consuming self-limiting foods doesn’t really matter. When you use it to run away from emotions and everything you don’t want to deal with and to avoid feeling anything at all, you will never eat enough and you will never throw up enough. Eating according to the Primal Blueprint will not help that.

      Katie wrote on May 14th, 2009
  33. That’s a great letter, Greg. It echoes my own reservations about the PB exactly.

    I have eaten carbs as my primary food my whole life. A few months ago I started to read this blog – and a great one it is too, Mark! The arguments for the PB diet are compelling, but I couldn’t put my finger on why I never actually embraced the diet. It was only until I tried to explain the idea to someone else, that I realised I couldn’t recall reading any scientific facts to back up the PB.

    I do agree that science probably isn’t advanced enough to prove what’s good for us and what’s not. Look at how different the health sciences were 100 years ago compared to now. Certainly, what used to pass as being ‘healthy’ has changed! And I think in relation to diet, there is still a lot for us to discover.

    The number of people who have tried the PB and found it to work for them seems like a good argument for PB. And likewise, the number of people who are on other diets and enjoying a healthy lifestyle is also very compelling.

    Being a very science-minded person myself, I find it difficult to convince myself to make significant lifestyle changes without at least some scientific backing. I’m still not sure if and when I’ll try the PB, but who knows …

    cobalteffect wrote on April 21st, 2009
  34. There’s so much great stuff here- from Greg’s letter to the various wise replies.

    Andrew- your comment above was really interesting for me to read. Like you, I’m a former vegetarian/ pescatarian (20 yrs!) and former chronic cardio-addict. My diet has slowly evolved from veggie junk food to a more whole-foods based diet. But my naturopath & her boyfriend, a personal trainer, finally convinced me (after years of houndng) to try the Paleo/Primal lifestyle. I’ve taken the 30 day Primal Blueprint challenge (I heart MDA!) I’ve been buying my produce & occasional raw milk dairy at local farmer’s markets for over a decade-now I buy my protein there as well. It was really hard to start eating meat again, but I took to turkey & chicken pretty quickly. I’ve moved onto bison burgers (these take a little getting used to!) I am on supplements galore to help balance my hormones. At the gym, I now do only intense weight lifting and sprints on alternate days- both workouts last 45 minutes. It’s so much better than taking endless spin or cardio-sculpt classes! And I bike outdoors & take yoga on my off days. It’s perfect.
    This Thurday marks my 30 days. While I have not noticed a significant difference in my body comp (that will be confirmed when I visit my naturopath next week) I fully expect to see a decrease in fat & increase in lean muscle mass as time goes by. I have noticed I am much less humgry than when I consumed whole grains & beans with abandon. My hair is shinier, and my itchy/flakey scalp is a thing of the past. I am also seeing my regular physican for an annual next week. I am looking forward to what he says & what my labs reveal. I fully expect to report back with all good news!
    My father died of melanoma & my mom is a breast cancer survior, and I feel that taking control of my health the PB way is the wisest choice for me. I wish I had known about this site a few years ago- I could have shared it with them, and perhaps their health would have taken turns for the better. I’ll never know.
    But I intend to stay on the PB for the rest of my life – it makes perfect scientific sense to me!

    Marci wrote on April 21st, 2009
  35. About grains, it really bothers me that it’s so promoted in that old food pyramid. I have a cousin that is a dietician and she was taught to believe in it and she thinks it’s healthy, i’m healthier than she is, that speaks in itself doesn’t it! I wish everyone would find MDA and know the truth how bad grains are for you and eating Primal is the healthy way to go!!!

    Donna wrote on April 21st, 2009
  36. The big things make a big difference. Cut out candy, sodas and junk food and you’re going to be much healthier. Start exercising and being active in general and you’ll live longer. At that point, adding a few more or a few less apples a day will make some difference but it’s going to be pretty small.

    All these cultures live a relatively healthy lifestyle. It may not be primal, but it’s also not McDonald’s central.

    Gal

    60 in 3 - Health and Fitness wrote on April 21st, 2009
  37. I live in Campania, Italy (Southern Italy) were they are famous for their pasta and pizza … which they eat a lot of including other various sweets. Not at all like the diet of Rome and further North. They, as a group, are short, fat, weak (I play Rugby, and have never played with/against such weak opponents), and die young. In fact, my neighbor died two months ago at 55 from complications to diabetes. The more traditional diet is plant and meat based, with a little pasta and sometimes some potatoes, but very few of them eat that way anymore. Especially the younger generation, and they are extremely unhealthy. When I go to the grocery store here, it is as bad as the states when it comes to processed foods. Of course there is a section for the traditional food, which I take advantage of, but that is not what is primarily bought by the average Southern Italian.
    If you are concerned about the science behind a PB type diet, try reading the book about the Metabolic diet. It will give you more studies and references than you could ever want. They advocate using a once a week carb-up for hormonal/body building purposes. It works, but I don’t think you feel as good as the PB diet. In fact, sometimes during the week (especially after the carb-up), you feel down right sick. However, using the diet I got the strongest I have ever been. (405 bench, 500 dead-lift, 475 squat) I am now following more of a PB diet, because I am trying to lose weight and am not as concerned about strength as I was before. I feel a lot better, and am losing weight (fat) faster. This post kind of got away from me, I hope it helped.

    Tate wrote on April 21st, 2009
  38. Just thought I should add some observations on my Chinese relatives.

    Calorie restriction: I calculated my average daily calories while staying in China: ~1200 (I ate as my family did too). And I wasn’t hungry. The only reason I can guess at for this is that the food’s ALWAYS the same. There isn’t any “Oh, feel like some Indian tonight?”. All meals are home-cooked, and they’re all the same flavor family. I mean, you CAN go to Pizza Hut or KFC if you want, but it’s generally viewed as a special treat (and it is–KFC’s a popular date place over there).

    Another note, but I don’t know if it’s just my family–when we go out to restaurants on weekends or special events, we don’t order rice. At big parties and banquets it’s not normal to eat rice either.

    And and I noticed when my aunt and uncle wanted to lose weight, she just stopped eating rice at dinner and ate only veg.

    No sugar, too. Like, ever. Sometimes a piece of fruit after dinner, if in season. It’s actually because of my family that I knew fruit wasn’t too good even before I started hearing about Primal–my great-aunt became diabetic after a long affair with lychees.

    Yup, diabetic on FRUIT.

    Andy wrote on April 21st, 2009
  39. Donna – It can make quite the argument when you come up against someone who has studied diet and nutrition! I try not to comment too much but the other day couldn’t help it as the topic of health and nutrition came up with a friend who is a fitness/Health professional. The conversation really revved up when I said that ‘basically most of what you believe in, my beliefs are the opposite.’ These people have gone to uni and studied for years for their degree so I can see why they stand their ground. I think that it is fantastic how for me personally, only been into the PB for approx five months can see from my own results that my new way of eating and fitness far out ways my former decades of the ‘old way.’ The results do speak for themselves and so for me to turn everything on its head is a major augment with most people, after all I was one of those ‘most people’ not too long ago – which is why I don’t get into it with friends/family, only those that are genuinely interested.

    Yes it would be so good if others found the knowledge that we have found, only I think we are the minority.

    Sonya wrote on April 21st, 2009
  40. I’m so glad someone wrote that e-mail because I’d been wondering about the exact same things.

    Mia wrote on April 21st, 2009

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