Dear Mark: Red Blood Cell Fatty Acid Content and Obese Paleo Figurines

Red Boold Cell FinalFor today’s edition of Dear Mark, I’m answering a pair questions that, well, question some of the fundamental principles of Primal living and eating. First up concerns a study seeming to show that linoleic acid (from seed oils) is a healthier, less inflammatory choice than olive oil or fish oil. Could it be true? Find out below. Then, I discuss the existence of obese female figurines from the paleolithic as evidence of obesity in actual paleo populations. Does a doll with a belly mean the Primal way of eating, living, and moving needs to be reworked?

Let’s go:

“Leaner bodies, less heart disease and diabetes risk found in people with higher levels of linoleic acid”
Ok. Now I’m really confused. Please comment for the coconut/olive-oil drenched masses. Thanks!

Interesting paper. Thanks for the link.

The relationship of diet to the fatty acids in the body to health is interesting, and we have to be careful about assuming that the relationship is straightforward. For example, one recent paper examined how fatty acids of varying chain lengths relate to the risk of type 2 diabetes. Drawing on results from over 340,000 people across eight European countries, the researchers found:

Very long-chain saturated fatty acids were linked to lower rates of type 2 diabetes.

Odd-chain saturated fatty acids were linked to lower rates of type 2 diabetes. These include pentadecanoic acid and heptadecanoic acid, found abundantly in dairy.

Even-chain saturated fatty acids were linked to higher rates of type 2 diabetes. These include palmitic acid, myristic acid, and stearic acid, found abundantly in meat and butter.

Sounds pretty damning, right? Hold on. In a comment to the journal, Dariush Mozaffarian makes an important point: plasma levels of fatty acids do not necessarily correlate with dietary intake of these fatty acids.

Although even-chain saturated fats are found in meat and butter, serum levels of those fats were not associated with consumption of those foods. Instead, people who ate the most sugar, potatoes, starchy foods, and drank the most alcohol—which Mozaffarian describes as “drivers of de novo lipogenesis”—had the highest serum levels of even-chain SFA. There was no relationship to meat or other foods actually rich in even-chain SFA. The likely explanation is that serum levels of “these SFAs are mainly derived from endogenous hepatic synthesis, driven by consumption of starch, sugars, and alcohol.”

Odd-chain saturated fat levels predicted dairy consumption, as you’d expect. This lines up with the growing evidence for the considerable health benefits of high-fat dairy.

Very long-chain saturated fatty acids were curiously linked to nut and seed consumption.

Now let’s turn to the study you cite.

A group of adults had their red blood cell fatty acids analyzed and plotted against inflammation and diabetes biomarkers and body composition.

Linoleic acid was linked to lower inflammation, higher insulin sensitivity, greater lean mass, and less visceral fat. Good stuff all around.

Oleic acid (a monounsaturated fat found in avocado oil and olive oil) and omega-3 (found in fish) were both linked to lower inflammation but had no relationship to insulin sensitivity, lean mass, or visceral fat. They were mostly neutral.

As far as I could tell, they didn’t track any saturated fats. Too bad.

Red blood cell linoleic acid does track well with dietary linoleic acid, so the people with lower inflammation, higher insulin sensitivity and other positive markers were eating linoleic acid. The authors remark that these were healthy adults, so it may be that RBC linoleic acid reflected consumption of healthy sources of linoleic acid like nuts and seeds. Notice that people with higher levels (and thus intakes) of linoleic acid had more lean mass, less visceral fat, and lower inflammation. In other words, they probably exercised more and ate better diets overall. Sure, you could argue that the linoleic acid was the causative factor promoting all these superior biomarkers, but you’d actually have to test for that; the current study did not.

But it also doesn’t mean oleic acid and fish oil are suddenly bad or useless. First of all, RBC oleic acid doesn’t necessarily indicate olive oil consumption. At least in rats, eating olive oil increases red blood cell PUFA (both omega-3 and linoleic acid). And we already have clear, clinical evidence for the direct benefits of consuming omega-3s and extra virgin olive oil, just as we do for nut and seed consumption.

Other studies have found different relationships between red blood cell linoleic acid and health. RBC linoleic acid has been linked to higher hip fracture risk and telomere shortening (a marker of aging), for example. Doesn’t mean “almonds are bad for you,” though.

The only solid takeaway–and it’s an important one—is that dietary linoleic acid is compatible with good health. Heck, I’ve been saying this for a long time. Nuts and seeds are good for you. But this study doesn’t let us make any conclusions about other dietary fats because the connection between other dietary fats and RBC fatty acids is less clear-cut.

As for the suggestion that the fats we espouse on the Primal eating plan, like coconut oil, olive oil, or butter, will crowd out the linoleic acid and counter the effects seen in this study, this doesn’t make that claim. In fact, a recent study from Finland examined the effects of diet on RBC fatty acid content and found that butter consumption did not affect the omega-3/omega-6 ratio in RBCs.

One day in the future, maybe I’ll take a closer look at the link between dietary fats and RBC fatty acids. For now, keep doing what you’re doing.

Hello Mark,

I must say that I love and share your entire approach to health, fitness and life in general.

I visited Malta some years ago and saw pictures of a statuette from paleolithic days. It was of a decidedly obese feminine form. Just for fun, I searched and found loads of other similar examples from all around Europe.

It would appear that obese females were around and even admired over their more svelte sisters.

Where does that leave our approach?



You’re probably referring to the Venus of Malta, similar to the famous Venus of Willendorf or any of the dozens of others obese female figurines from paleolithic Europe.

And yes: these are definite representations of obesity. Realistic, too—abdominal fat, large sagging breasts, rolls of fat, large thighs, knock knees. Whoever made these figures had seen it with their own eyes.  A recent analysis of available figurines from the paleolithic found that a hair over half of them depicted overweight or obesity. Why?

The Venus figurines represent the human potential for obesity. Sometimes that potential is realized, as humans have always had the genetic ability to become obese. Shove enough food in a person’s mouth for a long enough time and they’ll gain weight. Doesn’t matter how grass-fed, wild-caught, or low-carb that food is.

But that doesn’t mean obesity was common. You don’t make figurines and totems of the mundane. The Venus figures probably represented the abnormal, the ideal, the rare. And it wasn’t just the women who got unrealistic representations. Some of the earliest male figurines depict men with enormous erections spanning half their height. Are those realistic? Were foot-long penises the norm in the paleolithic?

Probably not. Look at us—who do we idolize? Are the body types we idealize common or rare?

Do most people look like Henry Cavill or Kim Kardashian? These are the body types we see most frequently in popular media—lean and muscular for the men, slim and voluptuous for the women. But walk through your average mall and the reality is decidedly different from the ideal. Or consider pornography, where every attribute is exaggerated and oversized. These are real humans with these physical endowments, but they aren’t normal or typical of the broader population.

If you’re wondering why any culture would revere obesity, it still happens today. Take the Bodi tribe of Ethiopia, whose men compete to gain the most weight (and female admirers) by drinking a calorie-dense blend of milk and blood, the “fattening rooms” of Calabar, Nigeria where young brides go to gain weight before marriage, or Mauritania, where obesity is a sign of prestige and a startling number of young girls are force-fed to make them fat.

But when the rubber meets the road, when people actually follow the Primal way of eating, living, and moving, good things tend to happen. This kind of obesity doesn’t develop. Since you love and share this entire approach to health, fitness, and life, I’d bet it’s working well for you, too. If Primal isn’t making you into a Venus figurine, don’t worry.

Thanks for reading, everyone. Take care and be sure to chime in with your input on today’s questions down below!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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28 thoughts on “Dear Mark: Red Blood Cell Fatty Acid Content and Obese Paleo Figurines”

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  1. I’ll keep using the figurine on my Grok key chain for my ideal body image. In Grok We Trust.

  2. PS, in the figurines, please remember that big breast and wide hips and fat storage was a sign of fertility in a woman, they had the reserve to carry a baby full term and feed them through harsh periods of infancy when food was scarce.

  3. The Venus figurines are not necessarily examples of a woman in obesity – but are possibly (since we can’t know for certain) examples of a woman in pregnancy. There is also the theory that they are self-portraits by women looking down at themselves, hence the distortion of view (large breasts, protruding pregnant stomach, tiny legs)

    1. That’s what I was thinking. The pregnant female form and the whole fertility thing have been revered throughout history as the ideal, even if it wasn’t always the norm. This might be partially due to the fact that prehistoric people often went through periods of famine, making a little extra meat on the bones something to be desired. Ideals do change, however. Few of us in civilized countries are ever faced with real famine, and pregnancy is no longer an excuse to pig out for 9 months. Appearances aside, we also know that obesity is unhealthy–regardless of what Paleo people may or may not have looked like. That should be reason enough to keep the fat cells from getting out of hand.

    2. This would make sense, Patty. I had an archaeology professor who gave this theory. He had his wife take a picture of herself (although she wore clothes) using a point-of-view shot of when she was pregnant. The photograph of the professor’s wife did indeed resemble the paleolithic “Venus” figurines.

      1. The problem with this hypothesis is that the figures were carved in the round. Many of them have highly detailed back views, as well as intricate carving of the top of the head that may depict elaborate hairstyles or possibly woven hats. I don’t see how these could be self-portraits made by women without mirrors.

    3. I just recently heard this theory, too, about these being self-portraits of women looking down on their own bodies. It makes sense due to their often having no feet and no heads! So maybe not obese at all, but pregnant, or just distorted.

  4. The problem with the Omega 6 fat study is that linoleic acid is in just about everything. Even when eating a anti-inflammatory diet rich in omega 3s, saturated and monounsaturated fats you’re still getting plenty of linoleic acid. Now unless you’re starving the likelihood of an omega 6 deficiency is rare. Take out the seed/vegetable oils where do you get it? Nuts, seeds, poultry, pork, avocados, olive oil, vegetables, dairy, fruits, even grass fed meats and wild fish contain a little. All of these are un-rancid forms of linoleic acid that contribute to better health. Eating a handful of almonds or a avocado is way different than eating something cooked in soybean oil.

    1. Also the fact (and to underscore part of Mark’s explanation), in a time when existence was more of a struggle than it is today, the larger body type was viewed as belonging to someone with more resources than the thin. In other words, the people carrying the most weight represented wealth and comfort.

  5. “Does a doll with a belly mean the Primal way of eating, living, and moving needs to be reworked?”

    No, it means she is pregnant.

  6. Weight gain and weight loss was all part of the ‘plan’. It is the weight gain weight gain ad infinitum that causes the problem. Weight gain is considered a benefit when starvation is a reality!

  7. Born with a contrarian mind I would suggest a different cause for the fat figurines: They can represent progress, good times, maybe even periods when nomad tribes didn’t have to wander much.

  8. I have always more closely resembled the Venus figurine, myself, even in childhood.

    Lovely, just what I wanted. Don’t care how rare of exciting it is/was for others. Its been a real turnoff to me, to be walking around, or at times running around, with this kind of baggage.

    Also, I have to say that as much as I agree in theory with the Primal approach, neither that nor “paleo” nor any other type of eating/living plan has changed my shape or composition very much. I’ll never really learn to accept it but the older I get, the more thankful I am that I seem to remain (knock on wood) healthier than I expected.

    1. I learned a long time ago that the shape I have even at my thinnest was a “gift” from my ancestors and that helped me to accept it just a little more. When I was reviling my “hip-ature” I was not rejecting my lovely and sturdy grandmother. When I detested my tendency to a double chin, I realized that it helped me to remember my mother.

      I stumbled upon an old photograph of a great-great-grandmother from the Irish side recently. There I saw both the things I like about myself and the things I don’t like about myself. It startled me and reminded me of my long -ago revelation that who I am and what I look like came down through generations. Who am I to complain about what my grand and great-grands gave me.

      That being said, I feel your pain. 🙂

      1. Er, “…I was rejecting my lovely . . .” Sorry for the extra “not” in there.

  9. wow this is bad, wife read the article and now she says she is not fat, she is a figurine. Go figure

  10. For those interested in Venus figurines, I did an analysis as part of my BA Honours’ thesis. I hypothesized that a microevolutionary event between 75,000 and 60,000 years ago, in a small circumscribed population in East Africa, gave modern Homo sapiens an adaptive edge over other human species, by allowing us to lay down really anomalous amounts of body fat. Even a very lean woman with body fat of 18%, barely enough to allow her to menstruate, is very fat compared to all other primates and just about all other mammals – a female chimpanzee in prime breeding condition has 5% body fat, a blue whale 12%! To cut to the chase, I did ethnographic analogy by comparing body shape and waist-to-hip ratio of images of Venus figurines, hunter-gatherer and subsistence farmer women, and western women. The pdf can be downloaded from my webpage:

    Not all paleo art depicts obese women. Men and children are also depicted. There’s a wide range of women’s body shapes and sizes. Excellent photos are provided on Don Hitchcock’s site:

  11. Interesting article! I’m relatively new to the ideas of Primal Living, still trying to understand what’s best and what works for me.

    The questions I find hardest to answer -when challenged- as one invariably is for being slightly offbeat, are along these lines:

    Why follow a diet and lifestyle that left people a good deal less tall than modern humans, gave them only two or three decades of life, and endowed them with considerably smaller brains ? Help, with those questions would be great.

    1. There’s actually a lot of evidence saying once humans adopted agriculture, they began to shrink in stature and their brains began to shrink as well. As far as the short average lifespan goes, this can be attributed to the high infant mortality rate as well as the probably high frequency of serious accidents. Modern day hunter-gatherers have virtually no chronic diseases that would contribute to a shorter lifespan (heart disease, cancer, diabetes, etc.).

    2. Both Mark and Robb Wolf go into that in some detail in their respective books. referring to Jared Diamond and his writing where he suggests that agriculture was “the worst mistake in the history of the human race.” They then present studies from present-day and past-time hunter-gatherer cultures with some interesting comparisons to agrarian cultures.

    3. This is the most common ‘common-sense’ counter argument against the Paleo idea but, as everyone who has done any kind of research on the matter will tell you, it a bit fallacious.

      The height thing is just wrong. Groups of modern humans vary massively in height from an average of below 1.50m to almost 2.00m. Modern Dutch and Scandinavians man have an average height of over 1.82cm, (like the Dinka people of Sudan had 100 years ago), whereas modern okinawan men have an average height of around 169cm; both are healthy populations, the latter arguably more so. Dietary factors in childhood and genetics impact height, height is not evidence of good health, stunting is bad for you, but is something that occurs more often in farming societies than hunter-gatherers. Your paleolithic ancestors were not shorter than modern humans.

      The considerably smaller brains thing is just silly. The increase of size of the human brain occurred almost completely before the neolithic and, although the cooking of starches may have contributed, it is clear that our upper-palaeolithic ancestors were consuming diets that would be given a massive thumbs up by the modern paleo community. A thousand years ago, about half of the world’s population, probably including many of your ancestors, were still living non- or semi-agricultural livelihoods in non-state spaces, but they didn’t have notably smaller brains than their agricultural cousins and were generally healthier by some standards, less so by others. Your paleolithic ancestors did not have smaller brains than you.

      The lifespan thing is also very easy to refute. Hunter-gatherer lifestyles are… well.. dangerous, especially when humans reached a stage of dominance when they were fighting for limited resources with countless other hostile groups. As any paleo-archeologist can tell you, wild animals, mosquito-borne disease, starvation caused by resource competition and warfare were common deaths, heart disease, cancer and diabetes weren’t.

      Your ancestors in the Paleolithic era lived hard lives, but I’d wager the majority lived to at least the age of 40, to have given birth to and raised your next ancestor, some far older. I’d bet they all lived amazing lives and none suffered from dietary based ailments, except for a spot of starvation and food poisoning. Sorry if this seemed like a rant, I’m bored.

    4. Ptolemy, don’t take the nomenclature too seriously. Even if it were possible or remotely desirable, modern-day Paleo doesn’t involve living in a cave, scarfing medium-rare dinosaur haunch. Think of it as eating as close to nature as possible, versus the Standard American Diet of processed and/or junk food. For most of us it means eggs instead of cereal, meat and plenty of fresh vegetables instead pizza or pasta, an apple instead of apple pie. Get the picture?

  12. Just like in Asia, the culture believes that small feet are beautiful and will force them by wearing small wood shoes to stay small, in Europe back then they believe that obecety meant you had wealth and would eat to look fat because it gave you status.. I lived in both continents and that is what people told me.

  13. One of the reasons the ‘venus’ of Willendorf was so named, is that other figurines, with more ‘usual’ attractive attributes had been found nearby. There’s a mix in actual finds.

    While some clearly represent obese or pregnant women. I did see a recent thing on some of the figures. Their proportions were actually distorted in a way that suggested they may have been self portraits. The body foreshortened since they were made with little or no access to reflective surfaces. So the breasts and belly crowd the foreground, the faces are blank or stylized…

    1. This hypothesis doesn’t explain the the highly detailed back views or the intricate carving on the tops of some of the heads. Some Venuses are wearing woven bands of fabric that would not have been visible to the wearer – beneath the breasts, over the shoulders, across the back. The statuettes are carved in the round, and are anatomically correct at all angles. The lack of facial features may reflect an artistic canon rather than self-portraits by women who couldn’t see themselves. Also, the body proportions are very similar to those of women living today. For my honours thesis, I downloaded selfies of women from, sourced historical images of hunter-gatherer and subsistence farmer women, and collected images of Venuses. Both by eye, and by statistical analysis, the range of women’s body shapes and sizes is strikingly similar across the three groups. So, I’d disagree that the tubby Venuses represent distortions caused by a top-down distorted view.

  14. Mark, thank you for this post – I received a similar question while speaking at a conference this week and I’m going to send them this link 🙂