Friday, March 6, 2009

Can High-Carb, Low-Fat Be Healthy?

Compared to us moderns, many paleolithic and neolithic cultures who ate high-carbohydrate, starchy diets exhibited good health -- full sets of teeth and nicely developed noggins along with an absence of degenerative disease. A few of these cultures include the Kitavans (tubers, fruit, coconuts, & fish), the Kuna (plantain, yucca, kidney beans, fruit, & wild game/fish), and the traditional Peruvians (potatoes, quinoa, & guinea pigs -- seen in Nutrition & Physical Degeneration by Weston A. Price). As somebody who has adhered to a carbohydrate model (ala Taubes) in explaining present-day diseases and ill health, the fact that human beings can thrive on high-carbohydrate diets fascinates me. So let's explore this!

We'll begin by examining some of the obsevations of T.L. Cleave, who wrote an important book called The Saccharine Disease. In this book, Cleave notes that the rural Zulu of Africa (in the 1950s) were in good health on a diet comprised of 90% carbohydrate calories (Matt Stone recently blogged about this subject and sparked my interest). In contrast, the urban Zulu ate less carbohydrates (81%), yet had more diseases than the rural Zulu. Cleave concluded that the amount of carbs being eaten by the two groups didn't matter so much as the types of carbs. This seemed to make all the difference: the rural population ate maize and root vegetables while the city-dwellers consumed refined, industrialized carbs, such as sugar and white flour. Through observations such as this, T.L. Cleave, like Weston A. Price before him, showed quite convincingly that refined foods are the cause of modern degenerative diseases.

But this isn't the entire story. If we are to think critically about Cleave's theory, we find that he oversimplified things a bit too much, lumping all detrimental foods into one category: refined carbohydrates. What this implies is that a person can consume all the whole grains, fruits, and potatoes he or she wants without experiencing the "diseases of civilization": diabetes, obesity, dental caries and crooked teeth, gastrointestinal ailments, heart disease, etc. As long we avoid sugar and refined grains, we'll live in good health, just as the rural Zulu did. Hmmm ... maybe.

While Cleave may or may not have been right about the general nature of refined carbs and their effects on human health, one glaring hitch in his theory is the fact that he overlooked something very simple: the chemical differences in carbohydrate foods and how these differences may be major factors in present-day diseases. In other words, it's not as simple as whole foods vs. refined foods -- it's also a matter of the qualities of the foods. To illustrate this, let's evaluate two of the evils that Cleave proclaims to be the cause of modern man's health demise. On one hand we have white flour: a starch -- also known chemically as a polysaccharide -- which is broken down to glucose in the body. Sugar, on the other hand, is a disaccharide with a significant difference: it's composed of glucose and fructose, which the body handles quite differently than it does starch. Gary Taubes, author of Good Calories, Bad Calories, explains sugar's disaccharide nature in the body:

"The fructose will stimulate the liver to produce triglycerides, while the glucose will stimulate insulin secretion. And the glucose-induced insulin response in turn will prompt the liver to secrete even more triglycerides than it would from fructose alone, while the insulin will also elevate blood pressure apart from the effect of fructose." (p. 201)

The effects of fructose and glucose on the formation of AGEs (junk proteins in the body implicated in age-related chronic diseases) is also interesting. Taubes writes:

"Glucose [alone] ... is the least reactive of all sugars, the one least likely to attach itself without an enzyme to a nearby protein, which is the first step in the formation of AGEs. As it turns out, however, fructose is significantly more reactive in the bloodstream than glucose, and perhaps ten times more effective than glucose at inducing the cross-linking of proteins that leads to the cellular junk of [AGEs]. Fructose [induced-AGEs] ... seem more resistant to the body's disposal mechanisms than ... glucose. It also increases markedly the oxidation of LDL particles, which appears to be a necessary step in atherosclerosis." (p. 201)


Glucose -- the "least reactive of all sugars" -- appears to be the most ideal carbohydrate to consume if we are to avoid disease. Fructose seems to be the worst. Together, as sugar or honey or high-fructose-corn-syrup -- all glucose/fructose combinations -- they are the worst of the worst. It's kind of like putting Vin Diesel and Chuck Norris in an action flick together. Not good. You know somebody's gonna die.

So perhaps it is sugar (more specifically, fructose) and not refined foods like white flour or white rice (starches) that lead to our modern health ailments. It's hard to say for certain which food caused problems when evaluating primitive cultures as Cleave and Price did because, in every case examined, where there was smoke there was fire: white flour and sugar were being eaten at the same time. Yet, if it were all refined carbohydrates that lead to ill health, then how are we to explain healthy cultures on a diet centered around white rice such as the Japanese and Koreans? These cultures also consume animal foods in the form of fish, beef, and eggs -- all cholesterol-rich foods. Yet they have little heart disease. What's missing, which many industrialized cultures consume plenty of, is excessive sugar and high-fructose corn syrup (particularly in the form of soft drinks). Fructose intake in these countries has been very low traditionally, although it continues to grow from year to year.

I was actually in Seoul, Korea recently and noticed that almost everybody was slim and healthy-looking. The only obese Koreans I observed were a few children here and there. As consumption of soda, candy, and other fructose-sweetened products are increasing, displacing the starch calories in the diet, it appears that nation-wide obesity (and its slew of health complications) is on the rise.

With all of this to consider, we are left with a question: is fructose the culprit in present-day chronic disease? A man by the name of Dr. Richard Johnson theorizes that it is. His research strongly indicates this food as the main player in everything from diabetes to heart disease. The more and more I research it, the more I am convinced of such a theory. The Nutrition & Metabolism Society had this to say in a paper on fructose:

The alarming increase in fructose consumption may be an important contributor to the epidemic of obesity and insulin resistant diabetes in both pediatric and adult populations.

And this (italics mine):

A high flux of fructose to the liver, the main organ capable of metabolizing this simple carbohydrate, disturbs normal hepatic carbohydrate metabolism leading to two major consequences... perturbations in glucose metabolism and glucose uptake pathways, and a significantly enhanced rate of de novo lipogenesis and TG [triglyceride] synthesis, driven by the high flux of glycerol and acyl portions of TG molecules coming from fructose catabolism. These metabolic disturbances appear to underlie the induction of insulin resistance commonly observed with high fructose feeding in both humans and animal models.


What I'm getting at here, in a long-winded, haphazard sort-of-way, is this working theory:
  • Fructose in excessive quantities (i.e. standard American diet) is detrimental to human health.
  • Starch alone is not detrimental to human health.
  • A high-carbohydrate, starch-based diet -- that includes animal proteins & fats -- is a viable diet for long-term health.
  • Human beings can thrive on a wide variety of diets -- a high-fructose diet does not seem to be one of them.
All of that being said, there is one important caveat to consider. If a person is already affected by diabetes and/or obesity or some other degenerative condition, a simple reduction in fructose may not provide health improvement. When the metabolism or equilibrium of the body is disturbed in such an unnatural way (theoretically from over-consumption of fructose), starch or any other carbohydrate may exacerbate the condition further. For these kinds of people, a low-carbohydrate diet may be the most therapeutic diet for the long-term.

I'd also like to add that, although fructose -- and not carbohydrates in general -- may be the true instigator in degenerative disease, a high-fat, low-carb diet has advantages that a high-carb diet does not: lipolysis, stable blood sugar, greater satiety, lack of hunger, more "protective" and nutrient-dense foods, and so on.

Not to mention the fact that the more carnivoristic tribes of ancient and contemporary history dispaly greater strength, minimal dental caries, and denser bones compared to agricultural, starch-eating peoples. Here's Dr. Price's observation in Africa:

In contrast with the Masai, the Kikuyu tribe...are charcterized by being primarily an agricultural people... [they] are not as tall as the Masai and physically they are much less rugged... teeth with caries [were] 5.5 percent ... 36.4 percent [of the population]. (pp. 138-139)

Therefore, although it's interesting that human beings can live in good health on a starch-based diet, I'll stick with a low-carb (100 grams or less), diet rich in animal products, thank you!

ADDENDUM TO THIS POST: Stephan from Whole Health Source challenged me on the notion that it is fructose alone that leads to the diseases of civilization. Read the comments section for our debate and witness Stephan -- the master of persuasion -- single-handedly alter my perspective on this issue ...

23 comments:

Stephan Guyenet said...

Ryan,

I think we're on the same page. One more factor I would add is the toxicity of wheat flour specifically. White rice doesn't seem to precipitate the same health effects as white flour when it's introduced to a culture, although as you mentioned it's hard to disentangle white flour from sugar.

I'm with you on the fructose issue. Fructose is one of my main punching bags. I wrote about Dr. Johnson's "fructose index" paper a while back:

http://wholehealthsource.blogspot.com/2008/11/fructose-index-is-new-glycemic-index.html

R K @ Health Matters To Me said...

Yeah, Stephan, I've wondered about the effects of white flour as well. It certainly seems to hurt modern, health-comprimised folks. But as far as it being inherently harmful, I don't know. I read a bit on your blog about lectins (?) in wheat that can lead to disease.

Yet, I still wonder whether it's fructose -- and only fructose -- that is the true instigator in human degenerative disease. It just seems to have a way of disturbing human metabolism to an extent that no other common food does.

Thanks for the link. I'll check that out.

Stephan Guyenet said...

Ryan,

My opinion is that white flour is as harmful if not more so than sugar. There are a few cultures we can look at that have adopted one but not the other.

The Kuna for example, eat a lot of refined sugar (they trade for it) but otherwise eat a fairly mesolithic diet (almost no gluten, not much grain in general). If I recall correctly, they eat more refined sugar than the average American, yet they mostly escape overweight and degenerative disease. In particular, their blood pressure doesn't rise with age.

Then there are societies that have adopted white flour but not sugar. There's an example from a recent epi paper looking at diet habits in China. People who had white rice-based diets had less than half the obesity prevalence of people with wheat-based diets. I wrote about that here:

http://wholehealthsource.blogspot.com/2008/07/wheat-is-invading-china.html

Wheat has not been good to humans from the very beginning. Even archaeological sites from the first wheat-eating agriculturalists show they were generally in poor health.

So I do think both white flour (and probably wheat in general) and sugar are individually problematic. I think that probably applies to most people regardless of the strength of one's digestive system. The combination of both white flour and sugar seems to be especially potent.

R K @ Health Matters To Me said...

Stephan,

I agree that there is something inherently different about wheat when compared to other grains. I've been researching lectins in particular and have found some leads, but nothing really conclusive. Maybe you can point me to some convincing studies.

One interesting study I came across is an evaluation/comparison of Mongolian and Japanese diets and how oxidative stress and body weight seem to be affected by "fruit and vegetable intake" (the conclusion of the authors):

http://www.nutritionandmetabolism.com/content/3/1/21

If you scroll down and take a look at Table 2, I'm sure you'll quickly see that the Mongol populations eat 2-3 times more flour than the Japanese and a minimal amount of rice.

Then, under "Soft and Alcohol Drinks" in the same table, there's quite a bit of soft drink consumption going on in the Mongol diet. As for the Japanese, the table doesn't show. Annoyingly, they lumped all drinks, including sugarless green tea and coffee under the same category, so it's not possible to fully evaluate sugar consumption. (I may post on this study later.)

So I'm definitely open to understanding the metabolic effects of wheat, as it is an implicated factor in ill health all over the world, side by side with sugar. My question is: how much damage does wheat alone cause?

Also, I would also like to know exactly how much sugar the Kuna eat daily. 50 grams? 100 grams? Any good sources for this information? I find it intriguing that these people can consume so much sugar and escape its supposed metabolic effects. Maybe their genetics and otherwise nutrient-rich diet is protective? The question is whether or not later generations of Kuna would be affected metabolically, even though currently nobody seems to have a problem...

Stephan Guyenet said...

Ryan,

Interesting study. I wonder why they didn't do a comparison with the urban Mongols who ate as many fruits and vegetables as the Japanese? Now that would have been a good test of their hypothesis.

As far as conclusive studies that wheat is problematic, I'm sorry to say I don't have any. I just have a lot of indirect data that point in the same direction.

About the Kuna, Dr. Hollenberg reports they eat 25 tsp white sugar per week. That's 3.6 tsp per day, 54 calories, 13 g. I guess that's not that much after all. But it's on top of the fruit they eat as well, about 5 servings per day (mostly mangoes, bananas and plantains). Maybe it's fewer than 5 if you don't count plantains which aren't sweet. Plus they drink a few cups of soda or Kool Aid a week. I can't find any number for total sugars in Hollenberg's papers but it's got to be pretty high. I don't think they're quite as healthy as some other isolated populations but they're definitely not fat Americans either. Hollenberg thinks it's the cocoa flavonols rather than the open-air mesolithic lifestyle!

Anyway, back to wheat. There are a few lines of evidence that make me think it's probably inherently harmful. There are the accounts and studies of cultures being introduced to wheat and sugar for the first time and degenerating to a degree that I believe is beyond sugar's ability to cause.

Then there's the fact that about 12% of the American public has an immune reaction to gluten as judged by anti-gliadin antibodies in the blood. If you look for them in the stool, you find about 30% of people are secreting anti-gliadin antibodies. The percentages are higher if you look in people who have autoimmune disease, digestive disorders or neurological disorders. Then there are preliminary findings that most people may have a non-antibody-mediated immune response to gluten in the gut (inflammation).

Wheat seems to have some unique metabolic effects that other starches don't have. I don't know if you're familiar with Dr. William Davis of the Heart Scan blog, but he's a cardiologist who swears by wheat avoidance for correcting metabolic problems.

Then there's the fact that the two most effective diets for weight loss and overall health that have been studied in controlled trials- low-carb diets and paleolithic diets- both minimize wheat. Paleo diets minimize it to the point of eliminating it, and they seem to be more effective then LC diets.

Again, this is all indirect evidence, but I do feel it points consistently in the same direction. Add to that the fact that nearly everyone I know who has tried avoiding wheat has felt better without it, and I feel inclined to believe it's problematic for most people if not everyone.

R K @ Health Matters To Me said...

Thanks for explaining where you're coming from, Stephan! That gives me plenty of food for thought...

A few comments I'd like to explore:

"About the Kuna, Dr. Hollenberg reports they eat 25 tsp white sugar per week.... I guess that's not that much after all. But it's on top of the fruit they eat as well, about 5 servings per day (mostly mangoes, bananas and plantains). Maybe it's fewer than 5 if you don't count plantains which aren't sweet. Plus they drink a few cups of soda or Kool Aid a week. I can't find any number for total sugars in Hollenberg's papers but it's got to be pretty high."

To me, it would seem that the fructose content in their diet is still very low compared to Americans and other nations where diabesity and other ill-health is prevalent.

Here's a nice little chart showing fructose content of various foods by Cordain:

http://www.thepaleodiet.com/nutritional_tools/fruits_table.html

Mangos: 7.9 grams fructose per 100 grams

Bananas: 6.0 g fructose per 100 g

An average mango is around 207 grams, according to a nutrional analysis I came across.

An average banana is 120 grams.

So eating 2 mangos and one banana (and the rest of the fruit we'll say are plantains), that's approximately 17 g fructose from the mangos and maybe 7 g from the banana.

Then we add in 3.6 tsp of sugar (or around 18g) with 9 g of fructose.

GRAND TOTAL FRUCTOSE CONSUMPTION BY THE KUNA: 33 grams!

That is far fewer grams of fructose than any American soda-drinking, candy-bar eating person consumes daily. You may find that I miscalculated though.

Jimmy Moore, who I think balooned up to like 400 pounds, did so by drinking A DOZEN sodas a day (as he mentions in an interview with Dr. Johnson). At 13 tsp sugar per 12 oz. soda, that's 300 grams fructose! I would think that most people that gain that kind of weight would have similar eating habits.

I wonder if anybody out there ever gained weight and developed diabetes by eating a low-fructose, high-starch diet ...

And about the wheat: there's no doubt that wheat is harmful to modern people who are very unhealthy when compared to the primitives. The tests that you mentioned were all done on moderns -- and the American people, no less. I wonder whether or not it's the wheat or the substandard health of the subjects that's causing the problems?

Low-carb diets and paleo diets also significantly reduce fructose consumption in addition to wheat.

I'll look into Dr. William Davis.

If only we had the means to truly test our theories, Stephan! At this point, either one of us could be right. Or both of us!

Stephan Guyenet said...

Ryan,

I admit the Kuna sugar intake based on that Hollenberg paper doesn't seem to be as high as I thought. But you forgot to add in the roughly one soda/Kool aid-type drink per day, another 41 grams of sugar. That brings them up past 100g of sugar per day, say 110 g. That's 440 calories, compared to the average American eating just under 500 calories. Americans might get a little more of that as fructose due to half of it coming from HFCS. So I suppose the Kuna don't eat more fructose than us, but not far off either.

I have no doubt that excessive fructose is a metabolic poison, and I'm not arguing that it's not. All I'm saying is I don't think it's capable of causing the full blown array of "diseases of civilization" without its good pal white flour (and even worse with polyunsaturated vegetable oil).

Paleo diets don't necessarily reduce fructose. The latest paleo diet trial I posted about on my blog used a diet high in fruit and juices and saw remarkable improvements in supposedly healthy individuals. It was a short trial and I doubt that amount of sugar is best in the long term, but it certainly didn't impede some big improvements in insulin sensitivity despite increasing caloric intake. I believe the improvements came mostly from avoiding wheat and processed junk in general (except mayo- how paleo of them!).

I'm not 100% confident in the wheat theory, but at this point it seems to fit all the data better than any other theory I have.

R K @ Health Matters To Me said...

"But you forgot to add in the roughly one soda/Kool aid-type drink per day, another 41 grams of sugar."

Oops! Sure did. And that brings the grand total of fructose consumption to 54 grams. Still not anywhere near what unhealthy Americans and natives living on gov't supplies are consuming. It isn't fructose per se that leads to degenerative disease, IMO, but *excessive* fructose. Like Jimmy Moore with his 12 sodas a day.

Wheat, as you've explained in your blog, may compound the problem by creating an artificial hunger of sorts, which can lead to overeating.

"All I'm saying is I don't think it's capable of causing the full blown array of "diseases of civilization" without its good pal white flour (and even worse with polyunsaturated vegetable oil)."

Fair enough, sir! That's a valid position to have seeing as industrialized foods always come in one neat little package. But I myself always prefer the simplest theory -- Occam's Razor -- over more complex theories. Which is why I prefer to label fructose as the prime suspect, not wheat AND fructose. I'm a big fan of isolating factors and testing before complicating things with multiple factors.

There is quite a bit of data showing the detrimental effects of fructose. Wheat ... not so much. Until more studies come out, we may have to agree to disagree on this subject.

As for the Paleo diet trial, that's interesting that they consumed lots of fruit and juices. How much exactly? (I don't have access to the article besides the abstract.)

Like you, I'm not 100% confident in the fructose theory of disease, but it seems to be the most plausible that I've come across.

Thanks for the engrossing debate, Stephan! I'm learning a lot.

Stephan Guyenet said...

In the paper they don't specifically list the sugar content of the diet, unfortunately. But they do list the total amount of carbohydrate, which is 249 grams (about the same as their usual diet). Looking at the menu, the starchiest thing they ate was parsnip, which has a ratio of starch to sugar of about 2:1. Most of their carb calories came from sugar: honey, fruit, and a buttload of carrot juice. Those foods are all typically about half fructose by calories. Dr. Eades posted a copy of their menu if you want to take a look:

http://www.proteinpower.com/drmike/saturated-fat/rapid-health-improvements-with-a-paleolithic-diet/

I think we can safely assume they were eating at least 150 g of sugar, which is more than the average American. And their sugar intake definitely increased relative to their normal diet, since their total carb intake remained the same despite the fact that it was mostly from sugar during the intervention.

R K @ Health Matters To Me said...

Wow, that's really interesting. I have often wondered about the effects of fructose in fruits as opposed to the fructose in HFCS and sugar. It's fascinating that the participants health parameters improved despite eating the same number of carbs and sugars as their previous diet. I wish I could pick over the study myself, but I trust your assessment, Stephan.

That definitely challenges the theory of fructose being the problem by itself. Well done!

The only significant change in diet I can see in the study is exactly what you observed: no grains. Especially *no wheat*. If wheat truly does affect insulin and overall metabolism in a negative way, then this would explain some of the results.

Or maybe the vitamins and "whole" nature of the fruit products prevented a problem with fructose...? But this isn't a satisfying answer in my book.

I've been reading up on Dr. William Davis, and his clinical experience with wheat reduction certainly seems to indicate this food as a prime suspect in disease. Thanks for pointing me to his research.

So wheat does cause some sort of physiological disturbance in the body that goes much further than a food-intolerance-type reaction into the realms of insulin, appetite-control, and apparently heart disease (from what Williams writes about).

Then again, Dr. Johnson's experience has been the same results by reducing fructose and never even mentioning wheat.

So is it a matter of reducing one or the other (fructose or wheat) to improve health? Or both?

Maybe both act synergystically, as you suggested, to create an overall state of ill health. Kind of like the Egyptian diabetic Pharoahs eating wheat and honey.

Crud, now I need to amend the blog post that started this whole discussion!!!

Curse you, Stephan, and your infinite logic!! :-)

Stephan Guyenet said...

I don't think Dr. Johnson is wrong, I just think he's too focused on one thing.

Wheat was around before we got fat in the US, and before CHD became a significant killer too. I think the real problem is the synergism between wheat, sugar and excessive n-6 polyunsaturated fats (and probably some other things like trans fats, chemicals etc). Removing one variable definitely helps, but removing all three is better.

Also, I haven't ruled out the possibility that there's a difference between natural sugar and refined sugar. I doubt it, but there aren't any data that I've found to say conclusively one way or the other. If you believe Dr. Johnson's theory that uric acid is the culprit, then it doesn't matter whether the fructose comes from fruit or Pepsi.

Also, I just wanted to add that the paleo diet trial was pretty short, so I'm not convinced that way of eating is best in the long term. I think getting the same amount of carb from starchy tubers would be better. Art DeVany is big on getting carbs from fruit and avoiding sat fat, but despite his excessive bravado, he doesn't look as good as my baguette and butter-eating grandfather did at his age.

R K @ Health Matters To Me said...
This comment has been removed by the author.
R K @ Health Matters To Me said...

Good stuff, Stephan. I can agree with all of that. I especially agree that a starch-based high-carb diet is much healthier in the long-term than one based fruits. And, as to the synergism between excessive fructose, wheat, and polys, how this may lead to the destructive pattern of the diseases of civilization moreso than any alone.

However, as you mentioned about your grandfather, who ate baguettes and butter, there is a bit of a paradox to the idea that white flour in and of itself causes metabolic disturbances -- the French. Here is a population that is known to be far healthier than Americans, yet they consume their fair share of white flour. Perhaps the difference is that these folks eat proper fats and traditional foods and don't suffer from unnder-nutrition the way that your typical American might. As I said earlier, wheat may be detrimental to those who consume nutrient-poor diets, but NOT to those whose diet contains protective foods, rich in fat-soluble vitamins.

This would explain the reason why the cultures of Price's studies degenerated so quickly: under-nutrition coupled with white flour consumption lead to improper absorption/assimilation of this food. In other words, a damaged body cannot handle the white flour the same way that an adequately nourished one can, and metabolic effects will soon follow.

This would also explain the honey-addicted Egyptian pharoahs who presumably ate a nutrient-poor diet coupled with wheat consumption and were affected by diabetes and obesity, even though -- as you mentioned some other time -- they were consuming sourdough bread.

I've read little bits and pieces of preliminary research suggesting that glucosamine somehow protects the body from the effects of lectins in wheat and other foods. I wonder whether fat-soluble vitamins and/or certain foods can do the same.

So maybe it's the *abscence* of certain nutrients that allows wheat to do its thing...

Stephan Guyenet said...

Ryan,

The French are only healthy when you compare them to Americans. They have plenty of health problems over there too. My grandfather died of gastric cancer. I do think the traditional fats protect them somewhat, but not completely.

Jeff Consiglio said...

Regarding the Egyptians. Were the unhealthy ones from the ruling class, who could presumably afford a luxury like honey? Or did they find the "lower classes" of ancient Egyptians to be equally unhealthy?

I would love to think a person does not have to go to the "extreme" of a low-carb diet. That merely going back to a neolithic diet (as opposed to an modern, industrial diet) would suffice, and allow much broader range of food selection, thereby facilitating dietary compliance in the long term.

But what little I've read of those ancient Egyptians health, always makes me not so sure of that notion.

R K @ Health Matters To Me said...

Hi Coach Jeff,

My stance on the ancient Egyptians' health is that the entire population was below the bar. While the upper class had access to just about every food category there is -- meat, fat, honey, fruit, grains, etc. -- the lower class would have subsisted largely off of grains. It's my understanding that, while the ruling class had access to meat, it was not consumed in great quantities. Perhaps due to the abundance of sugars and alcohol in the diet, the upper class would have experienced ill health in the form of rotting teeth, diabetes and obesity. The lower class would have suffered more from diseases of undernourishment, such as bone loss, lowered immunity, and the like. My guess is that many pharoahs were sugar and beer addicts and consumed large amounts of these foods. Why? Because they could!

The situation in ancient Egypt, with its division of classes, would have looked very similar to ancient Mayans or Aztecs -- both civilizations in which the ecological environment was one of dwindling animal foods due to overpopulation. All ancient civilizations which did not exercise population control -- a common practice in primitive cultures (i.e. infanticide) -- and turned to agriculture to support the nutritional needs of the populace experienced ill health as a result of nutritional deficiencies.

So, I would say a high-carb diet, if eaten, should include adequate proteins and fats. Protein at around 10-12% of the diet seems to be the rule of thumb in most cultures. Fat percentages range all over the map (10-80%). My opinion -- based on primitive cultures -- is that a high-carb diet should also be starch-based (barring white flour, of course).

Inadequate protein (i.e. a grain-based diet), as in the case of the lower class Egyptians, and/or too much sugar (fructose really), as in the ase of the Egyptian ruling class, appear to be the extremes to avoid. Neither will hurt you in the short term, IMO, but over time eaten consistently, will have detrimental effects.

(BTW, sorry it took so long to reply. My job situation is 8-day shifts in the wilderness -- no internet -- with 1 or 2 weeks off in between.)

undertow said...

Ryan,
Late to the party on this one, and there have been many discussions on 180 and else where about wheat.

What are your thoughts on fresh ground wheat berries, ie to make homemade bread/pancakes/cookies compared to white flour.

I kept gluten out of my diet for over a year, and just recently added back wheat in the form of fresh ground wheat berries, digestion seems to handle it well so far, but it is by no means a staple yet :)

R K @ Health Matters To Me said...

Hi undertow,

Sorry for the late reply -- I've been traveling a lot lately and have been away from blogging for a few weeks.

Yeah, wheat is a hot topic of debate, particularly within the paleo diet crowd. I had a discussion with Dr. Harris over on his blog, PaleoNu, a while back about it, and, of course, wheat is a true dietary evil in his opinion (along with any other neolithic food out there).

My opinion as of late is that fresh ground wheat is in a league of its own and cannot even compare with the rancid, nutrient-deficient white flour that harms most people. These are two completely different foods.

As Matt has pointed out, many cultures have subsisted on freshly ground wheat berries as one of their staples without the ill effects that white flour is associated with. That being said, our modern bodies may not be able to handle gluten in any form due to many years of poor nutrition and, as a result, lowered immunity. The lowered immunity is most likely from our physical degeneration, of which a lowered metabolism -- Matt's # 1 culprit in modern disease -- could certainly be a part.

In a nutshell, listen to your body. I recently met an indigenous man from Ecuador who was raised on wheat, quinoa, and corn as staples, all home-grown and freshly prepared. His facial structure and teeth were quite impressive (I'll post the interview I did with him soon). I believe freshness of food has a huge impact on health and disease.

That being said, I avoid gluten just to be safe, even the fresh stuff.

Wati said...

Hello, I just came across your blog through your comment on PaNu. I enjoy reading it and feel like commenting on this entry.

Regarding your remark about the low rates of obesity and heart disease in Japan despite eating a high carb diet that includes polished white rice (and also a lot of white bread), yes it's true, but it is also common to see crowded teeth here. I'm not Japanese but have been living here since 2000, and after reading Weston A. Price, now I understand why Japanese have crowded teeth. I have a crooked tooth myself. I've also noticed bowed legs especially in young girls, I'm not sure if it's the genetic make-up or is it because of their or their parent's diet, and why only happens to girls, not boys.

While I don't have any statistic to point, stomach cancer is one of the common illnesses in Japan, along with other maladies.

Looking at the photos in Price's book, the people who had bad teeth were not obese and yet they were not healthy.

In my opinion, if there is a lack of essential nutrition, whether you're fat or thin, it's just a matter of time before an illness or imperfection to the physical form develops (as in my case a crooked tooth).

R K @ Health Matters To Me said...

Hi Wati,

I agree that, even though Japanese don't seem to suffer much from obesity and heart disease, they have other forms of ill health that aren't necessarily any better.

When I visited another Asian culture, the Koreans, I noticed that the only people who appeared to be overweight were the children. Soda and candy and pastries are all quite recent additions to their diet, and I think these foods are going to bring about disease in the form of obesity and diabetes just as they do in the Western world.

And you're right. Weight isn't the prime indicator of health. A person's teeth can say a lot about their health and the foods they may have been raised on. I believe that a traditional Japanese diet (all parts of fish, rice, seaweed, etc.) is a healthy diet to replicate. A modern one most certainly is not.

Thanks for the comment!

elhnad said...

didn't get to read the whole comments section since i wanted to write this in before i forgot it, but why is it that you don't buy in to fructose-in-whole-foods as being protective than fructose isolated. Are there not a many civilizations that eat a ton of fruits and fat. Surely eating fructose in conjunction with all the cofactors found in its whole counterpart might have a balance in the equation that a scientist only looking at a few chemical processes might not find.

good post by the way.

R K @ Health Matters To Me said...

Hi danh,

I've changed my position on this. I believe there is something inherently harmful in fructose that is biochemically manufactured -- i.e. HFCS, crystalline fructose, etc. However, honey and fruit have never scientifically been shown to cause ill health to folks who are otherwise physically nourished (in fact, some studies suggest the opposite), so I cannot conclusively say that these natural forms of fructose are actually a problem.

That being said, some folks with extreme metabolic problems may not do well with even natural fructose. The root of these metabolic problems, in my opinion, are nutritional deficiencies and epigenetic inheritances from the mother and possibly the father, which make a person more susceptible to health problems. It's possible that these issues can be reversed over time through proper diet and supplementation.

As of right now, I personally have no problem eating fructose from honey and fruit -- even juice. All I can say to others is: eat real foods to satisfaction and listen to your body!

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