Diseases of Civilization

Historical observations primarily from colonial and missionary physicians administering to populations prior to and coincidental with their first substantial exposure to Western foods, as well as anthropologists.

This dietary transition inevitably included carbohydrate foods that could be transported around the world without spoiling or being devoured by rodents on the way: Sugar, Molasses, White Flour, and White Rice.

The Diseases of civilization or Western diseases would appear: obesity, diabetes mellitus, cardiovascular disease, hypertension and stroke, various forms of cancer, cavities, periodontal disease, appendicitis, peptic ulcers, diverticulitis, gallstones, hemorrhoids, varicose veins, and constipation.

People groups around the world who ate traditional diets did NOT have these diseases. When ANY diseases of civilization appeared, all of them would eventually appear, they appear in a tight cluster.

This led investigators to propose that all these diseases had a single common cause - the consumption of easily digestible, refined carbohydrates. The hypothesis was rejected in the early 1970s, when it could not be reconciled with Ancil Keys' hypothesis that fat was the problem (an attendant implication of which was that carbohydrates were part of the solution). 

Heart Disease

Ancel Keys - his scientific abilities arguable. He became convinced that the crucial difference between those with heart disease and those without it was the fat in the diet. He wasn't taken seriously for a long time, but was one of the chief advocates. In 1957 the AHA opposed Ancel Keys on the diet-heart issue.

Less than four years later, the evidence hadn't changed, but the committee members and their recommendations had.

From the 1950s onward, researchers worldwide tested Keys' hypothesis. 2 decades of research absolutely convinced half; the other half still remained unconvinced. Why? Opposing philosophies. The skeptics were rigorously scientific. The proponents felt the need to "do something", luxury to wait for "proof".

The McGovern Report - the creation of consensus. 1977 publication of Dietary Goals for the United States was the first comprehensive statement by any branch of the Federal Government on risk factors in the American diet. All hell broke loose, even the AMA argued against the recommendations to decrease fat increase carbs.

Philip Handler, president of NAS testified: "What right has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good? Mr. Chairman, resolution of this dilemma turns on a value judgment. The dilemma so posed is not a scientific question; it is a question of ethics, morals, politics. Those who argue either position strongly are expressing their values: they are not making scientific judgments."

Still no consensus, but once the government began advocating fat reduction in the American diet it changed the way many investigators in this science perceived their obligations - now they seemed to consider their obligation to be that of reconciling their study findings with current programs of prevention.

French-Italian-Spanish-Japanese paradox - Increases in fat consumption coincident with decreases in heart disease

In 1986, Japanese physicians were advising patients to raise their cholesterol, because low cholesterol levels were linked to hemorrhagic stroke

After 30 years of Framingham study, disturbed to find if low cholesterol does prevent heart disease, then it must raise the risk of dying from other causes!

As for women, if anything, the higher their cholesterol, the longer they lived.

Cholesterol was the first easy thing to measure, but as the measurement technology became increasingly more sophisticated, every one of the complications that arose has implicated carbohydrates rather than fat as the dietary agent of heart disease. Total cholesterol is not a risk factor for heart disease at all. Low HDL, high triglycerides, obesity and glucose intolerance are, but by the late 1980s when they figured this out, heart researchers were committed to low-fat diet.

Polyunsaturated fat was big for a while, but started to lose popularity when implicated strongly in cancer. In 1985, they reached a compromise in monounsaturated fats, focusing on the fats in diet, not carbs. (Monounsaturated fat raises HDL and lowers LDL.) 

Ironic: the principal fat in bacon, red meat and eggs is monounsaturated!! 

Until 1960 we had no real way to measure insulin in the blood. When they did, they were surprised by what they found: Adult-onset Type 2 people had higher levels of insulin -- it had been assumed they had a lack. In the 1930s, high fat diets were prescribed to diabetics, and Yale showed that it did not increase cholesterol. By 1962, triglycerides had increased 40%; there was increased atherosclerosis in diabetics, from 10% to 56%. This coincided with the diet now recommended, which featured double the carbs and low fat.  

Despite nearly a century's worth of therapeutic innovations, the likelihood of a diabetic's contracting coronary artery disease is no less today than it was in 1921, when insulin was first discovered.

Cognitive dissonance - the tension that results from trying to hold two incompatible beliefs simultaneously.

In 1975, a seminal analysis of diet and cancer reported that the higher the sugar intake in different nations, the higher both the incidence of and mortality from cancer. Epidemiologists still fixated on the fat-cancer hypothesis. 

In the late 1970s, to study the potentially deleterious effects of sugar in the diet was to endanger your reputation!

Raising blood sugar increases the production of reactive oxygen species (AKA oxidants/free radicals) and AGEs (advanced glycation end-products), both of which are equally toxic. 

Alzheimer's is another disease of civilization. Type 2 diabetics have twice the risk, and diabetics on insulin have four times the risk of Alzheimer's! AGEs

Cancer is a disease of civilization, and remarkably uncommon in people eating traditional diets. The WHO concluded in 1964 that most human cancer is preventable (70-90% preventable) 

By the end of the 1990s, trials and large studies showed the dietary fat and fiber hypothesis of cancer is almost assuredly wrong. They failed to confirm that red meat plays any role, and failed to identify any diet-related carcinogens or mutagens to account for any of the major cancers. 

Sugar intake in international comparisons to be positively correlated with both the incidence of and mortality from most cancers, mostly ignored.

Tumors can survive by fermentation, burning 30x the blood sugar of normal cells. Insulin is a promoter of growth and proliferation in healthy and malignant tissues.

Insulin is the primary regulator of fat, carbohydrate, and protein metabolism. Eventually, insulin's effects on disease have come to be accepted. But authorities interpret the evidence while ignoring the unique ability of refined carbohydrates to elevate insulin! 

The fiber hypothesis got accepted pretty well worldwide, quite quickly, but it has gradually been disproved.

Hypertension is also a disease of Western civilization. Salt hypothesis has in no way been proven, but it is known that carbohydrates/insulin cause the body to retain water.

Dental cavities the chronic-disease equivalent of the canary in the mine.

Obesity is the most widespread form of malnutrition in industrial countries.

The belief in physical activity as a method of weight control is relatively new, however, and it has long been contradicted by the evidence.

Conservation of Energy - the 1st Law of Thermodynamics - "a calorie is a calorie"

Change in energy stores = Energy intake - Energy expenditure

Fundamental error: observe correctly that positive caloric balance must be associated with weight gain, but then assume without justification that positive caloric balance is the cause of weight gain.  

Children do not grow because they eat voraciously; rather, they eat voraciously because they are growing.

Luxuskonsumption - spendthrift metabolism that wastes excess calories

Genetics determines our propensity to put on weight, but those genes have to be triggered by an agent of diet or lifestyle to explain the association of obesity with poverty, the present obesity epidemic, and the emergence of obesity in recently Westernized populations. Nature and Nurture. 

Alternative hypothesis constitutes three distinct propositions. 

1) Obesity caused by regulatory defect in fat metabolism - defect in distribution of energy rather than imbalance of intake and expenditure. 

2) Insulin plays the primary role in this fattening process

3) Carbohydrates, especially refined carbs are the prime suspects in the chronic elevation of insulin; hence the ultimate cause of common obesity

(The latter 2 propositions have never been controversial, but they've been dismissed as irrelevant to obesity, given the ubiquitous belief that obesity is caused by overeating!)

Lipophilia "love of fat" - local body areas differ in fat amount -- extreme is Lipodystrophy

Fat tissue is NOT inert. Fat cells are interlaced with blood vessels and nerves, and it is in a continual state of flux. Fatty acids are continuously slipping from the fat tissue into circulation, and if they aren't taken up and used for fuel are continuously being reconverted to triglycerides and transported back to the fat tissue for storage. Principle regulator is insulin. All other hormones will work to release fatty acids from the fat tissue, but the ability of these hormones to accomplish this job is suppressed almost entirely by the effect of insulin and blood sugar.

Nicotine may be the most successful weight-loss drug in history.

The perceived taste of sweetness is sufficient to stimulate insulin secretion! Or in some people, even just looking at or thinking about food!
The reflexive release of insulin anticipates food, even no calorie sugar substitutes. All this, too, can lead to increased consumption and possible weight gain.

The biggest changes in our diet in the past few hundred years has been the increasing refinement of carbohydrates, and the dramatic increases in fructose consumption that came as the per-capita consumption of sugars - sucrose and now high-fructose corn syrup increased from less than ten or twenty pounds a year in the mid-eighteenth century to the nearly 150 pounds it is today. WHY would a diet that excludes these foods specifically be expected to do anything other than return us to "biological normality"?

Carb-restricted diets do not restrict green vegetables, only starchy food, refined grains and sugars - AKA those foods without essential nutrients.
Calorie restriction cuts ALL nutrients. Carb restriction keeps those nutrients (vitamins, minerals, etc).

American diet today - 140-150 pounds of sugar and HFCS / year, nearly 200 pounds of flour and grain, 130-plus pounds of potatoes, and 27 pounds of corn.

MATERIALS
Good Calories, Bad Calories by Gary Taubes

Nutrition and Physical Degeneration by Weston A. Price

Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats by Sally Fallon

Eat Fat, Lose Fat by Mary Enig and Sally Fallon

The No-Grain Diet  by Joseph Mercola

Fat Head - documentary movie by Tom Naughton (rebuttal to SuperSize Me)