The Primal Blueprint

"So the argument that Cleave made was that we are products of a long history of evolution, and we should eat what we are adapted to eat. Our genes haven’t had a lot of time in the past 10,000 years to come to grips with agriculture, and they’ve had virtually no time to deal with the machine-refining of carbohydrates that has happened since the industrial revolution. In the 1980s this idea was captured in the notion of the Paleolithic diet by a couple of Emory University researchers, and it’s grown into the idea of the Paleo diet. There are a lot of Paleo diet books now. It’s fundamentally a carbohydrate-restricted diet that also restricts some other foods we never ate and that we didn’t evolve to eat, like dairy. I like to refer to them as not-your-father’s Atkins diets – that’s part of their popularity. Mark Sisson did probably the best job of all these books in capturing the essence of the science. He didn’t go too far overboard with ideas that are not well tested, because there are a lot of ideas out there that still haven’t been tested in rigorous clinical trials. He’s got 10 basic ideas, including everything from avoiding the poisons in your diet – which are mainly processed foods, sugars, grains and chemically modified fats – to getting enough sunlight and play. It’s a very good basis to learn the fundamental ideas, to get enough of the science to convince you that this is a healthy diet, or at least a healthier diet than what you’ve been told to eat by the government. Yes, Mark focuses on the insulin connection, which I think is crucial because insulin regulates fat tissue. That’s been known since the 1960s, and all these other disorders – metabolic syndrome and maybe even Alzheimer’s – are all insulin disorders. If you eat the way Mark recommends and the way these other books imply, then you are going to be minimising insulin secretion and eating more like the indigenous populations that never saw Western diets, and the way we evolved to eat over the Paleolithic era. In Japan they’re not eating a Western diet but they’re eating a relatively carb-rich diet. The question is, what’s the difference? One possibility is that this whole hypothesis is wrong. The other hypothesis – which I argued in a New York Times Magazine article in April, “ Is Sugar Toxic? ” – is that sugar is required to create insulin resistance. Our livers didn’t evolve to deal with these large doses of fructose that are dumped on them in the course of drinking a glass of orange juice or a Coca-Cola. So the sugar causes the initial insulin resistance, and then when your body becomes resistant to insulin you have to secrete more insulin to deal with the carbohydrates you’re consuming, and now other carbohydrates become bad too. The Japanese, and East Asians in general, historically ate exceedingly little sugar. In the early 1960s they were eating the amount of sugar that we were eating in the 1860s, back when diabetes appears to have been virtually non-existent here too. In fact, many of the populations that are held up as having the healthiest diets are populations that eat, or at least ate, exceedingly little sugar. There’s the French paradox – the French eat about half as much sugar as we do. The Greeks and the Mediterranean diet analyses of them – particularly the island of Crete where the original Mediterranean diet studies were done – showed that they were eating virtually no sugar. If they sweetened things it was with honey. Not by our standards. Also, we’ve taken these fruits and bred them to be as sweet and juicy as we can, which makes them both easier to digest and increases the fructose content. One of the reasons why I get in trouble with the conventional wisdom people is I argue that if you’re obese or overweight you’re probably not doing yourself any favours by eating a lot of fruit. Before the government and people like Weight Watchers recommend we eat a lot of fruit, they should really do some randomised clinical trials. They can’t just assume that if Adam and Eve ate it in the Garden of Eden then it’s good for us. Look where it got them, anyway. Let me know how it goes. When you switch from eating a carb-rich diet to a carb-poor diet that is rich in fat, you’re switching the fuel on which your body is runs. You’re switching from using carbohydrates for fuel to running on fat for fuel, and usually your own fat too. Which is what you want it to do – you want it to burn your own fat and not have it locked away in your fat tissue. But there can be side-effects to the switch. They’re not deleterious aspects to the diet itself, once you successfully make the switch. But you’ve got to keep an eye out, because often these things happen and then people say that the diet is dangerous. It’s not that it’s dangerous, it’s that you’re literally changing the fuel your body is running on and that can take some fiddling to get right. Yes, many people get something known as the Atkins flu. Not everyone – I don’t know what the numbers are because it’s never been studied, but anecdotally maybe 10% of people. You can get around that by drinking chicken or beef broth. You actually need more salt on these diets, which is one of the many counterintuitive aspects. You just have to have faith that it’s not killing you. You can even get a heart disease risk factor test and test yourself. You can do it now, and then again in a month or ideally three months from now, and see whether you’ve improved or not. I got into it because I was writing these big articles for Science magazine, first on the salt and blood pressure issue. I spent a year on the story, and it won the National Association of Science Writers Science in Society award. While I was reporting, one of the worst scientists I’ve ever interviewed in my life – and given my expertise in controversial science I’ve interviewed some terrible scientists – took credit not just for getting Americans to eat less salt, but less fat and fewer eggs. One of the lessons I had learned from my 15 years of reporting on controversial science was that bad scientists never get the right answer. I put down the phone after I interviewed him, called up my editor and said: When I’m done with the salt story, I’d like to write about fat and cholesterol. If this guy was involved in any substantive way, there’s got to be a good story there. So I started reporting a story that became an article called “The Soft Science of Dietary Fat”. Over a year I interviewed about 120 to 150 people for that one story. While I was doing it, I was up at MIT doing another magazine article, on the mathematics of the stock market. I was interviewing an MIT economist and we got talking about the fat story. He said, “If you’re writing about dietary fat, you’ve got to write about the Atkins diet.” He said he had a colleague at Wharton whose father had lost 200 pounds on this diet. He’s Asian American, and he said that he lost 40 pounds on the diet, basically giving up white rice. So I went back to California and tried the diet as an experiment. I didn’t have kids, I wasn’t worried about killing myself, and I lost 20-25 pounds of my excess weight in six weeks. The weight just dropped off. I didn’t stay on the diet by the way, though I have since gone back to it now that I understand the science. It’s an experience that every nutritionist, every nutrition writer and every obesity researcher should undergo. [Health columnist] Tara Parker Pope had an article the other day in the New York Times Magazine about how it’s impossible to lose weight, how we struggle with it if we’re predisposed [to putting on weight]. You mentioned that you’re a bit chubbier since having children. It’s not that you want to be chubby, it’s just something that unless you starve yourself you can’t get over. As we get older it gets harder and harder. Then you try this other way of eating and the weight just goes away. You’re not hungry, and actually you can eat as much as you want. One argument I make to these researchers is: Just try it, so you know what is happening here, because this should at least make you ask questions that you’re not asking right now. In the past four years, I’ve probably increased the awareness of these issues and ideas, both inside and outside the public health community, a thousand fold. But that means it’s gone from one millionth of the population and the relevant research community caring and understanding these arguments to maybe to one thousandth. I’m actually putting together a non-profit to raise money for research, because there are experiments that I think need to be done that the NIH [National Institutes of Health] is never going to pay for. So we’ll pay for it ourselves. We’re making progress, but the problem is that there’s just so far to go. For example, I’m writing a letter to the New York Times in response to the Tara Parker Pope piece, hoping that we can get several hundred physicians to co-sign it . 200 have so far, after 18 hours up. Yes! The reason you can’t lose weight is because you’re trying to cure a hormonal disorder by starving people. It’s not a disorder of eating too much, and starving people isn’t the cure. In all the studies we’re looking at, that remains the underlying assumption – that the way to lose weight is to starve people. People think its impossible to lose weight and keep it off because they don’t understand why they’re fat to begin with, and they’re using the wrong treatment, not because the hormonal disorder can’t be cured or prevented. It’s like doctors trying to cure bacterial infections with antiviral drugs, and then throwing up their hands saying it’s hopeless because the treatment failed. Get the right treatment, the right intervention, and obesity can be cured and prevented in most people. That’s what I’m arguing."