Dr. Loren Cordain Interview Part Two
October 7, 2010 Written by JP [Font too small?]In part two of my interview with Dr. Loren Cordain, I’ll turn the spotlight on the most recent scientific developments regarding Paleolithic nutrition. Dr. Cordain shares some insights about using a traditional diet to manage autoimmune diseases. He also comments on a current batch of “modern day Paleo diets” and describes what he’d like see in future scientific investigations. We’ll even get a sneak peak into his forthcoming book, The Paleo Diet Cookbook.
JP – You just co-authored a paper in the British Journal of Nutrition which estimated the macronutrient and fatty acid composition of an East African Paleolithic Diet. Several recent studies have attempted to replicate a paleolithic-style diet in the context of controlled trials involving diabetics and healthy volunteers. What is your impression of those interventions?
Dr. Cordain – These are the very first pioneering studies which show modern day “Paleo” are more effective than so-called healthy diets such as the Mediterranean diet in improving blood lipid and other health parameters. I suspect that more and more randomized controlled trials will be conducted on Paleo diets to show their therapeutic effects. Particularly exciting is their role in preventing or ameliorating autoimmune diseases. (1,2,3,4,5)
JP – On your website, you offer a program which “may slow or even ameliorate symptoms of M.S. (multiple sclerosis) in some patients”. Can you please describe the basis for that work? What kind of response have you received from patients and physicians who have adopted the program?
Dr. Cordain – Except for celiac disease, no good randomized controlled trials of Paleo Diets have yet been tested in other autoimmune diseases. However, it is increasingly being recognized by immunologists that a leaky gut may be a universal dietary trigger of autoimmunity. Multiple elements in the typical western diet cause increased intestinal permeability (lectins, saponins, gliadin, alcohol, capsaicin, thaumatin like proteins). Because the Paleo diet is generally free from foods (wheat, all grains, potatoes, legumes and all beans, capsaicin containing chili peppers) that contain these substances and other foods (dairy) known to be associated with autoimmune diseases, it likely will improve or prevent certain autoimmune diseases.
JP – Is there a place for nutritional supplements in a paleolithic diet? If so, are there certain supplements in particular that are more congruent with your philosophy than others?
Dr. Cordain – As I have pointed out in my paper (Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24.), modern day Paleo diets are incredibly nutritionally dense and supply 2 to 7 times the DRI (Dietary Reference Intake) for all vitamins and minerals except vitamin D. In contemporary diets vitamin D is fortified in margarine and milk which are not components of the Paleo Diet. Hence, unless you get regular sun exposure, vitamin D should be supplemented. To achieve optimal blood concentrations of vitamin D (40-70 ng/ml) without sunlight exposure, it is necessary to supplement with at least 2,000 IU per day. If you don’t like to eat fish then fish oil supplements (EPA and DHA) should be taken. (6)
Modern “Paleo” Diets Improve Various Risk Factors in Diabetics
JP – Are some dairy products and grains worse than others? Do you believe it makes any difference whether these foods are eaten in fermented, organic, sprouted and/or unrefined forms?
Dr. Cordain – As I have pointed out in my paper (Loren Cordain, S. Boyd Eaton, Anthony Sebastian, Neil Mann, Staffan Lindeberg, Bruce A. Watkins, James H. OโKeefe, Janette Brand Miller. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54.) grains and dairy are nutritional lightweights when compared to calorically matched samples of lean meats, seafood, fresh fruits and vegetables. Hence inclusion of these food groups into the diet will make the diet less nutritionally dense by reducing its vitamin, mineral and phytochemical content. Additionally dairy products and milk in particular (whether whole, skimmed or fermented) is highly insulinotropic and has been demonstrated to cause insulin resistance in children while simultaneously increasing free IGF-1, a risk factor for many epithelial cell cancers (breast, colon and prostate). Wheat is perhaps the worst of all grains. Recent work from Alessio Fasano’s group has shown wheat increases intestinal permeability in all people — not just celiac patients. A leaky gut likely promotes chronic low level inflammation which drives cardiovascular disease, cancer and autoimmune diseases. (7,8,9,10)
JP – If money were no object, what type of study would you most like to conduct on paleolithic nutrition?
Dr. Cordain – A long term (2 year) randomized controlled trial of the Paleo Diet in a variety of people with common health issues (the metabolic syndrome, autoimmune disease, certain cancers, mental problems, acne, gastrointestinal disease etc.). It would be interesting to contrast the Paleo Diet to other diets such as the USDA Food Pyramid, the American Heart Association Diet, Atkins, the South Beach Diet, Japanese Diets, Mediterranean, etc.
In addition to answering my questions, Dr. Cordain was kind enough to send over a list of Paleo-style breakfast, lunch, dinner and snack ideas contained in his upcoming cookbook, The Paleo Diet Cookbook. The menu items appear quite varied. For breakfast, one might consider having “Fired Up Steak and Eggs” with a side of fresh cucumber spears. A proposed lunch offers up lighter fare: “Nopales Cactus Salad”, sliced mango and herbal tea. Dinner could be composed of a “Fajita Stir Fry”, “Arugula Avocado Salad” and steamed asparagus spears. Snack options include select fruits (ex. Asian pears) and nuts (ex. raw walnuts). And to drink? Herbal tea, mineral water, red wine and water with lemon juice top the list.
I want to sincerely thank Dr. Cordain for taking the time to share his breadth of knowledge about traditional eating with us. This is an area that I think deserves serious consideration as we, as individuals and societies, examine how we should be eating. Learning everything possible about the productive and destructive practices in our past can only lead to a more enlightened and healthier future.
Note: Please check out the โComments & Updatesโ section of this blog โ at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Acne, Milk, Multiple Sclerosis
Posted in Interviews, Nutrition
October 8th, 2010 at 2:09 am
Good morning, JP ๐
very interesting and Dr. Loren affirms my impression, that diary products are not the healthiest ;-). Supporter of the Mediterranean Diet push the intake of legumes and beans i.e. tasty black balsamico lenses etc. and i thought the nutritional density is ok, what should i do now? Should i avoid eating them? I eat them in small portions and not very often.
If you try to follow the diet, could you please post some delicous inspiring paleo recipes? Would be great ๐ ๐
Greetings from the far far side ๐ ๐
Nina K.
October 8th, 2010 at 2:22 am
Me again ๐
have a question: do you know if squash is healthy – in order to the paleo diet? what is the carb count of hokkaido or butternut squash? i don’t find exact values of that ๐
Thx so much ๐
Nina K.
October 8th, 2010 at 3:11 pm
good 2nd half, although i disagree with the raw dairy, love it. i dont think carbs are as important as people seem to think they are.
i wish he would conduct a study on eating disordered individuals(binging to anorexia and in between) fed a HIGHLY(like organ/marrow etc) nutritious paleo diet and see if it doesnt cure them beause it has more than done wonders to meand i dont know how to promote it!
October 9th, 2010 at 2:03 pm
Nina,
I’ll post some Paleo-friendly recipes in the coming weeks. ๐
Re: legumes
You’ve probably read this column in the past (below). If not, this offers some pretty recent data about the pros and cons.
https://www.healthyfellow.com/430/are-legumes-healthy/
I’m not as much of a purist as Dr. Cordain re: dairy. At least not currently. For instance, I’ve recently reported some data that indicates that cultured dairy has a much milder impact on blood sugar and insulin.
https://www.healthyfellow.com/644/buttermilk-honey-custard-recipe/
Be well!
JP
October 9th, 2010 at 2:07 pm
Nina,
They’re not very low carb. However, they are nutrient dense and contain a fair share of dietary fiber. Their glycemic load is also quite reasonable.
http://www.whfoods.com/genpage.php?tname=nutrientprofile&dbid=134
http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2648/2
Be well!
JP
October 9th, 2010 at 2:10 pm
Mallory,
IMO, one of the best ways to promote it is exactly how you’re doing it: by being a living example! Share your success wherever you can. Together, all our individual voices can make a difference! ๐
Be well!
JP
October 10th, 2010 at 5:23 am
Good morning, JP ๐
thx for your answer. I’m looking forward for the paleofriendly recipes ๐ โผ i’m excited…
Have a great weekend!
Nina K.
October 10th, 2010 at 10:50 am
Enjoyed the two-part interview. This new dietary approach makes sense to me, and I’m trying to figure out how I can incorporate it into my lifestyle.
Thanks JP!
October 10th, 2010 at 12:48 pm
Thank you, Nina! I hope you a wonderful weekend as well! ๐
Be well!
JP
October 10th, 2010 at 12:48 pm
Thank you, CW! ๐
Be well!
JP
October 11th, 2010 at 11:46 am
Thank you for these excellent interviews.
I still cannot understand why red wine is suggested in anyone’s diet. I have read your post on it and remain unconvinced that it is a good source of fuel! Surely there are other ways to achieve similar benefits without alcohol ?
I find it hard to keep reading of its promotion within Paleo lifestyle as if it’s the greatest thing. Doesn’t it burn like sugar/white bread ?
October 11th, 2010 at 12:07 pm
Linnea,
Red wine doesn’t carry a similar glycemic load as sugar or white bread. It’s actually very low in naturally occurring sugar and has a GL of 0. It’s also a good source of dietary antioxidants & health promoting phytochemicals.
http://nutritiondata.self.com/facts/beverages/3847/2
I can’t answer for Dr. Cordain. But I suspect red wine is considered more Paleo-friendly because it’s derived from fruit. Concentrated sweeteners (except for honey) and grains are discouraged on this diet plan – but fruits aren’t. It’s also possible that our ancestors were exposed to some level of alcohol via the consumption of over-ripened fruit.
http://icb.oxfordjournals.org/content/44/4/315.full
Be well!
JP
May 18th, 2015 at 4:49 pm
Update 05/18/15:
http://www.nrjournal.com/article/S0271-5317%2815%2900097-4/abstract
Nutrition Research – May 13, 2015
Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations
Recent research suggests that traditional grain-based heart healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol (TC), HDL, LDL and TG concentrations in non-diabetic adults with hyperlipidemia to a greater extent than a grain-based heart healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male, 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart healthy diet for four months, followed by a Paleolithic diet for four months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated measures ANOVA. Four months of Paleolithic nutrition significantly lowered (P < 0.001) mean TC, LDL, and TG and increased (P < 0.001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart healthy dietary recommendations. Be well! JP
June 3rd, 2016 at 2:54 pm
Updated 06/03/16:
http://www.mdpi.com/2072-6643/8/5/314/htm
Nutrients. 2016 May 23;8(5).
Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial.
(1) BACKGROUND: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns;
(2) METHODS: 39 healthy women (mean ยฑ SD age 47 ยฑ 13 years, BMI 27 ยฑ 4 kg/mยฒ) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention;
(3) RESULTS: Significantly greater weight loss occurred in the Paleolithic group (-1.99 kg, 95% CI -2.9, -1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (-14.63% of energy (E), 95% CI -19.5, -9.7), sodium (-1055 mg/day, 95% CI -1593, -518), calcium (-292 mg/day 95% CI -486.0, -99.0) and iodine (-47.9 ฮผg/day, 95% CI -79.2, -16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and ฮฒ-carotene (6777 ฮผg/day 95% CI 2144, 11410) (all p < 0.01); (4) CONCLUSIONS: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations. Be well! JP