The Adventist Health Studies
Figure 1: Survival of California Adventist men (1980-1988) and other California men (1985) beyond the age of 30 years. The difference between the 2 groups was significant (P,.001). These were non-Hispanic white subjects. Hazards for 1989 are used for non-Adventist Californians older than 94 years (see the “Subjects and Methods” section of the text). AHS indicates Adventist Health Study; CI, confidence interval.
The Seventh-day Adventist Church (SDA) is a Christian denomination that was founded in 1963 as an offshoot of the Millerite movement in the US during the middle part of the 19th century. Ellen White, the principal founder of SDA, advocated a lifestyle incorporating the following five behaviors: not smoking, eating a plant based diet, eating nuts several times per week, engaging in regular exercise and maintaining normal body weight throughout the individual’s lifetime Adventists also typically eschew alcohol (~8% drink), tobacco (~1.8% smoke), butter, strong seasonings (including pepper), caffeine (coffee, tea, cola) and consider the eating of pork, shellfish, and other foods proscribed as “unclean” in Leviticus as especially unwholesome.
Beginning in 1960, two studies were conducted to determine the effects of the SDA lifestyle on all-cause mortality, as well as on disease-specific mortality and morbidity. The first study was conducted in the interval from 1960 to 1965. The Adventist Mortality Study, also known as the Adventist Health Study-1 (AHS-1) was comprised of 22,940 California Adventists and consisted of an intensive 5-year follow-up, and a more informal 25-year follow-up. The AHS-1 found that the mean lifespan for California Adventist men was 6.2 years longer than for non-Adventist California men. The mean lifespan extension achieved by SDA women was more modest; a 3.7-year advantage over their non-SDA counterparts. These statistics were based on life table analyses.
The reduction in disease specific mortality was impressive, with the overall death rate from neoplasms being 60% lower for SDA men and 76% lower for SDA women.[3, 5] The incidence of breast and colorectal cancer were dramatically lower than in the control population with SDA women experiencing 85% less breast cancer [6-8]and SDA men and women experiencing 62% less colorectal cancer.[3, 9, 10]The incidence of coronary heart disease (CHD) was 66% lower for SDA men and 98% lower for SDA women.[11-13] On average Adventist men live 7.3 years longer and Adventist women live 4.4 years longer than other Californians.
The second Adventist Health Study (AHS-2) took place in the time period between 1974 and 1988 and involved approximately 34,000 Californian Adventists over the age of 25. AHS-2 was designed to try to determine which components of the SDA lifestyle provided protection against specific types of disease. The AHS-2 found that the consumption of red and white meat was associated with an increase of colon cancer and that, independent of meat consumption, eating legumes was protective against the disease.[5, 10, 14] The consumption of nuts was found to be inversely related to the incidence of myocardial infarction, and regular consumption of nuts several times a week reduced the incidence of coronary heard disease CHD by ~50%.[15-17] A strong inverse relationship was found between the risk of CHD and the consumption whole grain wheat bread, as opposed to white bread (~45% reduction in CAD). In men, the frequent consumption of tomatoes and of soy milk was associated with a ~60% reduction in the incidence of prostate cancer.[16, 18, 19]
Figure 2: Survival of California Adventist women (1980-1988) and other California women (1985) beyond the age of 30 years. The difference between the 2 groups was significant (P,.001). These were non-Hispanic white subjects. Hazards for 1989 are used for non-Adventist Californians older than 94 years (see the “Subjects and Methods” section of the text). AHS indicates Adventist Health Study; CI, confidence interval.
Unlike the Cretan diet, the dietary practices of the SDAs are less homogenous and typically incorporate foods commonly consumed by Americans (although with more moderation), including many associated with degenerative disease, such as refined sugar and snack foods. Similarly, the SDA diet typically strives to replace traditional American foods with healthier alternatives, while maintaining the flavor, texture and appearance of the original dishes. One way this is done is by using a range of proprietary textured vegetable protein products (TVP) derived from wheat or soy (with corn or soy oil providing the calories from fat) as meat substitutes. There is also a heavy emphasis on the consumption of vegetables, nuts, whole grains and fruits.[21, 22]
Figure 3: Examples of textured vegetable protein products made to resemble commonly eaten meat dishes in the US.
These products have historically been manufactured by companies owned by or closely associated with the SDA church and this was an added factor in their widespread use. Lentils are also often substituted for meat in traditional American recipes, such as meatloaf and soup. The use of TVP meat substitutes increase compliance by making products that allow for the preparation of foods that fill the cultural niche of beef, chicken and turkey. There are even faux-meat hot dogs available (Figure 3). Nuts are also commonly used as an ingredient in TVP dishes to provide added flavor and a more meat-like mouth feel. Examples of commonly used SDA “meatless meat products” (Figure 3) along with their ingredients and nutritional content are available at http://fatsecret.com/calories-nutrition/worthington-loma-linda#Meatless_Foods.
The primary sources of lipids in the SDA diet have historically been from corn and soy oils, and to a lesser extent oils from nuts (corn oil has partly been replaced by canola oil in the contemporary SDA diet). In examining the commonalities between the SDA and the Cretan diet, the following components seem the most likely candidates to explain the reduction in morbidity and mortality observed in both populations:
- No or very low consumption of red meat
- No or low consumption of meat (excluding fish) in general
- Large consumption of fresh fruits and vegetables
- Use of free range hens’ eggs
- No or low consumption of butter
- No or low consumption of unfermented milk products
- Emphasis on legumes in the diet
- Emphasis on the regular consumption of nuts
- Fat intake primarily in the form of polyunsaturated or monounsaturated fats of vegetable origin
- Regular exercise
- Maintenance of near ideal body weight over the lifespan
- Abstention from smoking
Which Diet for a New Lifestyle?
Figure 4: The Greek Food Column and the three critically important lifestyle elements that accompany it; balance, proportionality and regular exercise.
The Lyon Heart Study clearly showed that the diet of Crete can be adhered to over a period of 5 years. Figure 4 is the Greek Column Food Guide based on the diet of Crete. The visualization of this food guide in the form of a Greek column includes the concepts of genetic variation and nutrition and balanced energy intake and energy expenditure; it is based on foods, not food groups. Although it excludes certain foods made with hydrogenated oils, it does not restrict the intake of naturally occurring foods. It also takes into consideration moderation, variety and proportionality. Dietary guidelines shown in Table 1 provide further information on how to implement the diet of Crete.
The seven dietary guidelines of The Cretan Diet
1. Eat foods rich in (n-3) fatty acids such as fatty fish (salmon, tuna,
trout, herring, mackerel), walnuts, canola oil, flaxseeds and green
leafy vegetables. Or, if you prefer, take (n-3) supplements.
2. Use monounsaturated oils such as olive oil and canola oil as your
3. Eat seven or more servings of fruits and vegetables every day.
4. Eat more vegetable protein, including peas, beans and nuts.
5. Avoid saturated fat by choosing lean meat over fatty meat (if you
eat meat) and low fat over full fat milk products.
6. Avoid oils that are high in (n-6) fatty acids, including corn,
safflower, sunflower, soybean, and cottonseed oils.
7. Reduce your intake of trans fatty acids by cutting back on
margarine; vegetable shortening; commercial pastries; deep-fat
fried food; and most prepared snacks, mixes and convenience
Studies on the diets of hunter-gatherers suggest that (n-3) fatty acids were present in practically all foods that humans ate, and present in equal amounts with (n-6) fatty acids (i.e., 1:1 ratio). The depletion of the (n-3) fatty acids in Western diets is the result of the industrialization of farming, and to a lesser extent, the recent emergence of aquaculture. The high ratio of (n-6) to (n-3) fatty acids (16.74:1 instead of 1:1) is a consequence of the inexpensive mass production of vegetable oils and their substitution in much of the diet for saturated fats as a consequence of economic considerations, government policy (corn and soy subsidies) and erroneous health advice by the “experts.” The latter, led by Ancel Keyes, recommended the indiscriminate substitution of saturated fat and butter with oils high in (n-6) fatty acids to lower serum cholesterol. This effort was successful in reducing the incidence of CVD, however it has not reduced the incidence of other pro-inflammatory diseases, and the mean lifespan has not increased fully commensurate with the decrease in CVD mortality.
The results of the Seven Countries Studies and the Lyon Heart Study based on a modified Cretan diet that is balanced in (n-6) and (n-3) fatty acids, rich in antioxidant micronutrients, and in chemoprotective trace minerals from fruits, vegetables, wild growing herbs and greens is associated with decreased rates of heart disease and cancer; more so than any other diet, drug intervention, or technique. Indeed, all attempts to date to administer nutrients believed to be protective against disease as supplements have been unsuccessful. Attempts to reduce the incidence of CVD with vitamin C, vitamin E and with folic acid and vitamin B-6 (the latter to achieve reduction in elevated serum homocyeteine levels) have failed, suggesting that the biochemical protection these molecules provide in vitro, and in laboratory animal settings, requires the presence of other molecular species in order to act in vivo.
What appears to be unique about the Cretan (and to a lesser extent the SDA diet) is the content of bioprotective nutrients with a broad range of action, specifically the following: 1) a more balanced intake of essemtial fatty acids (EFAs) from vegetable, animal and marine sources; a ratio of (n-6) to (n-3) fatty acids of ;2:1 instead of the 15:1 in most Western diets (it is 16.74:1 in the US); and 2) a diet rich in antioxidants, i.e., high in vitamin C, vitamin E, b-carotene, glutathione, resveratrol, selenium, phytoestrogens, folate, and other phytochemicals from green leafy vegetables; phenolic compounds from wine and olive oil; high intakes of tomatoes, onions, garlic and herbs, especially oregano, mint, rosemary, parsley and dill, which contain lycopene, allyl thiosulfinates, salicylates, carotenoids, indoles, onoterpenes, polyphenols, flavonoids and other phytochemicals used in cooking vegetables, meat and fish.
Some Serious Caveats Regarding the Applicability of Historical Data
In asking people about how long they expect to live, I’m often surprised by the high degree of confidence they exhibit based on the longevity of relatives. If you challenge the assumption that because their aunts, uncles or parents lived into their 80s or 90s that they will too, you will likely be met with the vehement assertion that this fact pretty much guarantees a similar outcome for the respondents. This assertion would be more credible if their long lived 1st or 3rd degree kin were reared under identical, or at least under similar conditions. And therein lies the rub, because this is usually not the case.
Figure 5: Average weekly hours spent on home production from 1900 to 2000 for two aggregates of the population; those in their productive prime, and those in their declining years.
It must be remembered in making historical comparisons with contemporary Westerners in terms of both life expectancy, and dietary or other interventional lifespan studies, that 20th century Cretans and Adventists were, of necessity, far less sedentary than is the average 21st century Westerner today. In this cohort of people housework (household production) involved a considerable amount of exercise, and often no small amount of hard physical labor. Until the middle of the 20th century in the US, laundry was done by hand, in whole or in part, and clothing was hung up to dry, taken down and ironed. Even operating automobiles involved clutching, shifting gears and manual operation of windows – small things by themselves, but cumulatively important.
Figure 6: Between 1950 and 2000 there was a ~ 20% reduction in the types of work classified as “high activity.” What is neither shown nor known is the degree to which both high and low activity jobs have become less strenuous. 
Meal preparation in 1965 required ~ 16.5 hours per week and the total numbers of hours spent in home production was on the order of 51.8 hours at that time.  As can be seen in Figure 5, time spent on home production decreased significantly beginning around 1960. Beyond the decrease in total hours spent on housework, there was a much larger decrease in the amount of physical effort required. Washing machines and clothes dryers, prepared meal components and entire prepared meals, as well as countless other “labor saving” devices, goods and services have markedly decreased fitness. The same has been true of strenuous physical activity in the work place where the overall number of high activity jobs have decreased by ~ 20% from 1970-2000.[26, 27] There has also been a large shift in the workplace demographic since the mid-2oth century. Life expectancy increased from 47.3 years in 1900 to 77.8 years today, a consequence of which (in part) was the exodus of teens from the workforce. In 1920, ~20% of the US labor force was comprised of males aged 15 to 18 years of age. Today, very few teenagers work full time jobs, and the number of teens employed in summer jobs has decreased from ~60% in 1994, to ~40% in 2008. Of those teens who do find summer employment very few are in physically demanding (and consequently usually hazardous) areas of work, such as construction or agriculture. This change, coupled with increased TV viewing and other sedentary activities, translates into reduced fitness in the age 15-30 demographic.
Figure 7: The graph above shows the distribution of the Body Mass Index between the 1971–1975 and 1988–1994 surveys. Over this time, median BMI increased by 0.9; the 75th percentile increased by 1.5; and the 95th percentile increased by 2.7.
In their article, “Why Have Americans Become More Obese?” Cutler, et al., take the contrary position and argue that it is not reduced energy expenditure (or fitness) in the the population, but rather, the reduced investment required in terms of time per calorie consumed, that has been the primary cause of the change in US, and increasingly Western European eating habits (and thus is responsible for the current epidemic of obesity and type II diabetes). Superior food packaging and preservation have cut not just meal preparation time dramatically, but also cleanup time. The mess generated in the preparation of multiple elements of a meal is now confined to the factory and the cleanup is included in the price of the food. It is also no longer necessary to spend as much time cooking, or even heating food, because it can be rapidly prepared and be made ready to eat in a matter of minutes from refrigerator or cupboard by the use of the microwave oven. These technological changes have thus reduced the threshold for eating formerly time consuming and messy to prepare dishes to the point of almost no effort or expenditure of time at all. It is now almost as easy to eat a piece of cake or pie, a brownie, or complex entree as it once was to eat an apple. All the mess and time involved in baking a cake or a pie from scratch is gone.
Regardless of the cause, we are most certainly not our parents or our grandparents, and as the current epidemic of obesity and type II diabetes attests, we are not likely to age or die as they did, either. Any doubts about the difference between “us” and “them” (or even “us then” and “us now”) should be laid to rest by a careful perusal of Figure 7.
The generations who participated in the AHS and Seven Countries Study were also fed differently. In Europe, they were subjected to nearly a decade of reduced calorie consumption, and even in the US, the relatively high cost of calories (in time, if nothing else) combined with less leisure time and fewer options for sedentary work, no doubt acted to limit calorie consumption, compared to today. This reduced calorie consumption may have been protective, and might have served to add years to life even in the presence or the absence of a more optimal diet. These generations of people were also fed on agricultural products derived mostly from small farms where crops and livestock had the opportunity to acquire a broad range of micro-nutrients and phytochemicals that are now less abundant in the food supply.
How Square is Curve Already?
Figure 8: The death rate from cardiovascular disease in the US has plummeted since the turn of century in part due to the replacement of saturated fats with of polyunsaturated fats in the diet.
It should also be pointed out that data from longitudinal studies like the AHS-1&2 and the Seven Countries Study reach us as light does from a distant star. When we point and look at the star in the crook of the handle of the Big Dipper we say, “Look, there’s Alcor!” But of course that isn’t the Alcors we are looking at, but rather the light that shows what they looked like 83 years ago. Similarly, all of the data in AHS-1&2 and Seven Countries Study is a generation or two (or three!) old by the time we have it. The participants in those studies are mostly dead now, as indeed they would have to be in order for us to be able to plot lifespan curves for them. Thus, it is easy to make the mistake of saying, “If I adopt this diet I can expect 7 additional years of life, or 10 additional years of life, because that’s what the study participants experienced.
At least one problem with that assumption is that some of the benefits from both studies have very likely already been realized in the form of the switch from saturated to poly- and monounsaturated fats in the diet, which began in the early 1960s and continues through the present. The most significant benefit from both the Seven Countries Cretan diet and the Adventist Vegetarian diet has been the reduction in mortality (and morbidity) from CVD that has been ongoing since ~1968 in the US. The death rate from CVD has been halved since 1960 when both of these studies were undertaken (Figure 8). To those who vilify Ancel Keys for not getting it just right, I can only say, “Look at (Figure 8) and try to tell me that you could have done better.” So, we’ve undoubtedly used up some of benefit from these dietary interventions in terms of mean lifespan extension.
Figure 9: These curves show the best case extension of mean lifespan that can be anticipated with the Adventist Vegetarian diet or the Cretan Diet.
Finally, it is critically important to understand that both the Cretan and the Adventist Vegetarian diets are really not “diets” at all, but rather lifestyles. Both lifestyles have in common a strong emphasis on low impact exercise and a non-sedentary way of life. Both lifestyles were a product of a time without televisions or computers, and both lifestyles required then, and will require now, considerably greater time for food preparation and cleanup. The upside of that is that we should also eat less, if Cutler et al., are correct. That is important to consider as well, because, leaving aside whether fats, carbohydrates or protein should comprise X- percentage of a given diet’s calories, one thing both these diets have in common is modest to moderate calorie restriction. Five, or possibly even 10 extra years of healthy, productive life should hopefully make the practical costs worthwhile.
The Caveman Diet, or Just How Credulous Are You?
“There are races of people who are all slim, who are stronger and faster than us. They all have straight teeth and perfect eyesight. Arthritis, diabetes, hypertension, heart disease, stroke, depression, schizophrenia and cancer are absolute rarities for them. These people are the last 84 tribes of hunter-gatherers in the world. They share a secret that is over 2 million years old. Their secret is their diet- a diet that has changed little from that of the first humans 2 million years ago, and their predecessors up to 7 million years ago. Theirs is the diet that man evolved on, the diet that is coded for in our genes. It has some major differences to the diet of “civilization”. You are in for a few big surprises.
The basic principles of the Paleolithic Diet are so simple that most high school students can understand them. Within 15 minutes from now you will grasp the major elements. At the technical level, Paleolithic Diet Theory has a depth and breadth that is unmatched by all other dietary theories.” – Dr. Ben Balzer, M.D.
The ideas underlying the Cretan Diet and the SDA Vegetarian diet are complex and do not admit of easy reduction to a catchphrase. The actual foods permitted and consumed in both diets differ markedly – one proscribing all meat, the other urging fish consumption, one obtaining most of the dietary fat calories from PUFAs, and the other from monounsaturated olive oil… It is these differences in the face of the common outcome of greatly improved health and moderate extension of the mean lifespan that are, in fact, key, because they tell us about the likely underlying common mechanisms and thus possibly of their action. They also offer us the opportunity for more choice, and therefore for more flexibility and the likelihood of greater compliance.
The Paleo Diet: A diet so unscientific, only a caveman would do it.
That is not, however, how people make a quick buck. Neither diet is particularly ‘sexy.’ And both diets require an understanding of the underlying biology that makes them work in order to be credible. It’s not possible, or at least not as easy to offer up a one sentence explanation for the feeble minded, such as, “This is a healthy diet that will extend lifespan because it is the natural human diet that our ancestors were evolved to eat.”[32-34] That sounds great because it is simple, easy to understand and “seems right” to a lot of uninformed, ignorant and fearful people. It also speaks to that deep and abiding suspicion that our health (and our other woes) is an artifact of our having lost our way – either from the primordial Garden of Eden, or from our biologically appropriate evolutionary ground state (i.e., before we embarked on agriculture). In fact, the emphasis on a 1:1 or 2:1 ratio of (n-6) to (n-3) fatty acids was derived from observations of contemporary hunter gatherer populations who have a low incidence of inflammatory and age-associated degenerative disease compared to that seen in post-agricultural populations. That was a useful insight that was subsequently validated in many human studies, the best of which extended over a period of decades. That’s the heart and soul of Level 1, Evidence Based Medicine.
In 1988, S. Boyd Eaton, Marjorie Shostak and Melvin Konner published a book entitled The Paleolithic Prescription: A Program of Diet & Exercise and a Design for Living advocating a diet based on what the authors hypothesized the primordial pre-agricultural human diet was like. Subsequently, well over a dozen books have been published advocating variations on this diet based on arm chair hypothesizing from findings in the scientific and ethnographic literature. The diet (depending upon the version you come across) is low (10-15% energy) or moderate in fat , low in carbohydrate (20–40% energy), and high in protein diet (19–35% energy) which provides 55–65% of total calories from meat, 35–45% of calories from non-grain and low glycemic index vegetable sources with a primarily saturated fat intake (10%–58% energy) similar to or higher than that found in Western diets.[35-37]
The first problem with this approach is that the diet is not validated; the AHS and the Seven Counties studies had the considerable advantage of being able to study actual, living human beings under real world conditions, and then apply those insights to other populations, including populations already suffering from CVD. Indeed, that is where so many of the insights, as well as so many of the unresolved questions regarding these diets/lifestyles come from (i.e., the data are complex and robust). Late Paleolithic people are not only long dead and gone, they are really long dead and gone, and contemporary hunter gatherers – the few that remain – cannot be considered equivalent. Ironically, most of the data cited on the relationship between CVD and diet by the originators of the Paleolithic diet are from the Seven Countries Study![32, 37]
Even more to the point, there is present in the hypothesis of Eaton, Konner et al.,[32, 33] the notion that 10,000 years of agriculture is evolutionarily insignificant. In essence, they posit that human evolution with respect to diet stopped 10,000 years ago.[32, 35] At first glance this might seem to be credible, because human evolution has occurred over a period of millions years and it would seem that any changes that would occur in population genetics over a mere 10,000 years must be trivial. However, this is not the case for several reasons. First, the rate of evolution is a function of a complex interplay of multiple factors, including environmental change and selection pressure. It is only necessary to look at the various breeds of dogs, or pigeons created by artificial selection to understand that evolutionary change can be swift.
The introduction of agriculture was a watershed event and it would be astonishing if it was not accompanied by significant evolutionary adaptations to the dietary changes that resulted. To understand that this is so it is only necessary to examine the strong natural selection for the gene that controls lactase production. Human populations with a long history of cattle herding and milk consumption can metabolize lactose present in cow’s milk throughout adulthood, whereas populations that did not domesticate cattle cannot. Natural selection for the heterozygous carriers of the sickle-cell gene to maintain sickle-cell trait in populations exposed to malaria is another post-advent of agriculture evolutionary adaptation. This adaptation was selected for as a direct result of an agriculture-induced alteration to the environment; the clearance of the tropical forests in central Africa, which in turn led to the explosion in the population of the Anopheles mosquitoes that are the vectors for the Plasmodium parasite that causes malaria.
Recently developed techniques for measuring genetic variability now allow for the determination of selection operating in the human genome. Directional selection has been identified in the glucose-6-phosphate dehydrogenase (G6PD) gene, which confers resistance to malaria. What is more, G6PD resistance has evolved not once, but twice in humans, in both Africa and in the Americas. Similarly, the genes expressing chemokine receptor 5 (CCR5) among Europeans, which confers resistance to the human immunodeficiency virus (HIV) are likely to have been selected for within this population over a period of several hundred years in response to Yersinia pestis (bubonic plague) and tuberculosis, both of which use the CCR5 receptor as an entry portal into the host. Numerous other studies have also provided evidence for the recent operation of natural selection on the human genome as a result of very recently developed techniques that allow for comparisons over long sections of DNA.[43-46]
In addition to the conservation of lactase production into adulthood, there is substantial evidence of evolutionary adaptation to the high carbohydrate diet that was a product of agriculture. The incidence of obesity that occurs upon exposure to high calorie “affluence diets” is known to vary greatly by ethnicity. The Pima people (or Akimel O’odham) are a racial group of Amerindians living in central and southern Arizona. One-half of adult Pima Indians have diabetes and 95% of those with diabetes are overweight or obese.
Obesity is thought to be 50-90% heritable. Genome scans in obesity studies are highly reproducible and, despite ethnic and environmental differences, the loci at chromosomes 2 and 10 are generally confirmed as the source of the phenotype. Obesity is “oligogenic,” with expression modulated by “polygenic modifier genes” interacting with the environment in food choices, physical activity, and smoking. Prior to their introduction to the “American” diet after WWII the Pima were not obese and diabetes was extremely rare.[39-41] The diet of the Pima was a very low fat, high carbohydrate diet consistent with the subsistence agriculture of the desert southwest.[42, 43] Some variations in the ectonucleotide pyrophosphatase phosphodiesterase gene-1 (ENPP1) are associated with a 50% increase in the risk of morbid obesity in adults and a 69% increased risk of childhood obesity. An ENPP1 mutation, for example, which is known to protect against obesity and type II diabetes, is present in about 90 percent of non-Africans, but nearly absent in Africans and, not coincidentally, in the Pima. Human evolution in response to environmental change and in response to dietary change is both ongoing and dynamic.
Of course, the Paleolithic diet may be the best diet yet conceived. I could give many reasons why I believe this is not so, but absent hard data gleaned from human trials, I can’t prove much. And that is my final and most important point. I did a Pubmed search using the keywords “Paleolithic diet” and I got 67 hits. Of those 67 hits only 9 were papers that involved actual human or animal application of the diet, or even discussion of same. I’ve copied all of the cites for these studies below:
1: Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010 Dec;25(6):594-602. PubMed PMID: 21139123.
2: Jönsson T, Granfeldt Y, Erlanson-Albertsson C, Ahrén B, Lindeberg S. Apaleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7:85. PubMed PMID: 21118562; PubMed Central PMCID: PMC3009971.
3: Klonoff DC. The beneficial effects of a Paleolithic diet on type 2 diabetes and other risk factors for cardiovascular disease. J Diabetes Sci Technol. 2009 Nov 1;3(6):1229-32. PubMed PMID: 20144375; PubMed Central PMCID: PMC2787021.
4: Eaton SB, Konner MJ, Cordain L. Diet-dependent acid load, Paleolithic[corrected] nutrition, and evolutionary health promotion. Am J Clin Nutr. 2010 Feb;91(2):295-7. Epub 2009 Dec 30. Erratum in: Am J Clin Nutr. 2010 Apr;91(4):1072. PubMed PMID: 20042522.
5: Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009 Jul 16;8:35. PubMed PMID: 19604407; PubMed Central PMCID: PMC2724493.
6: Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC Jr, Sebastian A. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009 Aug;63(8):947-55. Epub 2009 Feb 11. PubMed PMID: 19209185.
7: Osterdahl M, Kocturk T, Koochek A, Wändell PE. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr. 2008 May;62(5):682-5. Epub 2007 May 16. PubMed PMID: 17522610.
8: Jönsson T, Ahrén B, Pacini G, Sundler F, Wierup N, Steen S, Sjöberg T, Ugander M, Frostegård J, Göransson L, Lindeberg S. A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond). 2006 Nov 2;3:39. PubMed PMID: 17081292; PubMed Central PMCID: PMC1635051.
9: Eaton SB, Eaton SB 3rd. Paleolithic vs. modern diets—selected pathophysiological implications. Eur J Nutr. 2000 Apr;39(2):67-70. PubMed PMID: 10918987.
If I enter the keywords “Mediterranean diet” I get 2,269 hits, of which 225 are reports of clinical trials. I will not copy those here!
That’s it. Nine papers of poor quality and not a single clinical trial demonstrating reduced morbidity or mortality – even in CHD or type II diabetes. Sixty-seven papers of hypothesizing 25 years after this diet was put forth. That is dismal science and it is inexcusable to take a position advocating such an intervention in the complete absence of any evidence that it will actually extend the human (or the laboratory animal) lifespan when there is a large body of high quality data that supports far less extreme, and far more practical dietary and lifestyle interventions that will accomplish those ends.
I have no problem with people coming up with a hypothesis, however kooky or sane, and then proceeding to try it out – even on people – as long as those people have informed consent and the data they are given is accurate. In looking over the various books and the countless media articles on the Paleolithic diet, I was struck by how much the Paleolithic Diet’s hype reminded me of the Pritikin diet hype, and even more so of the Pearson & Shaw Life Extension Revolution circus from 30 years ago. “Live to be 100!” “Feel great! Experience all day energy every day!” “Lose Weight!” Well, at least one of those is very likely true, and that is that most people who undertake any version of the Paleo diets I’ve reviewed will likely lose weight. But as to the other claims? Right now they are preposterous. The sad thing is that for first the time in history we have one diet/lifestyle choice that satisfies EBM-1 criteria, and another that satisfies EBM-2 criteria. Both are “proven” to reduce morbidity from a range of degenerative diseases, and both have been proven to significantly extend mean lifespan…
Max More, CEO Alcor Life Extension Foundation
As I so often say, “You pays your money and you takes your chances.” Still, it is embarrassing to see cryonicists buy into yet another quick fix cure all, with no appropriate science to back it up. In his article “The Cryo-Paelo Solution” Alcor President Max More advocates the Paleolithic Diet as a life extending add-on to cryonics. This recommendation is supplemented by a web interview. His citations consist these of these popular books on the subject: Loren Cordain, The Paleo Diet; Nora T. Gedgaudas, Primal Body, Primal Mind; Mark Sisson, The Primal Blueprint; Gary Taubes, Why We Get Fat;Gary Taubes, Good Calories, Bad Calories; Arthur de Vany, The New Evolution Diet. The expert More cites as the one to consult for an introduction to Paleo-dieting is Loren Cordain, author of The Paleo Diet. The quote that open this section on the Paleolithic diet is by Dr. Ben Balzer, M.D., and is from the “Introduction” to Cordrain’s book. Need I say more?
End of Part 3
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