Science-Based Medicine » It's a part of my paleo fantasy, it's a part of my p... - 0 views
-
If I had to pick one fallacy that rules above all among proponents of CAM/IM, it would have to be either the naturalistic fallacy (i.e., that if it’s natural—whatever that means—it must be better) or the fallacy of antiquity (i.e., that if it’s really old, it must be better).
-
Basically, it’s a rejection of modernity, and from it flow the interest in herbalism, various religious practices rebranded as treatments
-
there is a definite belief underlying much of CAM that technology and pharmaceuticals are automatically bad and that “natural” must be better.
- ...33 more annotations...
-
it’s hard not to note that cancer and heart disease are primarily diseases of aging, and life expectancy was so much lower back in the day that a much smaller percentage of the population lived to advanced ages than is the case today.
-
Even so, an implicit assumption among many CAM advocates is that cardiovascular disease is largely a disease of modern lifestyle and diet and that, if modern humans could somehow mimic preindustrial or, according to some, even preagricultural, lifestyles, that cardiovascular disease could be avoided.
-
Over the last decade, Cordain has become the most prominent promoter of the so-called “Paleo diet,” having written The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat and multiple other books advocating a paleolithic-mimetic diet as the cure for what ails modern humans.
-
there have been indications that the idea that ancient humans didn’t suffer from atherosclerosis is a comforting myth, the most recent of which is a study published a week ago online in The Lancet by Prof. Randall C. Thompson of Saint Luke’s Mid America Heart Institute and an international team of investigators entitled Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations.
-
Basically, it was a study of 137 different mummies from four different geographic locations spanning 4,000 years.
-
So, although there was a fair amount of evidence from studies of Egyptian mummies that atherosclerosis was not uncommon, in Egypt it was mainly the wealthy and powerful who were mummified after their deaths. Conceivably, they could have lived a very different lifestyle and consumed a very different diet than the average Egyptian living around that time.
-
So the authors obtained whole-body CT scans of the 137 mummies, either pre-existing scans or scans prospectively done, and analyzed them for calcifications.
-
The mummies to be included in the study were chosen primarily based on two factors, being in a good state of preservation with identifiable vascular tissue, and being adults.
-
The authors obtained identifying information from an extensive search of museum and other databases by a team of archeologists and experts in mummy restoration, and sex was determined by either analysis of the genitals and reproductive organs when present and by pelvic morphology when they were not present.
-
Age was estimated by standard analysis of architectural changes in the clavicle, femur, and humerus.
-
Finally, multiple anthropological and archeological sources were used in an attempt to estimate likely risk factors for the mummies.
-
Figure 2 summarizes the findings nicely: There’s also this video featured in a Nature report on the study showing the reconstructed scan of one of the mummies with atherosclerotic plaques in the coronary arteries.
-
As expected, more atherosclerosis correlates with advanced age, and the amount of atherosclerosis in the young and middle-aged (although the times in which the people who became these mummies after death lived age 50 was old) was less.
-
Although the sample number was far too small to draw definitive conclusions (as is often the case in archeological research), the prevalence of atherosclerotic disease in these mummies did not appear to correlate with the cultures in which the mummies lived.
-
As is noted in Thompson’s article, ancient Egyptians and Peruvians were agricultural cultures with farms and domesticated animals, Ancestral Puebloans were forager-farmers, and the Unangans were hunter-gatherers without agriculture. Indeed, the Peruvians and Ancestral Puebloans predated the written word and were thus prehistoric cultures.
-
One notes that no one, including the authors of this study, is saying that lifestyle and diet are not important factors for the development of atherosclerotic heart disease.
-
What they are saying is that atherosclerosis appears to be associated with aging and that the claims that mimicking paleolithic diets (which, one notes, were definitely not vegan) are overblown. In other words, there is a certain inherent risk of atherosclerosis that is related to aging that is likely not possible to lower further
-
I actually think that the authors probably went too far with that last statement in that, while they might be correct that atherosclerosis is an inherent component of human aging, it is quite well established that this inherent component of aging can at least be worsened by sedentary lifestyle and probably certain diets.
-
One notes that, although the Paleo Diet is not, strictly speaking, always sold as CAM/IM, the ideas behind it are popular among CAM advocates, and the diet is frequently included as part of “integrative medicine,” for example, here at the University of Connecticut website, where it’s under integrative nutrition.
-
In particular, the appeal to ancient wisdom and ancient civilizations as yet untouched by the evil of modernity is the same sort of arguments that are made in favor of various CAM modalities ranging from herbalism to vegan diets rebranded as being somehow CAM to the appeal to “natural” cures.
-
Indeed, the fetish for the “natural” in CAM is such that even a treatment like Stanislaw Burzynski’s antineoplaston therapy is represented as “natural” when in fact, if it were ever shown to work against cancer, it would be chemotherapy and has toxicities greater than that of some of our current chemotherapy drugs.
-
The book is by Marlene Zuk and entitled Paleofantasy: What Evolution Really Tells Us About Sex, Diet, and How We Live. Zuk is an evolutionary biologist, and in particular she points out how the evolutionary arguments favored by advocates of the Paleo diet don’t stand up to scrutiny.
-
The interview begins with Zuk confronting Cordain at a conference on evolution and diseases of modern environments. At his lecture, Cordain pronounced several foods to be the cause of fatal conditions in people carrying certain genes.
-
These foods included, predictably, cultivated foods such as bread (made from grain), rice, and potatoes. Zuk couldn’t resist asking a question, namely why the inability to digest so many common foods would persist in the population, observing, “Surely it would have been selected out of the population.” Cordain’s response? That humans had not had time to adapt to these foods, to which Zuk retorted, “Plenty of time.” Apparently, in her book, Zuk produces numerous examples of evolution in humans occurring in a time frame of less than 10,000 years, including:
-
Lactase persistence (production past the age of weening of the lactase enzyme that digests lactose in milk) probably dates back only around 7,500 to 10,000 years, around the time that cattle were domesticated
-
Zuk detects an unspoken, barely formed assumption that humanity essentially stopped evolving in the Stone Age and that our bodies are “stuck” in a state that was perfectly adapted to survive in the paleolithic environment. Sometimes you hear that the intervention of “culture” has halted the process of natural selection. This, “Paleofantasy” points out, flies in the face of facts. Living things are always and continuously in the process of adapting to the changing conditions of their environment, and the emergence of lactase persistence indicates that culture (in this case, the practice of keeping livestock for meat and hides) simply becomes another one of those conditions.
-
For this reason, generalizations about the typical hunter-gatherer lifestyle are spurious; it doesn’t exist. With respect to what people ate (especially how much meat), the only safe assumption was “whatever they could get,” something that to this day varies greatly depending on where they live. Recently, researchers discovered evidence that people in Europe were grinding and cooking grain (a paleo-diet bugaboo) as far back as 30,000 years ago, even if they weren’t actually cultivating it. “A strong body of evidence,” Zuk writes, “points to many changes in our genome since humans spread across the planet and developed agriculture, making it difficult at best to point to a single way of eating to which we were, and remain, best suited.”
-
we humans have long been known to abuse and despoil our environment, even back in those “paleo” days. Indeed, when I took a prehistoric archeology course, which was largely dedicated to the period of time of the hunter-gatherers, one thing I remember my professor pointing out, and that was that what he did was largely the study of prehistoric garbage and that humans have always produced a lot of it.