This week’s guest is a fellow podcaster, myth-buster, and wellness warrior, Chris Kresser. Chris is the author of the New York Times bestseller The Paleo Cure and host of the Revolution Health Radio podcast.
For a man so freakishly knowledgeable about health, Chris’s non-dogmatic, balanced approach to wellness is refreshing. Case in point: last time I saw him in person here in Austin, we were chowing on grass-fed ice cream. And it was delicious.
Ever wonder if you can eat cheese and still be Paleo? Maybe you feel better eating fruit than super low-carb. Is that okay? Listen up, because we’re talking about:
- The top 5 myths in fat loss, health, and longevity
- Why science tells us a different story than the media
- Why even if 50 million people say a foolish thing, it’s still a foolish thing
- Why it’s okay to eat ice cream sometimes
- Why cavemen died young, and much more!
CHRIS KRESSER: OUR FAVORITE HEALTH DETECTIVE
Abel: Chris Kresser is a practitioner of integrative and functional medicine, author of the New York Times bestseller Your Personal Paleo Code (aka The Paleo Cure), and our favorite health detective.
You like to take things that most people understand to be true and stomp on them until they are dead. How did you get started?
My interest in health came out of my own experience. In my early twenties, shortly after I graduated from UC Berkeley, I decided to take off and see the world, and I sold most of my possessions and started traveling.
I began in Thailand and Southeast Asia, and ended up in Indonesia to do some surfing. I’ve been a lifelong surfer and Indonesia is kind of a Mecca for that. I was living on a little island called Sumbawa, and surfing in a village there, and I got the typical tropical illness—delirious, vomiting, diarrhea, fever, and I didn’t really know what was going on for three or four days. I had some antibiotics in my medical kit that an Australian who was in the village managed to administer to me while I was there, and that kind of brought me back from the brink, but it then evolved into this basically decade-long mysterious chronic illness that really just took me to the curb, essentially.
There were years where I couldn’t even work, I was so sick. I tried everything you could possibly imagine, from the conventional treatments to the most bizarre, esoteric, left-field, shamanistic energy medicine treatments. I moved to a retreat center in Big Sur for two years at one point to explore the psycho-spiritual-emotional aspects of the illness. I mean, no stone was left unturned. And during that process it became clear to me that there was nobody more invested in my health and well-being than me, right?
Most of the doctors I saw were very well-meaning, and they were good people, and they wanted to help, but they just didn’t have the tools or the time, or they were also victims of the same system that we’re victims of as patients of the conventional medical care system. So, at one point I was in Boulder, and I saw an acupuncturist and a practitioner of Chinese medicine. That was the first time I actually saw some real results, and that inspired me to go back to school and start studying on my own. And in that process, I took classes in research methodology and began to read the literature myself, and learn how to critique it and understand what it actually says—versus what the media and people reporting on the research say it says, which are often two different things, as you know. And so then it just evolved from there.
I really started to get obsessed with reading the literature on certain topics, and to be honest, Abel, I didn’t start out with the kind of conspiracy theorist bent, and I still don’t have one. I don’t think there are big conspiracies to delude the public, for the most part. I mean, certainly there are conflicts of interest with the pharmaceutical industry that play a role, but I think it’s mostly just a case of science evolving and changing our understanding—evolving and changing over time. And then this notion of groupthink, which is just that when a lot of people believe something, it’s pretty hard to go against the grain. Especially if you work in a field where your funding comes from organizations that are invested in that particular hypothesis.
There’s a great saying I love from a philosopher named Anatole France that says, “Even if fifty million people say a foolish thing, it’s still a foolish thing.”
So that’s what I try to keep in mind when I’m reading the literature. And when we come across these ideas that are not even questioned because they’re so deeply ingrained in our cultural consciousness, I try to keep that in mind.
5 MYTHS OF THE FOOD INDUSTRY, BUSTED
Abel: If someone is just dipping their toes into this crazy, wild world that we live in, can you do, the top five “What is the myth, what is the truth?”
Number one, I’d have to say that saturated fat and cholesterol are right up there. So the diehard hypothesis is that eating saturated fat and cholesterol raises cholesterol levels in the blood. And then the second part of it is that high cholesterol levels in the blood cause heart disease.
I’m somewhere in the middle on this, actually, compared to other low-carb Paleo advocates. I think it’s more complex than it’s made out to be. You have two extremes—like on one end, you have the cholesterol believers, who say you should avoid saturated fat and cholesterol at all costs, and avoid having high cholesterol levels at all costs.
On the other end, you have the cholesterol deniers or skeptics, we might call them, who say cholesterol has nothing to do with heart disease.
The truth is a little bit more complex. But the truth according to the scientific literature that we have is that on average, eating saturated fat does not raise cholesterol levels. It does in some people, but on average, meaning overall, it doesn’t. And eating dietary cholesterol doesn’t raise cholesterol levels in the blood.
The second part is that high cholesterol levels in the blood do have some association with heart disease, but it’s certainly not the only risk factor, and may not even be the primary risk factor. So that’s number one, I would say.
Abel: One of my favorites.
Number two is related to number one, but it’s separate, too. It’s the idea that red meat is bad for you. And I would say that’s generally broken into three parts:
- The idea that red meat raises cholesterol in blood.
- The idea that red meat increases the risk of colorectal cancer—colon cancer.
- The idea that red meat contributes to inflammation.
And it turns out that none of those are true according to the research that we have. So that’s two.
Number three would probably be the connection between sodium, and salt, and high blood pressure, and cardiovascular disease.
It is true that sodium raises blood pressure in some people—a small minority of people who are what is called sodium-sensitive or salt-sensitive. So they’re particularly sensitive to the effects of sodium, but in the majority of people, there’s not a strong relationship. In fact, salt, like many other nutrients, plays an important role and is actually important to health. So too little sodium can cause problems, just as too much sodium can cause problems.Ironically, too little sodium can actually contribute to heart disease. @ChrisKresser #HeartHealth Click To Tweet
Number four: The idea that we shouldn’t eat fish because of concerns about mercury. And then, more recently, concerns about radiation from Fukushima. In both cases the risk is minimal, and the benefits, especially of cold water fatty fish consumption, are so dramatic and profound, that the risk of not eating fish is far, far greater than the risk of eating fish.
Frequently, when you see critiques of the Paleo diet and the Paleo concept, you’ll hear something along the lines of, “Well, okay, why do we even care about our Paleolithic ancestors and why would we want to emulate their health and their diet and lifestyle, because they all died when they were thirty.” Right?
So, what’s the point? It is true that the average lifespan of our ancestors was short, but that’s because they faced challenges that we don’t have to face today, like very high rates of infant mortality.
Abel: Saber-toothed tigers.
Yeah, exactly. Lions, trauma, accidents, violence amongst tribes, living outdoors, exposure to the elements. If you took, say, ten hypothetical hunter-gatherer ancestors, and four of them die in early childhood, another three of them die due to warfare in their teenage years, and the other three live until they’re eighty, then the average lifespan of that group is going to be very low, right? But it’s got nothing to do with their diet and lifestyle. It has everything to do with their access to emergency medical care and infant mortality and trauma, violence, etcetera.
So some interesting studies were done by these anthropologists, Gurven and Kaplan, who went down to South America and studied some of the last remaining contemporary hunter-gatherers who’d had very little contact with Western culture. And they found that these groups that did actually have access to rudimentary emergency medical care had lifespans that were, on average, about the same as ours. They reached those ages without any other chronic inflammatory diseases that characterize our old age, like diabetes, heart disease, arthritis, most cancers, etcetera.
Abel: That’s what a lot of people say when they hear “the caveman diet,” and it’s a joke.
I guess it was unavoidable from the start, because it was so ripe for caricature. The whole Fred Flintstone concept and the guy running around with the big club, beating people over the head. I wonder if there is a way that could have been avoided. Probably not, but the unfortunate thing about that is, I think a lot of people developed a knee-jerk reaction to the concept of Paleo. When some people hear it, there’s an immediate shut-down and a lack of openness to even considering what is very legitimate science that supports the concept of mismatch.
I was just browsing through Reddit, the subreddit for Paleo. I’m completely new to Reddit. It was my first time ever using it. Apparently, I’ve been living in a cave myself. Someone described it as the front page of the Internet, and I was like, “I haven’t seen the front page of the Internet. I better go check this out,” and there’s sixty thousand members in the Paleo subreddit. There was a thread on there started by someone about, it was something to the effect of, “What parts of the Paleo diet do you not agree with or do you think are bunk?”
It’s very educational for me to see what people are saying about it, and of course the main points that were raised were things like this, or other red herrings like, “Paleo is necessarily low carb,” or there is a single Paleo diet, which of course we know isn’t true.
There’s a very wide variation in what Paleo people eat. But what is really clear is that there are a lot of people who have this strong association with Paleo, one way or the other. There wasn’t a really open-minded conversation… Well, actually, the quality of the discussion was pretty high compared to some forums I’ve seen.
This is what I was saying, where people say there’s no evidence to support the Paleo diet, and this is a really limited view. Because, certainly, if you looked for studies that explicitly are testing the Paleo diet in a clinical trial, there are only about three of four of those (as of 2013). But there are hundreds, if not thousands, of studies that indirectly support the Paleo concept.
Anthropological studies looking at the diet of our ancestors in contemporary hunter-gatherer societies show that they were virtually free of all the modern diseases that kill millions of us every year.
That alone is a very compelling body of evidence to examine. There’s this idea in our culture that all of these diseases are somehow inevitable. It’s just a normal part of aging. You go to a doctor and you tell them you’re getting tired, or your blood pressure is going up, or all of these things, and they’re not going to think that’s unusual or abnormal. They just think that’s a normal part of aging. But we know by looking at these other populations that it’s not a normal part of aging, and these diseases are not, in fact, inevitable.
Actually, they are pretty new on the scene. We’re talking about, really, only a few hundred years where these diseases have become commonplace, and really in the last 100 years for things like heart disease. And in the last fifty years for things like type 2 diabetes, where they’ve become as common as they are. So we all think they’re normal, but there’s a big difference between common and normal, and that’s what studying these populations can tell us.
Then we have a lot of research supporting this mismatch hypothesis that is often discussed in the conferences I speak at and go to, like the Ancestral Health Symposium, where it’s well known in the evolutionary biology world that all organisms are adapted to survive and thrive in a particular environment.When you change the environment faster than the organism can adapt, mismatch occurs. @ChrisKresser Click To Tweet
And that’s not really a controversial concept—it’s pretty well accepted—and humans, like it or not, are animals, so we’re subject to the same constraints. Then there are all kinds of studies that look at the nutrient density of foods and have shown that meat and organ meat, and fish, and vegetables, and fruits and nuts and seeds are, in general, far more nutrient-dense than grains and legumes. Especially when you consider the antinutrients like phytic acid that inhibit the absorption of some of the minerals those foods contain.
In my opinion, as I say in the book, that doesn’t mean we absolutely shouldn’t eat grains and legumes. Especially if they’ve been properly prepared. But it does mean they shouldn’t form the foundation of our diet, and it does mean that they’re inferior in terms of nutrient density to “Paleo” food. I could keep going down the list. There’s tons of evidence to support the Paleo diet or the Paleo template, or whatever you want to call it. Even though there aren’t specific studies looking at one particular diet.
Abel: And what science is there to support 100-calorie packs?
The things that we accept to be common versus normal—it’s an interesting debate, because what we accept as normal are all these things that we assume are supported by science, and the media says they might be. But the fundamental framework of calories in, calories out, and the idea that a 100-calorie pack of whatever would work, is a little bit preposterous when you take a step back.
I think you have a very balanced approach to that, and it’s one that’s fantastic for this community, because it’s easy to be polarized on either side.
I think humans are drawn to drama for some reason. I haven’t totally figured out the evolutionary basis for that.
When I first started writing, I wondered whether anyone would listen at all, because I do take a middle-of-the-road stance. Not on principle, or because I think the middle-of-the-road moderate approach is the best, but because when I look at all the evidence, that’s where I almost always come out. That’s oftentimes not as interesting as the polls, one side or the other, but I do agree with you. I think that generally, when you look at the evidence, it’s a lot more complex and nuanced than either side on the extreme makes it out to be.
I will admit that when I first started doing this, I tended to be perhaps a little bit more aligned with the side of the debate that was against the mainstream, and perhaps a lot of people will think that’s still true. But I would say now I have a much deeper appreciation and respect for mainstream researchers and scientists, and I don’t think they get it all wrong. I think there’s a lot they get right, but there are also some things that have escaped their attention for various reasons—whether those reasons are due to conflicts of interest or whether they’re just due to groupthink, or whether they’re due to some other reason. It’s just I think it’s a lot more nuanced and complex, but I don’t think we should throw out all mainstream research because we don’t like it.
HOW TO EVALUATE HEALTH CLAIMS
Abel: What about someone who reads an article saying, “Oh! I should never eat butter, butter is bad for me.” And then the next week they hear about putting butter in their coffee, and they’re drinking a whole stick of butter. What do you recommend for someone like that, who does get caught up in those details, and then starts living them back and forth?
Well, I can empathize with that. It’s really hard now to be a consumer. To be a person in this world that is trying to figure this stuff out, especially if you don’t have the training and the background, or the time or interest to read the original literature yourself.
Someone might come to my website and read an article that seems pretty compelling and well researched, saying saturated fat isn’t the evil nutrient they’ve been told, and then they might find themselves reading an article on CNN or some other place, in Scientific American or something, saying that red meat causes heart disease by a new mechanism that’s been recently discovered. It’s the contribution to TMAO levels, and it’s just overwhelming. And the average person is just really confused, understandably, and they don’t really know what to make of all this stuff.
As for me, I tend to evaluate health claims. Fairly early on I developed, at least in my head, a kind of framework for evaluating health claims. I think of it as a triangle. One point on the triangle is anthropological evidence, or evolutionary biology and traditional wisdom, we could say. Another point on that would be modern clinical and observational research. Randomized clinical trials, and then observational epidemiological research. And then another point on that triangle would be my personal experience and my clinical experience working with patients.
So when I evaluate a claim, I try to run it through all three of those lenses. And if it passes all three, I feel a lot more certain about it. I’m almost never entirely certain, but I feel a lot more certain about it. And then I feel comfortable making recommendations based on it.
If it passes one or two but doesn’t pass another, then I’m a little less sure about it. Let’s use an example, perhaps. If we say red meat is harmful because it causes cancer and heart disease and it increases chronic inflammation, and we have some modern observational and epidemiological studies that support that, then I’m going to go over to that other point on the triangle with the anthropological evidence and look at traditional cultures that eat a lot of red meat to see if there’s a high occurrence of those diseases in those cultures.
And sure enough, if you look at people like the Maasai in Africa, who ate primarily the milk, the meat, and the blood of the cattle they raised—they’re a pastoralist people—you see virtually nonexistence rates of all those inflammatory diseases. Either red meat is not solely to blame, or it doesn’t significantly contribute to those conditions, or they have some other magical thing going on there that negates those effects. That’s just one example of how this kind of framework can be employed.
I think particularly the evolutionary or traditional health lens is the most important when there’s any kind of conflict in the modern research. If you have some studies saying this and some studies saying that, that’s when I look back to the ancestral template and see what there is to be found there, and that can generally resolve the debate.
Abel: You’ve been doing this for a long time. Your work is highly respected. How often, using this framework, do you actually change your mind at this point?
Not often. But there have been some notable occurrences where I have changed my mind. And I really make an effort to do that when I come across new research that informs my opinion in a different way.
There are a couple of examples that come to mind right off the bat. One is fructose. When I first started doing this, I was influenced by some other thinkers in the field who claimed that fructose is uniquely toxic to the human body and is uniquely problematic, and we should really try to minimize our intake of fructose as much as possible.
I never really suggested limiting fruit intake that much, but the idea was that even fructose in fruit, if you eat a lot of fruit, can be harmful. I don’t think that’s true anymore for most people. I think that both glucose and fructose can be harmful when eaten in excess.
There have been some really interesting studies, which David Despain has reported on a news blog, that show that fructose is mostly converted into inner harmless substances, and it doesn’t have a toxic effect on the liver when it’s eaten in whole food form. There is some evidence, definitely, that suggests that fructose has some uniquely harmful metabolic effects when it’s eaten in really large amounts, which you can pretty much only get by drinking soda and fructose-sweetened beverages and things like agave syrup, which are 90% fructose. The healthy sweetener, right?
So I think there’s no evidence that fructose eaten in moderation, even in fairly significant amounts of fruit each day, is harmful for human beings. None.
Abel: Well, harmful in the sense that it’s “toxic,” right?
Abel: I just want to clarify because some people will hear that and think, “Oh, I don’t have to worry about fructose anymore.” So they’ll go and make a huge fruit smoothie.
Well, let me put it this way. It all boils down to individual tolerance. So everything that I say has to be taken through that lens, because if I say fructose isn’t harmful, then you might go read an article that I wrote about how fructose is a FODMAP, and people with digestive issues like IBS have fructose intolerance. In fact, a fairly high percentage of people—and IBS is really common. So that’s certainly a situation where excess fructose can be a problem. Not fructose itself, necessarily, because if there’s an equal amount of fructose and glucose in a food, fructose is transported out of the intestine, bound to glucose or with glucose. The same enzymes will do that for glucose, and it shouldn’t be an issue.
But if a fruit or food has more fructose than glucose, then that extra fructose there is going to linger around in the gut and become food for pathogenic gut bacteria, and then cause fermentation, gas, etcetera. So, yeah, it always has to be looked at through the lens of individual circumstances and needs.
But there are some really interesting studies I mentioned in my book that showed that even diabetics eating several pieces of fruit per day didn’t experience any change in hemoglobin A1C levels or insulin levels or weight. So I’m arguing that for most people eating a normal amount of fruit—you know, a few servings a day—is not going to be problematic at all.
Abel: Right – there’s a huge difference between saying, “Excess fructose is harmful in some way,” and saying, “Fructose is harmful and poisonous and toxic.”
That’s the problem, because when you take certain pieces of that fruit and then juice it, so instead of eating an apple, you’re like drinking thirty apples without any of the fiber, that’s an entirely different thing. So we need to exercise a bit of common sense.There's a huge difference between eating an apple and chugging fructose syrup. Click To Tweet
Yeah. And I think that gets back to where people get really confused, and in that confusion, it’s easy to get disconnected from that common sense and put your faith in an authority. And what if the authority is saying, “Fructose bad, fructose toxic.”
Every patient who comes to see me, I do a detailed case review. And part of that is, I’m filling out a diet survey and they’re giving me an average day and what they eat. A lot of people are on really low-carb diets. They don’t even know that they’re on low-carb diets. They think they’re low-ish, but they’re eating probably less than forty grams of carbohydrates a day, and I ask them why. Often the response is something like, “You know, because X person said fructose is bad, so I’m not eating fruit, because I think it’s going to give me diabetes or take my liver down,” or something like that.
That’s just kind of horrifying to me, that I may have contributed to that in some way, and so I’ve been doing my best in my writing to clear that up. So that’s one example. Another example is omega 6 fat, and linoleic acid in particular. And this is somewhere I certainly haven’t completely reversed my view on this. I would say it’s just become more nuanced and complex.
Abel: You’re getting more refined with age.
More refined with age, that’s a good way to put it. So yeah, the idea of course is that omega 6 fats like linoleic acid are pro-inflammatory, and we should avoid them for that reason. That’s maybe one extreme, and the other extreme in that argument, which is the mainstream view, is that omega 6 fats are beneficial because they lower cholesterol. So we should replace all of our saturated fats with liquid vegetable oils, which is of course the dominant paradigm, and has been the dominant paradigm for the past half century.
Again, I think the reality is probably somewhere in the middle. There is some evidence that high intakes of linoleic acid, even in natural foods like avocados and nuts and seeds and things like that, can contribute to the formation of these compounds called OXLAMs, which are byproducts—they’re a sign of oxidative damage occurring. And OXLAMs have been associated with increased risk of heart disease, and studies have shown that decreasing our intake of linoleic acid can decrease the production of OXLAMs.
But a lot of other studies that have looked at whether or not linoleic acid is pro-inflammatory have found no significant increases in pro-inflammatory compounds with high intakes of linoleic acid. So Christopher Ramsden, who works for, I think, the NIH, and is a really active researcher in this field, suggested that the adverse effects of linoleic acid might be tissue-specific and go beyond inflammation. In other words, you know, oxidative damage may not show up so much in pro-inflammatory markers, but one thing that can happen is that it inhibits the conversion of short-chain omega 3 fats and the long-chain omega 3 fats like EPA and DHA, which are beneficial and maybe interfere with some of the anti-inflammatory compounds that DHA and EPA produce. It’s a lot more complex when we’re talking about linoleic acid in the form of natural foods.
I still maintain that industrial seed oil is a poor choice for several reasons. These are like corn oil, soybean, safflower, sunflower, cottonseed, all the liquid vegetable oils. Industrial seed oils are much more likely to become oxidized. They’re used and processed in refined foods, which are cooked, and when you apply heat to those oils they can oxidize and become damaged and those damaged fats are problematic for the body. And they’re often highly processed and refined. They’re extremely nutrient-poor and calorie-dense, so they have very few beneficial nutrients at all. When you look at them from any perspective, other than the idea that they lower cholesterol, there’s not really much of a reason to favor those oils.
Again, that is where we can apply that framework. We look back at the evolutionary template and we say, “Were these seed oils part of our ancestral diet?” The answer is no. And then we look at the modern research. Did they have any beneficial effects other than lowering cholesterol, which is arguably beneficial? No, they’re not nutrient-dense. Other than vitamin E, they have almost no measurable nutrients, so they don’t play an important role.
So in my opinion, if they’re not benefiting us and they may be harming us, and they’re not part of the ancestral template, then…
Abel: Easy decision.
Yeah, easy decision. It shouldn’t be a part of our diet. Now, I do want to say, just to make it clear, that’s only the evaluation of whether they’re a part of our ancestral diet. It’s only one part of that framework that I mentioned earlier. And I don’t think that the lack of something in our ancestral diet is sufficient reason to avoid it today. A really good example of that is dairy, so maybe that’s myth number six.
BONUS MYTH #6: SHOULD WE EAT DAIRY?
One of the most prevalent myths. And this is another one, like the sodium myth, that is prevalent in both the mainstream and alternative health arenas. Well, actually, I would say this is more of a Paleo method, because in mainstream dietary recommendations, you often see dairy on the food charts as a healthy, beneficial food.
So the Paleo idea goes that dairy has only been around for ten thousand years, and that’s a tiny blip on the evolutionary time scale, and we’re not really adapted to eat it. And our ancestors weren’t eating it after weaning, so we shouldn’t eat it. There are a couple of problems with that. Number one is that, although our genes are largely the same as they were in the Paleolithic Era, there have been some significant genetic changes since then. And in fact, some evolutionary biologists have suggested that evolution is occurring at a hundred times faster rate than the average over the previous million years now, which is significant, right?
And as much as 10% of our genome has experienced changes in the past ten thousand years due to this increasingly rapid genetic selection that’s occurring, and that’s in part because of increased pressure to adapt, and increases in population, both of which can speed up that process.
So, dairy was a very interesting story, because around the dawn of agriculture, eleven thousand, ten thousand years ago, we went from a much more nutrient-dense diet during the hunter-gatherer period to a much less nutrient-dense diet. And that was starting to show up in diseases in nutrient deficiency, like Rickets, and skeletal deformities. We shrank by several inches as we made the transition from hunter-gatherer to agriculture.
In the case of dairy, it contains certain nutrients that were hard to obtain elsewhere in an agricultural diet, like some vitamin D and vitamin A—fat-soluble vitamins—and it was a good source of hydration, so during drought, you could drink milk and survive. And it has some other fatty acids that appear now, according to modern research, to have beneficial impacts on several different areas of physiology. So, here is this food source that had a lot to offer—and we couldn’t digest it, partly. But there would be a tremendous pressure to adapt to that food source. That’s just how it works.
And sure enough, that’s what happened. About ten thousand years ago, none of our ancestors could digest lactose, the sugar in milk after weaning, which happened at about age four in our ancestors. And then a genetic mutation occurred somewhere around eight thousand or nine thousand years ago that led to the ability to continue to digest lactose into adulthood, and this is called lactase persistence, and it was a pretty crude genetic mutation.
So, essentially, we have a gene that turns off our ability to digest lactose after weaning, and this mutation just broke that gene. So then it doesn’t turn it off. We’re not talking about this sophisticated, beautiful example, but actually in that short of a time frame, that’s about all you can expect. You can’t expect these complex, multi-gene mutations. So lactase persistence then spread very rapidly, as you’d expect it to, because it converged an advantage to anybody who possessed it.
So now you have around the world, a third of the population that can digest lactose into adulthood. Then, in certain parts of the world, where there’s a longer history of cattle herding, like in Scandinavia and northern Europe, you have up to 97% to 98% of the population that is lactose tolerant. Then, in the cattle-herding tribes, like in East Africa, you have 80%, 85% lactase persistence. That’s a huge change in ten thousand years, and that is a very relevant change in terms of our ability to better handle this agricultural food that wasn’t part of the ancestral template but nevertheless can be healthy when it’s well tolerated by the individual.
And then you have not only genetic changes, but you have cultural (or as they would call them in the research literature, technological) changes. By this I mean human beings learned to ferment dairy products, and they didn’t know the science behind this as we do now. But fermentation reduces or almost completely eliminates the presence of lactose in the dairy products.
Fermentation reduces or almost completely eliminates the presence of lactose in dairy products.
So if you are one of the two in three people worldwide that can’t digest lactose, that doesn’t mean that you can’t eat or drink kefir, for example. That is almost completely free of lactose. Or it doesn’t mean that you can’t eat butter, which people figured out how to make by churning the milk because it’s virtually lactose free.
So, there are these innovations, human technological innovations.
The last thing would be epigenetic, or microbiome changes. Changes in gene expression, changes in our gut bacteria, can affect our ability to tolerate and process certain foods. An interesting example of this is coastal populations in Japan that are used to eating a lot of nori have a certain type of gut bacteria that can break down the polysaccharides in the nori that other people aren’t able to break down. They actually pass that bacteria down from generation to generation, so if your family moves to this coastal part of Japan, eventually they would also possess the ability to break down those polysaccharides.
Abel: That’s crazy.
It’s pretty fascinating, and it just means that, yes, we should look to the ancestral template as a starting place, but we shouldn’t consider it to be a destination, because there are other factors to consider.
WHEN IT’S BETTER TO NOT BE 100% PALEO
Abel: I’d love for you to quickly touch upon something that I think it illustrates your approach quite beautifully. That’s the idea of not having to be 100% perfect all the time, not following dogmatically claims that are thrown out there by any dietary paradigm, but customizing your approach based upon your own food sensitivities, the way that your body responds, your training regimen, how much sleep you’re getting.
So an example of that is when you came to Austin, and I was driving around in my girlfriend’s car that smelled of dog. I was just shuttling Paleo people around the whole weekend. One of the places that we took everyone was to a grass-fed ice cream place, Lick.
Abel: And it was delicious. But I think a lot of people when they first hear about this Paleo approach, they’re just like, “Oh no, dairy is the worst thing in the world for you.” But what you’re starting to find is, even the leaders of this movement, after avoiding a lot of these foods for a few years in most cases, you can kind of sub in these “gray area” type foods, right, based upon your own experience. Why is that important?
Again, this came out of my own need and my own experience. I kind of discovered Paleo on my own before I even knew it was Paleo. I found out about Weston A. Price, and I started eating a lot of bone broth and slow-cooked meats, and organ meats, and traditional fats, and they also recommend properly prepared soaked grains and legumes. I tried that, but it really didn’t work for me at all, so I removed those from my diet. And then I just intuitively removed dairy for a period of time, just because I wanted to check out how it was for me, so lo and behold, I was on a Paleo diet.
But then I found that the really strict Paleo approach didn’t really work for me. A lower-carb, strict Paleo approach didn’t work for me. I found that I needed more carbohydrates, and I actually found, with experimentation with dairy, that I thrive on at least fermented full-fat dairy. I don’t drink milk, but I do really enjoy kefir and yogurt, which we make at home, and butter and ghee, and I find that I just feel great when I eat that.
When I started to work with patients, I also found that the one-size-fits-all approach was terrible with a clinical practice, because everybody had different needs and different circumstances, and lifestyles, and goals.
One patient might be sixty pounds overweight and sedentary, and working in an office, and their goal is to lose weight. Am I going to put them on the same diet as someone who comes in who’s training for the CrossFit Olympics, and is a lean male with a fast metabolism? Absolutely not, because there are really different circumstances there.
So, I developed this three-step approach in my own life, and then began to share it in my work with patients. Step one is a strict Paleo diet. And in fact, the way I like to refer to it, the strict Paleo diet is essentially an elimination diet. That’s where I think it functions best. You use it as a way of removing all of the foods that are most likely to cause problems. It doesn’t mean that they absolutely do in everybody, but it means those are the ones that are most likely to cause problems.
Then, in step two, you start to add back the foods that I think are healthy when they’re well tolerated by the individual. So those can include dairy products, as we’ve been discussing. White rice, which I think is better than brown rice because the anti-nutrients are in the hull of the bran of the rice and they’ve been removed, and then you just have starch, which is what remains, and I think humans are well adapted to starch, for the most part.
Then you have things like coffee and dark chocolate, both of which, actually, according to the scientific literature, are beneficial because of their antioxidant profile and other benefits, but can be problematic.
For example, coffee. If you have stage three adrenal fatigue, probably not such a good idea. So there are all these foods that are maybe yes, maybe no. I take people through this process of exactly how to reintroduce them and figure out whether they work for them.
Stage three is the refinement process, and that’s where you look at things like macronutrient ratio. Do you do better with low-carb or high-carb? You look at meal frequency and timing. Do you do better with three square meals and snacks in between, or do you do better with intermittent fasting (compressed food intake into an eight-hour window)? Then it’s customizing your diet for activity level.
Now, again, if you’re doing intense training, you’re going to have different needs than someone who’s barely exercising. And we look at what I call “Paleo superfoods.” So these are not the whiz-bang superfoods that you buy in a box, or at the store. These are things like bone broth, and organ meats, and fish eggs, and cold water fatty fish, and sea vegetables, and natural whole foods that are extremely nutrient-dense, and have certain nutrients that are hard to get elsewhere in the diet.
When you get to the end of that process, you have the Abel James diet, and that’s the diet you should be following. And all of your listeners will have their diet. And that’s really the message that I’m trying to bring here.
Abel: Once you embrace that it is your own within the template that works best for your health, that’s when you can really start having some fun and enjoy your life.
Absolutely, and I agree. It’s threatening at first, but it’s also empowering. When you’re the final authority on what works for you and doesn’t work for you, it’s a really quite a relief, because you don’t have to get caught up in all of these pointless Internet debates, whether this food is good or bad. And the beauty of it is that for most people, if you’re not dealing with a chronic illness that you’re trying to treat, and you’re generally healthy and just want to optimize your health, there’s some wiggle room.
Hence the trip to the ice cream shop, which was awesome, by the way. I don’t know if anyone got any pictures, but pretty much everyone was there, and everyone was eating the ice cream.
Abel: Some was coconut ice cream, but pretty much everyone ate it.
Right, that’s true. There’s a lot more to life than food. And just the pleasure and social contacts and the connection that comes from being able to go with everybody to that place, and then sharing that experience is powerful medicine. And that’s really often overlooked. And in fact, it can be more powerful.
There’s a great saying in Chinese medicine that, “It’s better to eat the wrong food with the right attitude, than the right food with the wrong attitude.”
Abel: Yeah, that’s right. So if you eat ice cream, don’t eat it from your fridge, from the tub in front of daytime TV. You go with a group of people who you really care about, and it’s about the experience, as opposed to how much you can shove down your gullet to make yourself feel better… because you won’t.
In the former case, you’re probably completely distracted. You’re using the ice cream to stuff down some bad feelings that you don’t want to experience. And you’re just out to lunch the whole time you’re doing it. In the latter case, you’re probably quite present. You’re connected with other people. You’re feeling pleasure and joy.
I think the research on how pleasure and the experience of pleasure affects our body supports the idea that it can be transformative. And that the ultimate beneficial effects of that outweigh any potentially harmful effect of eating ice cream, which I think, when it’s done occasionally, there really isn’t any harmful effect there.
WHERE TO FIND CHRIS KRESSER
Abel: Before we go, why don’t we talk about your book, Chris, and where our folks can find you.
So my book is called Your Personal Paleo Code (released in paperback as The Paleo Cure). The website is personalpaleocode.com, and you can find out more about the book there. There are some great free resources we’re offering. All the links to order the book are there as well.
On my main website, chriskresser.com, I blog several times a week and produce a podcast, Revolution Health Radio, where we talk about topics like this.
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