I started out as a dog trainer. In the 1980s, I went back to medical school to study psychiatry. I am an adult and child psychiatrist with a special interest in improving my patients’ health through diet and sleep.
As a dog trainer, I noticed that the better-nourished animals were ready to learn, calm focused. Those who were unwell, were hard of hearing, had a dry nose, cracked pads, were shaky and often fear biters.
Well-nourished dogs had beautiful clear eyes, granula pads, moist noses. I’ve learned a lot about dogs.
As a doctor I ask: Why don’t we look on human health and our children’s health in the same way?
How many of you would give cotton candy to your dog? Yet we would give it to our children.
Researchers have been looking at diet and mental health in the Arctic, and whether diet is an important risk factor for mental health in circumpolar peoples. For example, a study in the American Journal of Psychiatry In 2000, reported “a lack of seasonality in anxiety and depression that may reflect the low propensity for SAD that has been described in the Icelandic population”.
Four years later, research in the Laeknabladid journal concluded:
“The prevalence of disability due to mental and behavioural disorders in Iceland has been rising.”
Other research notes the change in traditional diets led to increased health problems, such as obesity, cardiovascular disease, and diabetes, while the mental health of circumpolar peoples also declined substantially during the same time period.
In the West, dietary changes were introduced in 1977 with official dietary guidelines. We were told to:
- Increase carbohydrate intake to 55 to 60 percent of calories
- Decrease dietary fat intake to no more than 30 percent of calories, with a reduction in intake of saturated fat
- Decrease cholesterol intake to 300 mg per day
In 1992 that recommendation became a Food Guide Pyramid with a base of grains that are USDA subsidized crops. So the recommended diet was heavy in carbohydrates, low-fat or non-fat milk – and when you take fat out of milk all you are left with is little protein and a lot of lactose (milk sugar).
Americans complied. There was a slight decline in protein. From 1977 to 2010, graphs show a steady increase in obesity and diabetes across the US.
Now one in three children in the US is overweight or obese. One in four adults and one in 10 children has NAFLD (non-alcoholic fatty liver disease), which in some cases can progress to cirrhosis of the liver.
Food companies have a role to play in changing health patterns with processed foods. The bottom line is obligation to their stockholders, they do what they need to do to make a profit. They embed themselves in nutrition organisations.
For example, The Academy of Nutrition and Dietetics in the US is sponsored by the Coca Cola Company Beverage Institute for Health and Wellness, and Pepsico. What role if any might Pepsico have in a balanced diet?
The result of this is that the US has become:
- 1 in the world for percentage of obese persons (30.6% in 2003)
- 1 in the world in total health expenditures per capita (2004)
- 22 among industrialized nations for healthy life expectancy (2001)
One of the problems is fermentable carbohydrates.
Here’s a tale of two dentists:
The first was a dentist called Weston Price, known as the “Charles Darwin of nutrition”. He noticed grandchildren had poorer dental health than their grandparents. He was so concerned about the state of his patients’ teeth, that the decided to travel and investigate the state of health of different communities.
He showed that our stone-age ancestors were not immune to tooth decay, from wrong nourishment – fermentable carbohydrates.
He looked at Native American skulls from US and Canada hunter-gatherers, and showed:
- No tooth decay
- Wisdom teeth useful
- Broad dental arches and cheek bones
- Fat soluble vitamins and rich mineral supple contribute to strength/structure of bone
His research in South Pacific Islanders showed that when they were on a traditional diet, they had no tooth decay. When they started eating the “diet of commerce” – fermentable carbohydrates, their dental health deteriorated.
Paleolithic people were not immune to tooth decay from fermentable carbohydrates. In 2014, an article in the Daily Mail, headlined: “Stone age junk food diet of acorns and pine nuts caused our ancestors’ teeth to rot and decay” showed that:
- Teeth from skeletons dating back 15,000 years showed evidence of decay
- Over half the samples were affected, while only three were cavity-free
- These samples predate a rise in farming, often blamed for dental problems
- The hunter gatherers would have therefore relied on acorns and pine nuts
- Both contain levels of fermentable carbohydrates that can destroy teeth
The second dentist is Dr Philippe Hujoel, of the University of Washington Oral Health Sciences, a periodontist and adjunct professor of epidemiology
In 2009, he did a paper inspired by Gary Taube’s research, titled Dietary Carbohydrates and Dental-Systemic Disease, published in the Journal of Dental Research. He showed that tooth decay is not just a local infection.
Hujoel says 60% of mortality worldwide is secondary to chronic non-communicable disease (CNCD), that
- Affects individuals for decades or a lifetime
- Includes, but not limited to: CVD, DM, dementia, certain cancers
- Dental caries, periodontal disease, certain oral cancers and leukoplakia are examples of dental CNCDs
The driver is shown to be fermentable carbohydrates, including refined starches and sugars. Ancient people did not manage these well. To reduce fermentable carbohydrates they had to soak grains, allow grains to pregerminate, and, for flour, allow for several rises of bread to ferment it. (Of note, wheat and types of grains they had then were totally different from what we have today)
The American Heart Association reported:
- Americans consume average of 22 tsps added sugar per day
- American adolescents consume 34 tsps added sugar per day
- Refined starches are not considered in this tally
Fermentable carbohydrates cause periodontal (gum) disease, including gingivitis that is linked to:
- Heart disease
- Rheumatoid arthritis
- Premature birth
Fermentable carbohydrates also influence gut health – the microbiome.
So what and how should we be eating?
Like the omnivore chimpanzee, 5-10% of whose food comes from small game eggs, and lizards, insects, etc.; or the vegetarian gorilla, who eats leaves and has a lot of cellulosis going through his system?
When you look at the fermentative capacity of animals, those who use plant sources, like sheep and cattle, they do so efficiently by fermenting and/or ruminating.
Humans are not good fermenters. Humans have an ability to ferment plants in line with cats and dogs. To eat plant-based foods we either have to pickle/ferment them or cook them, or breed them so they are weak and chewable.
The stomach of humans is similar to dogs, and very different from pigs, horses, rats, and oxen.
We’ve been told to eat low-fat foods: In 1912, an item in the Farmer’s Cyclopedia of Livestock ( pg. 545) had this to say about low-fat milk:
“Skim milk is one of the most valuable adjuncts of the farm for fattening swine. Used with corn, kafir corn or any of the common grain by-products, an almost ideal ration is formed. Hogs like it, and relish rations mixed with it. As a result of five year’s work in feeding skim milk at the New York station at Cornell, it is concluded that the most economical returns are secured when the milk is fed with corn meal.”
Since then, Harvard Research has verified that low-fat milk is not so healthy in terms of weight gain.
- 9 year study: 19,352 Swedish women: In middle age, one serving full fat milk per day –> 15% less weight gain; full fat cheese –> 30% less weight gain
(Rosell, et. al. AJCN 2006)
- 3 year study, 12,829 Adolescents: Skim and 1% milk, but not dairy fat, associated with weight gain
(Berkey et al, Arch Ped Adolesc Med 2005)
- 12 year study, 1589 Middle Aged Men: A high intake of dairy fat (butter as spread and high fat milk and whipping cream) associated with a lower risk of central obesity (Holmberg et al Scand J Prim Health Care. 2013)
Research shows that bad diet is behind an increasing incidence of metabolic syndrome, also known as pre-diabetes/Syndrome X . It is an umbrella syndrome that encompasses a cluster of problems, including heart disease, lipid problems, hypertension, type 2 diabetes, dementia, cancer, polysystic ovarian syndrome, and NAFLD.
It is now prevalent: In the US in 2012, research showed that 46.3% of adults over age of 20 either had diabetes mellitus or were pre-diabetic:
- 1M (9.3%) had DM
- 86M (37%) with Pre-DM
Metabolic syndrome is associated with
- Depressed mood
- Cognitive impairment
- Hyperglycemia itself is a risk factor for cognitive function and dementia
There are hormones involved, such as cortisol, that affect mood. Research shows that:
- At least 50% of MDD patients have high levels of cortisol in bodily fluids, such as saliva, blood, cerebrospinal fluid, and urine
- Women with depression with greater chronic difficulties shown to exhibit elevated salivary cortisol levels.
- Functional Hypoglycemia Mistaken for “Bipolar” or “ADHD”
Some years ago, I discovered I have metabolic syndrome. I have kept it under control simply with a low carbohydrate high fat ketogenic diet.
Ketogenic diets have been used to control epilepsy in children since the 1920s. Decades of experience has shown efficacy of these diets in epileptic children to the present (38% with > 50% size control in a 2008 study).
A modified Atkins diet is under study. Nephrolithiasis is a side effect prevented with K-Citrate
What about cholesterol?
Low blood cholesterol is associated with irritability and memory loss:
- Non-African-American children with total cholesterol <145 mg/dl nearly threefold more likely to have been suspended or expelled from schools than peers (Zhang 2005)
- Low cholesterol is associated with death by violence;)
- Emerging case reports of mental status changes on statins, including irritability
Animal fats and cholesterol are shown to be:
- Important to health
- Vehicles for fat soluble vitamins D, A, K, E
- Sugar stabilization
But doesn’t the brain need carbohydrates to function? Ask
- The brain functions well on ketones from carnivorous diet
- Ketones may help in Alzheimer’s
- Gluconeogenesis: Proteins converted to carbohydrates as needed; body conserves glucose
- ”The lower limit of dietary carbohydrate compatible with life is apparently zero, provided that adequate quantities of protein and fat are consumed.” United States Institute of Medicine
The US Dietary Guidelines Advisory Committee meeting Dec 15, 2014 now states: “Cholesterol is not a nutrient of concern for overconsumption.”
All traditional cultures consume animal protein and fat (meat, fish, shell fish, eggs, poultry, and/or insects).
Fat are important for
- Heart and brain electrical: depend on cell membrane integrity for function, fats provide energy as well
- Brain is 60-70% lipid
- Integrity of lipid membranes essential to neurotransmission
- Omega 3 FAs mediate receptor activity and signal transduction
- Omega 3 and 6 have to be in a good balance, but if you eat from feedlot cattle and farmed fish, you will take in a predominance of Omega 6.
- ~30 g: equivalent to 5 eggs or ¼ lb meat/fish/poultry
- 30 g TID equivalent to 18% protein in 2K Calorie diet
Gelatin is also important:
Gelatin (the cooked form of collagen) 50% of the protein in an animal
35% of the amino acids in gelatin are
glycine, 11% alanine, and 21% proline and
Glycine balances anti-metabolic amino acids, especially tryptophan and cysteine.
Degenerative and inflammatory diseases can often be corrected by the use of gelatin-rich foods.
My rule of thumb for diet:
Avoid fermentable carbohydrates (sticky/sugary foods, dried fruits, refined grains, crackers, potato chips). These are bad for teeth can damage the metabolism. Brushing and flossing does not solve the problem.
Eat fewer carbs, more fats, cholesterol and proteins:
- Fats and proteins block hunger
- Caloric restriction not necessary for weight loss or weight maintenance with low-carbohydrate diet
- Fats promote absorption of vitamins and minerals
- Fats slow release of sugar into the blood stream
- Cholesterol is the basis of steroid hormones
Is such a diet sustainable? – Yes,
- Joel Salatin model/Alan Savory Model (Savory Institute)
- Humane animal husbandry
- Pasture rotation
- Livestock Rotation
- Pasture as Carbon Sink