Category Archives: Perfect Health Diet - Page 10

Are the Boston Red Sox Malnourished?

Posted by Paul Jaminet on October 11, 2010 45 comments

Last Thursday’s post was mainly concerned with Abby’s bone injury that refused to heal. I noted that four nutrients – vitamins C, D, and K2, and magnesium – were essential for bone health, and that deficiencies could have contributed both to Abby’s injury and her slow healing.

Today’s post is about another group of people who frequently break their bones and don’t heal well: the Boston Red Sox.

Injury-Prone Sox

Those who follow baseball may know that a promising 2010 Red Sox season was sabotaged by a rash of broken bones:

Centerfielder Jacoby Ellsbury missed 144 games with hairline fractures in four ribs; they failed to heal properly and re-fractured months after the initial injury.
Second baseman Dustin Pedroia missed all but two games after breaking his foot June 25.
Catcher Victor Martinez missed a month with a broken thumb.
Backup catcher Jason Varitek played just five games after breaking his foot on July 2.

There were muscle and joint injuries too, but let’s stick to bones.

Is it possible the Red Sox players are suffering from micronutrient deficiencies?

The Red Sox Hire a Dietitian

A few years ago the Red Sox hired a professional dietitian to advise their players: Tara Mardigan of the Dana-Farber Cancer Institute.

Ms Mardigan is a lovely woman, a marathoner and former gymnast, with a charming personality that shines through in radio interviews. She obtained her position with the Red Sox after meeting Red Sox president Larry Lucchino at a charity breakfast.

But what is her diet advice, and which players are taking it? I found a hint about the latter question in an interview in the student newspaper at Tufts University’s Friedman School of Nutrition Science, where Ms Mardigan studied:

I stopped working full-time at Dana-Farber to accommodate working with the Red Sox, and luckily they have a great relationship with the team so I was able to reduce my hours. I also work with the Red Sox’s minor league teams, the Lowell Spinners, Pawtucket Red Sox, and Portland Sea Dogs. This is where I really make changes. I work with young guys who are interesting in learning about how nutrition can improve their performance. They are hungry to get to the big leagues. It’s great to see them move up into the major league, and then become someone like Jacoby Ellsbury (Left Field/Center Field) who is now well-versed in nutrition.

Uh oh! Jacoby Ellsbury, who managed only 18 games in 2010, whose bones break on incidental contact and whose hairline fractures won’t heal in six months, is the dietitian’s prize pupil?

The Dietitian Advises Avoiding Supplements

The Friedman School interview didn’t tell us much about Ms. Mardigan’s dietary recommendations, other than that she opposes most nutritional supplements:

I try to get them to choose food before supplements, and only supplements when necessary. Athletes are vulnerable and think [supplements] are well made and well regulated, and they are shocked when they find out they are not.

Those who have read our book know that we have a chapter titled “Why Moderns are Malnourished” which explains why modern agriculturally-produced foods and treated water don’t provide enough micronutrients, and why supplements are needed to optimize health.

Among the micronutrients for which supplementation is most needed are vitamin K2 and magnesium – two crucial nutrients for bone health.

What Is Her Diet Advice?

To get an idea of what diet she might be recommending, I looked at the Dana-Farber nutrition team web site, and was surprised to see this graphic illustration of their “Optimal Diet plan for cancer survivors”:

Yikes! No fats, and no mention of healthy plant foods like starchy tubers. A quarter of the diet is toxic grains and the protein may be derived from toxic legumes. It looks like roughly 70% of calories come from carbs and 25% from protein.

Later in the page they suggest such omega-6-rich oils as soybean oil, canola oil, flaxseed oil, wheat germ oil, and walnuts – all eliminated on the Perfect Health Diet.

It seems Ms Mardigan has recommended a similar diet to the Red Sox. From the Dana-Farber site:

On staff with the club since January 2006, she attends most home games to meet with players and make sure grilled chicken, steamed vegetables, and other healthful options are available in the team dining room.

Vegetables and lean protein, just like the Dana Farber diet. Another clue from this interview:

“My diet is very restricted right now, but Tara has been wonderful at helping me figure out what I can eat, like certain thick-skinned fruits and soy products,” says Anne Forgit, a leukemia patient and recent bone marrow transplant recipient.

Soy products. As readers of our book know, this is a highly toxic food.

Ms Mardigan does have a personal home page. The only clues I found there to her diet advice reside on her “Resources” page, where she recommends Michael Pollan’s In Defense of Food and Dr. Walter Willett’s Eat, Drink, and Be Healthy. Pollan is a journalism professor who has made a career attacking industrial agriculture, and has likened the Atkins diet to an eating disorder. He seems to avoid specific diet advice, but it looks like he favors grains and omega-6-rich plant fats over animal fats. Dr. Willett is mentioned in our book, where we object to his opposition to coconut oil and saturated fat. He is a promoter of polyunsaturated fat and whole grain consumption.

If this is what Ms Mardigan is recommending to the Red Sox, it’s no wonder their bones are breaking:

Grains are toxic to bones. Wheat, oats, and other grains induce rickets, a softening of the bones that leads to frequent fractures. (This is discussed extensively in our book, and has been known since Mellanby’s original experimental investigations into rickets in dogs [1].)
Omega-6 polyunsaturated fats reduce bone mineral density. [2]

The Missing Nutrients

So the Red Sox players are being recommended a diet that is highly toxic to bones. But what about the key bone nutrients? Are they lacking in those as well?

The answer is almost certainly yes. The fat-soluble nutrients are critical to bone remodeling, and it seems the Red Sox diet is completely lacking in vitamin K2. Plant sources of vitamin K1 aren’t sufficient for bones, and animal sources of K2 seem to be excluded from the Red Sox diet.

Bone fracture rates are very strongly dependent on vitamin K2 levels. Most people are deficient, and supplementation with K2 reduces risk of vertebral fractures by 60%, hip fractures by 77%, and non-vertebral fractures by a remarkable 81%. [3]

If that happens on ordinary diets, the reduction in fracture rates would probably be even more remarkable on a K2-empty diet like the one that has been recommended to the Red Sox.

Conclusion

If a biomedical scientist were asked to contrive a diet that maximized the likelihood of bone fractures, the advice would be:

Eat lots of grains to induce rickets.
Eat vegetable oils and non-tropical fatty plants to reduce bone mineral density.
Avoid animal and dairy fats to deprive the body of fat-soluble vitamins needed for bone mineralization, such as vitamin K2.
Do not take nutritional supplements, in order to maintain a deficiency of bone nutrients.

It seems that this is precisely the advice that is being given to the Red Sox and their minor league players.

This year’s broken bones cost the Red Sox a chance at a World Series. The player who followed this diet advice most rigorously, Jacoby Ellsbury, lost a full season to bone fractures, and his injury history could cost him millions when he becomes a free agent next year.

As a lifelong Red Sox fan, I beseech the team to reconsider their diet advice.

References

[1] Mellanby E. (March 15 1919) An experimental investigation on rickets. The Lancet 193(4985):407-412. Reprinted in Nutrition. 1989 Mar-Apr; 5(2): 81-6; discussion 87. http://pmid.us/2520279.

[2] Watkins BA et al. Dietary ratio of n-6/n-3 PUFAs and docosahexaenoic acid: actions on bone mineral and serum biomarkers in ovariectomized rats. J Nutr Biochem. 2006 Apr;17(4):282-9. http://pmid.us/16102959. Watkins BA et al. Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. J Nutr. 2000 Sep;130(9):2274-84. http://pmid.us/10958824.

[3] Cockayne S et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006 Jun 26;166(12):1256-61. http://pmid.us/16801507.

The China Study: More Evidence for the Perfect Health Diet

Posted by Paul Jaminet on August 3, 2010 10 comments

I previously noted that data from the China Study reported by Denise Minger were highly supportive of the Perfect Health Diet. In particular, the China Study supported our claims that:

Animal protein is healthier than plant protein.
Dairy fats are good, but dairy proteins can be problematic.
Grains are bad – especially wheat – but rice is OK.
Calories should come predominantly from fat.

Now, Stan the Heretic has done more work in the raw China Study data and shows charts that support the Perfect Health Diet and similar diets such as Jan Kwasniewski’s Optimal Diet.

What the Perfect Health Diet and the Optimal Diet have in common is that around 65-70% of calories come from fats, not carbs or protein. (The Optimal Diet is a bit higher in protein than carbs, the Perfect Health Diet a bit higher in carbs than protein, but the two are close.) By the standard of both diets, popular diets all over the world have too much carbs and (arguably) too much protein, not enough fats.

So we would expect to see that in China, people who eat more fat have better health, while people who eat fewer carbs or less protein have better health. And that’s exactly what Stan reports.

His charts show that:

Cardiovascular mortality trends down as fat increases, but trends up as carb or protein intake increases.
Cancer mortality trends down as fat increases, but trends up as carb or protein intake increases.

Go to Stan’s site to see the charts!

The Danger of Protein During Pregnancy

Posted by Paul Jaminet on July 12, 2010 64 comments

At PerfectHealthDiet.com we’re advocates of protein restriction. We recommend:

Avoiding all protein-containing plants, as plant proteins tend to be toxic;
Striving to eat fatty, not lean, meats and fish, in order to keep protein intake down and fat intake up.

Protein restriction helps protect against viral and bacterial infections by promoting autophagy, the process of intracellular protein scavenging, digestion, and recycling. During autophagy, bacteria and viruses, as well as junk human proteins and damaged organelles, are digested. Autophagy has been strongly linked to longevity [1] and is protective against many diseases.

Our advocacy of low protein intake separates us from many other Paleo bloggers. Loren Cordain, the dean of the Paleo movement, has long advocated consumption of lean meats. Although he has moderated his stance somewhat, the front page of his site still places lean meats first among his favored foods:

Learn how a diet based on lean meats …

The Paleo Diet is a way of eating in the modern age that best mimics diets of our hunter-gatherer ancestors – combinations of lean meats …

(The other major difference we have with Dr. Cordain is his exclusion of starchy foods from a “Paleo” diet, even though starchy tubers have been part of the ancestral human diet for 4 million years. But that is a story for another day.)

Those who have read the pre-publication draft of our book know that we place high store on human breast milk as an indicator of the optimal composition of the human diet. Human breast milk provides only 7% of calories in the form of protein. (Carbs are about 38% and fats about 55%.) One can debate whether 7% is the right level of protein for adults; but, if the principle of natural selection is sound, it must be that infants need a low-protein diet.

Science bears this out. As our book notes, diets containing 20% of calories as protein are highly toxic to infants. Pre-term infants fed 20% protein diets had more fever, lethargy, and poor feeding than infants fed 10% protein diets, and lower IQs at ages 3 and 6 years. [2] Even a slight increase in the protein content of formula, from 7% to 9%, significantly increased the likelihood that babies would be overweight by age 2. [3]

Given our skepticism toward high-protein diets, especially for babies, we were pleased to see Dr. Cordain in his most recent newsletter [The Paleo Diet Update v6, #20 – Protein Intake for Pregnant Women] acknowledge the dangers of high protein intake by pregnant mothers. Dr. Cordain advises a pregnant mother:

[Y]ou probably should increase your fat and carbohydrate consumption, and limit protein to about 20-25% of energy, as higher protein intakes than this may prove to be deleterious to mother and fetus for a variety of physiological reasons….

“Protein intakes above this [25% of total calories] threshold may affect pregnancy outcome through decreased mass at birth and increased perinatal morbidity and mortality.” [4]

The physiological basis for this aversion stems from a reduced rate of urea synthesis during pregnancy that is evident in early gestation [5] as well as increases in the stress hormone cortisol [6]. Hence, pregnant women should include more carbohydrate and fat (i.e. fattier meats) in their diets and limit dietary protein to no more than 20-25% of their total caloric intake.

What are the long-term effects of a high-protein diet during pregnancy on the offspring? In long-term follow-up studies of the adult children of mothers who ate high protein diets while pregnant between 1948 and 1954, it was found that by age 40 offspring commonly had high levels of the stress hormone cortisol [6] and high blood pressure [7,8]. The effects of faulty maternal diets can be long-lasting.

At PerfectHealthDiet.com, we think 20% is still likely to be a bit more protein than is desirable. We would advise pregnant mothers to restrict protein to about 15% of calories and to strive to obtain 30% of calories as carbohydrates. As long as adequate carbs are obtained, there is only a modest need for protein and as little as 10% of calories as protein may be sufficient.

Note that this advice is very close to the ratios of 30% carb, 15% protein, and 55% fat that we recommend to adults and children generally. Pregnant women may benefit from slightly more starch and slightly less protein than others; but on the Perfect Health Diet, pregnancy should not require a significant change in eating habits.

[1] Jia K, Levine B. Autophagy is required for dietary restriction-mediated life span extension in C. elegans. Autophagy. 2007 Nov-Dec;3(6):597-9. http://pmid.us/17912023.

[2] Goldman HI et al. Clinical effects of two different levels of protein intake on low-birth-weight infants. J Pediatr. 1969 Jun;74(6):881-9. http://pmid.us/5781798. Goldman HI et al. Effects of early dietary protein intake on low-birth-weight infants: evaluation at 3 years of age. J Pediatr. 1971 Jan;78(1):126-9. http://pmid.us/5539071. Goldman HI et al. Late effects of early dietary protein intake on low-birth-weight infants. J Pediatr. 1974 Dec;85(6):764-9. http://pmid.us/4472449.

[3] Koletzko B et al; European Childhood Obesity Trial Study Group. Lower protein in infant formula is associated with lower weight up to age 2 y: a randomized clinical trial. Am J Clin Nutr. 2009 Jun;89(6):1836-45. http://pmid.us/19386747.

[4] Speth JD. Protein selection and avoidance strategies of contemporary and ancestral foragers: unresolved issues. Philos Trans R Soc Lond B Biol Sci. 1991 Nov 29;334(1270):265-9; discussion 269-70. http://pmid.us/1685584.

[5] Kalhan SC. Protein metabolism in pregnancy. Am J Clin Nutr. 2000 May;71(5 Suppl):1249S-55S. http://pmid.us/10799398.

[6] Herrick K et al. Maternal consumption of a high-meat, low-carbohydrate diet in late pregnancy: relation to adult cortisol concentrations in the offspring. J Clin Endocrinol Metab. 2003 Aug;88(8):3554-60. http://pmid.us/12915635.

[7] Campbell DM et al. Diet in pregnancy and the offspring’s blood pressure 40 years later. Br J Obstet Gynaecol. 1996 Mar;103(3):273-80. http://pmid.us/8630314.

[8] Shiell AW et al. High-meat, low-carbohydrate diet in pregnancy: relation to adult blood pressure in the offspring. Hypertension. 2001 Dec 1;38(6):1282-8. http://pmid.us/11751704.

The China Study: Evidence for the Perfect Health Diet

Posted by Paul Jaminet on July 9, 2010 54 comments

T. Colin Campbell became famous for his book The China Study, which claims that a Chinese epidemiology study supports a vegetarian diet. Chris Masterjohn pointed out some time ago that Campbell’s conclusions had little basis in the study data. [1] Now, Denise Minger has delved into the raw data and shows clearly that Campbell has presented “a strongly misleading interpretation of the original China Study data.” [2] She concludes:

Campbell’s “China Study” book is a spectacular example of how you can cherry-pick data to create a trend that isn’t there. [3]

Campbell’s recommended diet is very different from the Perfect Health Diet. Although hardly carnivores, we at PerfectHealthDiet.com are not idolators of plant foods. Plants have much higher toxin levels than animal foods, and are more difficult to digest. Fiber is often adduced as a reason to eat plant foods, but fiber’s influence on gut bacteria is complex; not all plant fiber improves the composition of gut flora.

We recommend eating daily some safe starches (sweet potato and taro are our favorites; white rice is quick and easy), fruits and berries, seaweed, and assorted vegetables. We eat vegetables mostly to improve the flavor of our meals. What would a beef stir fry, chicken soup, omelette, or bibimbap be without vegetables?

But, though plant foods constitute 50-70% of the mass of food eaten on our diet, we recommend that carbs provide only 20% of calories.

So, now that Ms. Minger has summarized a lot of the data from the China Study, I thought it would be interesting to see whether the China Study data is supportive of the Perfect Health Diet. The China Study data, as summarized by Ms. Minger, is relevant to four of our claims.

1. Animal Proteins Are Preferable To Plant Proteins

The Perfect Health Diet deprecates plant proteins (which are often toxic) and recommends that protein be obtained from meat, fish, and eggs. However, we also recommend lower levels of protein consumption than other Paleo diets. We personally obtain about 10% of calories from protein.

So, did the China Study prefer plant or animal sources of protein? And what is its result for total protein intake?

Ms. Minger reports how protein intake is associated with cancer deaths:

[W]hen we look solely at the variable “death from all cancers,” the association with plant protein is +12. With animal protein, it’s only +3. [2]

The positive numbers mean that more protein is associated with more cancer deaths, suggesting that Chinese should eat less protein. Since the plant protein association is higher than the animal protein, it’s better to eat animal protein than plant protein. Just as we would expect!

What about heart disease?

Correlation between animal protein and myocardial infarction and coronary heart disease: +1

Correlation between fish protein and myocardial infarction and coronary heart disease: -11

Correlation between plant protein and myocardial infarction and coronary heart disease (from the China Study’s “diet survey”): +25

Correlation between plant protein and myocardial infarction and coronary heart disease (from the China Study’s “food composite analysis”): +21

Looking at myocardial infarction and coronary heart disease, fish protein was apparently protective (perhaps because it comes with omega-3 fats), animal protein was neutral (as we would expect from healthy protein, which is fairly innocuous health-wise), and plant protein was harmful (as we would expect from toxins).

2. Dairy Fats Good, Dairy Proteins Problematic

The Perfect Health Diet strongly approves of dairy fats (such as butter and heavy cream – clarified butter or ghee for those with dairy sensitivity) and approves of fermented dairy products (yogurt, cheese), but recommends avoiding most dairy protein – especially products containing pasteurized cow casein that has not been pre-digested by bacteria.

In the China Study, dairy proteins seem to have a strong relation to high blood pressure. Ms. Minger notes the following correlations with hypertension:

Milk and dairy products intake: +30

Egg intake: -28

Meat intake: -4

Fish intake: -14

Meat, fish, and eggs are all healthy. Milk and dairy products – higher blood pressure. Presumably this is because of the casein.

Cow casein, especially the pasteurized form which is difficult to digest, has various well-documented problems. Ms. Minger cites several studies showing that cow casein increases cancer growth, while milk whey and other protein sources are benign. [2]

3. Grains Are Bad; But Rice Is OK

The Perfect Health Diet strongly recommends eliminating all grains except rice. Wheat, which has an exceptionally high toxin load, is strongly deprecated. Rice, on the other hand, is accounted along with taro, sweet potatoes, and other underground starch storage organs among our “safe starches.”

Ms. Minger notes the extraordinary correlations of wheat consumption with disease rates:

Why does Campbell indict animal foods in cardiovascular disease (correlation of +1 for animal protein and -11 for fish protein), yet fail to mention that wheat flour has a correlation of +67 with heart attacks and coronary heart disease, and plant protein correlates at +25 with these conditions?

Speaking of wheat, why doesn’t Campbell also note the astronomical correlations wheat flour has with various diseases: +46 with cervix cancer, +54 with hypertensive heart disease, +47 with stroke, +41 with diseases of the blood and blood-forming organs, and the aforementioned +67 with myocardial infarction and coronary heart disease? (None of these correlations appear to be tangled with any risk-heightening variables, either.) [2]

Wheat was, indeed, by far the most toxic food found in The China Study. It consistently produced the highest correlations with disease. Ms. Minger concludes:

[W]heat may be one of the most toxic things you could ever put in your mouth. [3]

Note that almost everyone in China eats substantial amounts of either rise or wheat; the people who eat little wheat eat a lot of rice. Wheat has a high correlation with disease only because rice is anti-correlated with disease. If rice were not safe, wheat would not appear so dangerous.

In fact, the correlation coefficient of rice with heart disease deaths is -58%, almost the opposite of the +67% for wheat. Other grains had a correlation coefficient of +39%. [4] So: rice good, other grains bad, wheat worst of all.

4. Calories Should Come Predominantly From Fat

The Perfect Health Diet recommends obtaining most calories from fat: the ideal macronutrient ratio is around 20% carbs, 10% protein, and 70% fat by calories. These fat calories should consist of saturated and monounsaturated fats; polyunsaturated fats should be less than 5% of calories.

No region in China eats at these macronutrient ratios, but one comes substantially closer than others: the county of Tuoli. [5] Located in the far northwest of China, Tuoli is occupied by a herding people who traditionally eat a great deal of dairy and meat but very few vegetables.

While the average macronutrient intake of all counties in the China Study was 74% carbs, 10% protein, 16% fat, the macronutrient intake in Tuoli was 35% carbs, 19% protein, and 46% fat.

Helping the comparison with the Perfect Health Diet, the Tuoli obtain their fats predominantly from dairy and meat; these contain few polyunsaturated fats. Plant oils, legumes, nuts, eggs, and fish are all non-existent in their diet; so we can be sure they aren’t eating soybean oil, canola oil, or corn oil.

So how do the people of Tuoli stack up in health compared to the rest of China? Pretty well.

Death from all causes for people under the age of 65 was lower in Tuoli county than in 11 of the 13 counties that ate the least animal protein.

This excellent result was achieved even though the people of Tuoli are among the highest consumers of wheat in China: they average 0.82 pounds per day of wheat flour. Without their high consumption of this most toxic of foods, Tuoli county might have the best health in China. Add another point in favor of fat-rich diets.

But What About Seaweed?

In reading Ms. Minger’s discussion, I was able to find only a few correlations that went the wrong way. The only significant one was the correlation of sea vegetables with colorectal cancer (+76%). We highly recommend seaweed consumption, in part for its high content of iodine and other micronutrients.

However, as Ms. Minger notes, the association of seaweed with colorectal cancer is the result of a confounding factor. The areas of China that eat a lot of seaweed have very high rates of schistosomiasis infection, which is an extremely strong promoter of colorectal cancer.

Conclusion

At least in the data provided by Ms. Minger, there appears to be no data from the China Study that contradicts a recommendation of the Perfect Health Diet, and plenty of data that support our recommendations.

It seems that the China Study is much more supportive of the Perfect Health Diet than of T. Colin Campbell’s diet!

This doesn’t surprise us: the Perfect Health Diet is the result of a rigorous five year search through the literature, and every recommendation has, we believe, the weight of scholarly evidence behind it. But it’s nice to examine new data and find that it agrees with our findings. I’m tempted to look into the raw data of the study, now available from Oxford University’s web site [6], to see if the rest of the study is also supportive of our recommendations.

Thanks much, Denise, for your work. Bravo! A fine analysis of a large data set.