Mary Enig and Sally Fallon, in two postings rich in statements but poor in
references, have written:
>From the Eskimo of Alaska to the hardy Alpiner, from Gaelic villager to
>African tribesman, Price discovered that all healthy indigenous people
>had a plentiful source of animal fat in the diet.
I do not know how Price defined healthy, but there have been many
traditional populations with a low intake of animal fat (including dairy
products and fat from meat) who also have had low rates of cardiovascular
disease, hypertension, obesity and diabetes prior to westernization
[1-102].
>We cannot understand how dairy products per se can be blamed for the CHD
>epidemic.
But I can. Per capita intake of milk is the single environmental factor
which is most strongly related to international ischaemic heart disease
death rates [103], and for males of 19 OECD countries the negative relation
between mortality from ischaemic heart disease and wine or alcohol intake
was reduced to non-significance by controlling for dairy products [104].
But epidemiology can never prove causality. The cause could be some
undiscovered lifestyle factor which is related to milk intake.
Or it could be something else in the milk than saturated fat. Dr Jeffrey
Segall has suggested that it is lactose [105] and recently argued that
'International data show stronger correlations of mortality from ischaemic
heart disease with per capita supply of dairy products excluding fat than
with dairy fat, and of estimated lactose than with dairy fat or margarine
and other processed fats (positively) and vegetable oils and fats, fat of
fish or wine (negatively). Butter and cheese, which have a low content of
lactose, show moderate and zero correlations, respectively. Populations
with low or intermediate prevalence of adult lactose absorbers have a lower
supply of dairy products excluding butter (and therefore of lactose), and a
lower mortality from ischaemic heart disease, than populations with a high
prevalence of absorbers. Specific national and ethnic data suggest that a
diet low or relatively low in lactose, in populations with low or
relatively low prevalence of lactose absorbers, is more consistently
associated with protection against ischaemic heart disease than are high
intakes of unsaturated fatty acids, wine, alcohol or dietary fibre. In
seven countries with a high consumption of dairy products (six at least
with a high prevalence of lactose absorbers), trends in ischaemic heart
disease mortality appear to have reflected changes in the supply of milk
(and therefore of lactose), but not consistently of butter or inversely of
unsaturated fatty acids. The findings reviewed in this paper call for
further investigation of the subject, epidemiologically and biochemically'
[106].
In order to be absorbed, lactose is split by the intestinal enzyme lactase
into glucose and galactose. Paleolithic human adults did not drink milk and
were probably, like most adults of the world today, incapable of absorbing
lactose [107]. Accordingly, galactose is one of the few nutrients that did
not enter the metabolic system of adults during human evolution.
>...the Masai (high consumption of whole milk products, no CHD)...
Segall states that, among the Masai, 'the milk is consumed largely
lactose-fermented, and the prevalence of lactose absorbers in adults can be
assumed to be low because that in children aged 5-14 years is estimated to
be 38 per cent [108]' [106].
This is crucial. Does anyone else know whether the Masai really ferment(ed)
their milk?
>Assuming that man's tastebuds are not superfluous, but nature's way of
>guiding him to the food he needs, let us examine the notion that the
>cave man diet satisfied only the bitter, sour or pungent portion of his
>tasting apparatus, and not the salty or sweet.
Obviously our tastebuds lead us to the sweet, but sweet foods during
evolution differed dramatically from most sweet foods today regarding
nutrient density. Personally I would be at least 25 kg heavier if I had let
my tastebuds guide me through the supermarket.
>It is hard to imagine that he would have neglected his taste for salt. It
>occurs naturally in meat and blood and, as animals seek out natural salt
>licks, so our sensible cave man would have done the same.
Yes of course, we are all very similar. But meat and blood are low salt
foods and substantial evidence suggests that, since nature has not prepared
the cave man and his woman for excess salt, increasing their salt intake to
western standards would increase their risk of hypertension, stroke, heart
failure, esophageal and gastric cancer, kidney stones and osteoporosis
[109]. Hunter-gatherers by the sea may have added sea water or even sea
salt to their foods. But sea salt is only 65 per cent sodium chloride, the
rest is potassium chloride and magnesium sulphate, and in any case the
sodium to potassium ratio would not have been as high as for westerners.
>It is
>reported that the members of the Yanomami tribe in the Amazon basin
>do not take in any added salt. In an apparant adoptive measure, they
>also excrete almost no salt in the urine.
Yes, they excrete 1 mmol per 24 hours, which corresponds well with their
intake [110]. But this is not specific for them, all human are capable of
adopting to a low-salt diet [111]. Last time I checked my urinary excretion
of sodium it was 14 mmol per 24 hours compared to 150-300 in the West.
>Milk is salty because mammals need salt for the production of
>hydrochloric acid and for the development of the brain and nervous
>system. Without dietary salt, the human mind does not fully develop and
>man must live, not by his wits like the ingenious cave man from the
>dawn of time, but as a brute, even if he happens to be born in this
>modern age.
I am not aware of any evidence that that we do not get more salt than we
need from unsalted meat, fruit and saturating vegetables [111]. If Enig and
Fallon have references please share them with us. I have several thousand
colleagues here in Sweden who would be very happy to find arguments for
giving pills in stead of dietary advice to patients with high blood
pressure (although the effect of pills on their health is lousy [112-114]).
>Some studies have shown that with low salt diets, hypertension becomes
>worse.
But the bulk of evidence suggests the contrary [115]. Any cause-effect
relationship will by chance be 'reversed' in one or two studies out of
many, and readers who pick out such single studies are possibly in love
with some hypothesis.
But who is not? :-)
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Staffan Lindeberg M.D. Ph.D. Dept of Community Health Sciences, Lund
University, Mailing address: Dr Staffan Lindeberg, Primary Health Care
Centre, Sjobo, S-22738 Sweden, +46 416 28140, Fax +46 416 18395
http://www.panix.com/~paleodiet/lindeberg/
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