Paleo hype debunked (again). The Lancet

mattie

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Paleo is recommended a lot these days on ME forums and just about everywhere else on the Internet.
Yes I know, the discussion about the optimum diet will never end.
But Paleo wont save you and it sure as hell is not going to save our planet either.

Published in The Lancet thursday 16-08-2018
Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext

Want to learn more about the benefits of plant based eating?

Netflix:
Forks over knives
Cowspiracy
Vegucated
What the health
Food inc
Earthlings
Peaceful Kingdom
Fat sick and nearly dead
 
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sb4

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Paleo is recommended a lot these days on ME forums and just about everywhere else on the Internet.
Yes I know, the discussion about the optimum diet will never end.
But Paleo wont save you and it sure as hell is not going to save our planet either.

Published in The Lancet thursday 16-08-2018

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext

Want to learn more about the benefits of plant based eating?

Netflix:
Forks over knives
Cowspiracy
Vegucated
What the health
Food inc
Earthlings
Peaceful Kingdom
Fat sick and nearly dead
Whilst the study conclusion is interesting, I haven't actually read it, but did see this graph

This suggests that if you were eating a vegan diet, which I would assume in most cases would be higher than 50% carb, you have an increased risk of death.

It is also interesting how they did not include less than 20% carbs, as around 5% is when you start getting ketosis benefits.

This study somewhat goes against what I have learned about metabolism which is that the extremes are where the benefits are except they don't include either extreme (VLC or VLF).

Have you read the study? I wonder how they obtained these figures.
 

alex3619

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There are lots of conditions made worse by plant based eating, just as there are conditions improved by plant based eating. What the broad population should be eating is not the same as what people with specific health issues should be eating.

In terms of the general population most meats are nutritionally unsound, but then so are most plants these days. High quality meats are from animals that eat high quality food and are not deliberately fattened up by high carb strategies. Grass fed beef is not the same as from cows force fed grains. I imagine chicken has the same issues ... organic free range is much better than battery hens.

People with ME probably have a much higher protein need in general. This is super hard to get with vegetarian source, though not impossible.

Our farming practices, for plant and animal sources, have favoured mass production of lower quality cheap food. A good diet is very hard to afford for anyone on a very low income.

Given the problems in carb metabolism in ME the ideal carb intake is possibly much lower than for regular healthy people. Given our need to burn protein then our protein requirements are higher too.

Fats are trickier, as the type of fat is probably very important, and so its hard to say if we should be eating more or less fat. I do suspect however that a high-carb high-fat combination is about the worst we can eat. The iconic form of that bad combination? The french fry.

We lack good clinical trials of various diets in ME.
 

debored13

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There are lots of conditions made worse by plant based eating, just as there are conditions improved by plant based eating. What the broad population should be eating is not the same as what people with specific health issues should be eating.

In terms of the general population most meats are nutritionally unsound, but then so are most plants these days. High quality meats are from animals that eat high quality food and are not deliberately fattened up by high carb strategies. Grass fed beef is not the same as from cows force fed grains. I imagine chicken has the same issues ... organic free range is much better than battery hens.

People with ME probably have a much higher protein need in general. This is super hard to get with vegetarian source, though not impossible.

Our farming practices, for plant and animal sources, have favoured mass production of lower quality cheap food. A good diet is very hard to afford for anyone on a very low income.

Given the problems in carb metabolism in ME the ideal carb intake is possibly much lower than for regular healthy people. Given our need to burn protein then our protein requirements are higher too.

Fats are trickier, as the type of fat is probably very important, and so its hard to say if we should be eating more or less fat. I do suspect however that a high-carb high-fat combination is about the worst we can eat. The iconic form of that bad combination? The french fry.

We lack good clinical trials of various diets in ME.
I have heard that dairy, eggs, and meat from grass fed vs grain fed animals varies in fat composition.

I don't personally have a big appetite and I don't consume a ton of protein but I do believe in the value of saturated fat contra polyunsaturated fats, and also in animal protein. in this case though I think vegetarianism could be adequate as eggs and cheese are high quality sources of protein. In the future will experiment with more gelatin and glycine.

Sorry, actually started adding my thoughts but trailed off as I am in particularly bad crash.

Curious what yr thoughts on gelatin and the nutrients found in the non-muscle parts of the animal are. was raised vegetarian so I don't have a ton of experience eating meats, especially the "weirder" stuff, but some people suggest eating the whole animal is better in terms of getting gelatin and nutrient rich organs
 

brenda

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I know l am only speaking personally, but l was eating organic grass fed and finished (very important) meats, with organic vegetables on the AIP paleo type diet and did well at first. However as l have said previously, long term problems developed.

Since l transitioned to plant based, with plenty of fruit, in February this year, there has been a dramatic improvement. This week l was thrown out of the diabetes clinic and the nurse could not argue with me that l was cured, not controlled with a HbA1c of 5.9 down from 6.1 in April and will continue to fall with more weight lose. Her mind was blown actually by my admission that l ate loads of fruit including bananas and dates and anything else l fancied up to one kilo of plums some days.

No ME crashes now.

Alex the cows we eat for protein get theirs from grass.
 

debored13

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I know l am only speaking personally, but l was eating organic grass fed and finished (very important) meats, with organic vegetables on the AIP paleo type diet and did well at first. However as l have said previously, long term problems developed.

Since l transitioned to plant based, with plenty of fruit, in February this year, there has been a dramatic improvement. This week l was thrown out of the diabetes clinic and the nurse could not argue with me that l was cured, not controlled with a HbA1c of 5.9 down from 6.1 in April and will continue to fall with more weight lose. Her mind was blown actually by my admission that l ate loads of fruit including bananas and dates and anything else l fancied up to one kilo of plums some days.

No ME crashes now.

Alex the cows we eat for protein get theirs from grass.
There are other options besides vegan or paleo. Personally I believe that fructose and sucrose are good for diabetes, and good in general. http://raypeat.com/articles/articles/glucose-sucrose-diabetes.shtml

However I think saturated fats are also preferable to polyunsaturated. Hard to get plant sources of saturated fats, except coconut oil. Anyway, to each their own. I don't feel guilty about eating how I think I need to eat to--well not cure CFS with diet alone, but at least not make myself worse :/
 

pamojja

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Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake.
The first question to ask is always: Was it a randomized study?

It wasn't. And correlations don't prove causation. Too many confounder, the most likely those who went on low-carb already were suffering seriously and self-medicated.

As in my case. I went low-carb and added eggs end fish back in from a vegan diet. Because of a 60% walking-disability for a 80% blockage at my abdominal aorta (PAD). Nothing less than such a severe disease could have motivated me. Though I experienced remission after 6 years of changing diet and lifestyle, if I still die earlier, it can't mean low-carb was the cause - because the usually deathly disease came first.

This study is as silly and wasting money as if the would study who dies earlier? Those on blood-pressue medication or those without? It would be always be those on medication, which they got prescribed for a disease. And the disease not the medication is the real cause for earlier mortality.

Therefore one has to ask why money is wasted with such stupid study design, were the confounded answers could have been known from the outset? Who gains?

Could it be that large industry I don't buy my daily food from anymore?
 
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alex3619

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Too many confounder, the most likely those who went on low-carb already were suffering seriously and self-medicated.
This area is so mired in confounds that conclusions are at risk of being due to study design and factors not taken into account.

There will likely be a time when dietary advice is scientifically based upon individual patient tests. We are not even close to being there yet.

@brenda how an individual responds is a very different debate to how the population responds, and that would include a disease population like pwME. We don't have the science. Results are all over the place. For every person who says vegetarian is best I can find at least one, and probably two, who say ketogenic diets are best. Such is the state of knowledge that both claimants could be right, partly right, or wrong. The best we can do is try to find what works best for us, then keep monitoring because short term results may not be the same as long term results. If you find something that is working for you there is no reason to change unless it causes issues or something better comes along.

I have discussed my issues as a vegetarian before. Right now I do far better on a higher protein diet, but I still eat lots of carbs. My diet is slightly higher in protein than a typical diabetic diet. This scenario could change. I do know if I drop my carbs too far I get lots of gut issues. This is about carbs too, not fiber, as fiber makes no difference, high or low, in any of the times I have tested. My current carb intake is probably about fifty percent. My fat intake is moderately low, but not all the time. I need polyunsaturated fats to avoid certain symptoms. I mostly eat monounsaturated fats. That is my story. It might not be what most people need.
 

pamojja

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This area is so mired in confounds that conclusions are at risk of being due to study design and factors not taken into account.
And always most attention seeking headlines along the meaninless results are reported:

Paleo hype debunked (again). The Lancet
And never the disclaimer at the end of such useless studies:

There are limitations to this study that merit consideration. This study represents observational data and is not a clinical trial; however, randomised trials of low carbohydrate diets on mortality are not practical because of the long duration of study required.
 

tinacarroll27

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I have tried plant based diets with lots of fruit and vegetables and I always crash. I am now nearly plant free with only a small salad now and then. My diet is mostly meat,fish, chicken and eggs with healthy fats which include coconut oil,olive oil and animal fats such as beef and pork fat and I am doing so much better. I guess it is different for everyone. High carbs and fruit sugars nearly kill me. My body loves protein, especially animal!
 

alex3619

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And never the disclaimer
This is why prospective studies exist. Recruit thousands of people who well represent the target population, put them on the diet, then track them for a decade. This is still subject to confounds but gives better quality data in general. I don't see much of this happening. There might also be a need for subgroup analysis.
 

keenly

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Paleo is recommended a lot these days on ME forums and just about everywhere else on the Internet.
Yes I know, the discussion about the optimum diet will never end.
But Paleo wont save you and it sure as hell is not going to save our planet either.

Published in The Lancet thursday 16-08-2018

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext

Want to learn more about the benefits of plant based eating?

Netflix:
Forks over knives
Cowspiracy
Vegucated
What the health
Food inc
Earthlings
Peaceful Kingdom
Fat sick and nearly dead

lol Such nonsense

There is an agenda to push veganism and demean the AMAZING benefits of meat.
 

brenda

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how an individual responds is a very different debate to how the population responds, and that would include a disease population like pwME. We don't have the science. Results are all over the place. For every person who says vegetarian is best I can find at least one, and probably two, who say ketogenic diets are best. Such is the state of knowledge that both claimants could be right, partly right, or wrong. The best we can do is try to find what works best for us
It is a myth that the science is not on plant based. Watch Dave Asprey on this vid. He is the one that is not quoting science whilst the other two are.

 

Hip

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Paleo is recommended a lot these days on ME forums and just about everywhere else on the Internet.
That Lancet study does not appear to be about the Paleolithic diet, but about the level of carbohydrate intake.
A paleo diet does not restrict carbs, but restricts certain types of foodstuff, generally the new foods like grains that became available when humanity switched from a hunter-gathering to farming.


I was re-examining the low lectin diet. Lectins are natural toxins found in plant-based foods; their purpose is to make plants less edible to animals. Plants don't want to be eaten by animals, so plants synthesize toxic lectins to make consuming them less desirable to animals.

I recently came across a page in a book stating that dietary lectins potently skew the immune system towards the Th2 mode, and thus away from the antiviral Th1 mode which is desirable in ME/CFS. Tracking down the references in that book, you arrive at this paper which found dietary lectins induce IL-4, a Th2 cytokine.

So I am guessing it is possible that dietary lectins might be a factor that hampers viral clearance in some people, perhaps particularly in those with leaky gut which might allow the lectins to enter the circulation.

The interesting thing is that the paleo diet tends to avoid all the plant-based foods that contain the worst lectins, food like grains (wheat, rye, barley, maize, oats, rice, etc), nightshades (tomatoes, potatoes, bell peppers, aubergine, goji berries), legumes (beans, peas, peanuts, cashews, lentils, soya) and dairy products.


So perhaps a reason some people with chronic diseases report benefits on the paleo diet might be explained by the low lectin content of this diet. And in ME/CFS, which is linked to chronic viral infections, avoiding the worst lectins might conceivably help increase the antiviral immune response.


Dr Steven Gundry is a proponent of using a low lectin diet to help treat chronic disease. Though he says you need to do a low lectin diet for at least 6 month to even begin seeing any benefits on your chronic disease.
 
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Ema

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Do not be taken in by senseless vegan propaganda.

We may not know the best diet for every single person on the planet, but we do know bad science when we see it.

Repeated blunders and bad science make What the Health impossible to recommend.
That quote was written by a vegan nutritionist who has some integrity. https://www.vegan.com/posts/vegan-dietitian-review-what-the-health/

Denise Minger performs a similar autopsy on the equally ridiculous Forks over Knives here.
 

alex3619

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However I think saturated fats are also preferable to polyunsaturated.
We need some saturated fat for good health. In my case its very low, but if I go lower I get headaches. Saturated fat in ME is probably good to some extent because we need to use fats for energy more than most. To what extent this is the case is still not understood though.

People can live without saturated fat, our body will make what it needs from carbs. We die without polyunsaturated fat. They are essential fats, just as there are essential amino acids and one carb that is close to essential (pentose sugars). However many meats and animal fats contain some polyunsaturated fat.

Sucrose is bad for diabetics, for most of the population its rapidly broken down into glucose and fructose. Glucose is the main problem in diabetes. Fructose is slightly better, in moderation, as it has to be processed by the liver and so is released as glucose much more slowly into the blood.

Whether or not gelatin is a good protein source depends on its amino content. I have not looked into this. However in addition to consideration of the essential amino acids, I think in ME we need to think of the aminos that the mitochondria can use for energy. I forget the list, I would need to look them up.

The primary reason to go vegan/vegetarian is environmental. It is however not a great argument, in that the main problem is excessive consumption, nearly all of which is due to overpopulation. We possibly have twice the population the planet can comfortably sustain using traditional farming, but we also have massive waste, particularly in the wealthier parts of the world. Moving the world to a vegetarian diet is only a stopgap measure if we do not limit consumption.

The reason I still really like my vegetables is they taste so good. The variety of flavours is very good in the hands of a good cook. They also contain a huge range of vitamins and minerals, different type of fiber, and various polyphenols and other chemicals that are not vitamins but still good for us. I think most meat eaters would probably benefit from eating more vegetables than they do, but individual needs vary a lot.

Meat is still the best source of vitamin B12. It can taste good, but not with the variety of vegetables. Its also an easy source of the whole amino range, though when I say meat I also include animal products like dairy and egg white, and I include most fish. Fish increasingly has issues with heavy metal contamination however.

However there are some individuals who have to eat lots of greasy meat and carbs together due to genetic defects. Similarly there are many diseases that need dietary modification. What is good for a particular individual may be bad for the average person. When we argue diet we need to distinguish between population needs and individual needs.