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The Paleo Lifestyle

1. The Paleo Lifestyle. Using Foods to Treat Disease and to Maximise Optimal Wellness By Stephen Eddey M.H.Sc., B.Sc.(Comp.Med.), Dip.App.Sc.(Nat.), Ass.Dip.App.Sc.(Chem.), Cert.IV(Workplace & Training),N.D. 1. The Paleo Diet. Finding the right nutrition for: Obesity

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The Paleo Lifestyle

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  1. 1 The Paleo Lifestyle Using Foods to Treat Disease and to Maximise Optimal Wellness By Stephen Eddey M.H.Sc., B.Sc.(Comp.Med.), Dip.App.Sc.(Nat.), Ass.Dip.App.Sc.(Chem.), Cert.IV(Workplace & Training),N.D.

  2. 1 The Paleo Diet Finding the right nutrition for: • Obesity • Anti-aging/Wellness • Diseases • Heart Disease • Detoxification • Cancer • Inflammation • Functional foods

  3. 1

  4. 2 Basic Questions • Who were our ancestors ? • What did our ancestors eat ? • How do we know? • What dietary changes have occurred ? • What impact have dietary changes had ?

  5. 2 Evolution and Diet Evolution in a geological context Mammalian insectivores Or G Ch H. erectus “Lucy” (hominid) Primates Apes Ramapithecus H. habilis H. sapiens Oldest stone tools Oligocene Miocene Pliocene Pleistocene 25 mya 10 mya 2 mya 10,000 ya Major climatic change

  6. Australopithecus aferensis Approximately 4 million years ago

  7. 3 Evolution and Diet Dietary changes • Miocene apes: Specialised, leaf /fruit eaters >15 mya • Ramapithecus: First hominoid, ~ 10 mya • leaves /fruit /roots /meat scavenger (5-10% energy) • Lucy: First hominid, small, upright stance, ~ 4.5 mya, • fruits /roots /nuts /meat (>10% energy), probably hunted ! • Homo habilis: First tool maker, hunter, ~ 3 mya, • fruits /meat /roots /nuts (meat > 20% energy) • Homo erectus: Tall, large brain, big game hunter, ~ 1.5 mya • meat /fruits /roots /nuts (meat 20-50% energy) • Homo sapiens: Organised big game hunters, ~ 400,000 ya • energy intake from meat estimated > 60% • roots, fruits, vegetation, nuts, seeds

  8. 3 Optimal Foraging Theory • Pre-agriculture we were hunter-gatherers • Day-to-day survival depended on daily energy intake being adequate • Body energy use = Basal metabolism + activity • Best choices were foods with the greatest energy return(ie energy content - energy expenditure for collection and preparation) • High energy dense foods became critical (evident in brain gut trade off in our species)

  9. 4 Human Brain Size (Aiello & Wheeler 1995) 1800 Brain size (cc) Homo sapiens 1400  Homo erectus   1000 Homo habilis 600 Australopithecines 200 0 1 2 3 4 Age in millions of years

  10. 4 Gut morphology and diet Chimpanzee Insectivores Humans Horse Cat Gorilla Rabbit Dog Frugivores Martin, 1994. The life of primates. In: The Cambridge Encylopedia of Human Evolution Folivores (mid-gut) Faunivores Cow Folivores (fore-gut)

  11. 5 Hunter-Gatherers in Recent Time • Dietary data on 181 HG societies recorded in: “Ethnographic Atlas” (Murdoch 1967) • Animal:Plant subsistence ratio: 65:35 (Cordain, Brand-Miller, Mann, Eaton & Speth, Am J Clin Nutr, 2000) • Broad characteristic dietary macro-nutrient composition Hunter-gatherers USA Australia Protein 19 - 35% (15.5%) (17.0%) Carbohydrate 22 - 40% (49.0%) (45.1%) Fat 28 - 47% (34.0%) (32.4%)

  12. The Paleolithic Diet “It has been postulated that foods that were regularly eaten during human evolution, in particular during the Paleolithic (the 'Old Stone Age', 2.5–0.01 million years BP), may be optimal for prevention and treatment of type 2 diabetes, CVD and insulin resistance.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study Tommy Jönsson

  13. The Paleolithic Diet “A Paleolithic diet is a modern dietary regimen based on foods presumably eaten regularly during the Paleolithic, which includes lean meat, fish, shellfish, fruits, vegetables, roots, eggs and nuts, but not grains, dairy products, salt or refined fats and sugar, which became staple foods long after the appearance of fully modern humans.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  14. The Paleolithic Diet “In a randomized controlled study in 29 men with ischemic heart disease (IHD) and impaired glucose tolerance or type 2 diabetes (mean HbA1C 4.8% at baseline), we found improved glucose tolerance independent of weight-loss after 12 weeks of Paleolithic diet compared to a Mediterranean-like diet.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  15. The Paleolithic Diet “In a non-controlled study on 14 healthy individuals, Österdahl et al found that three weeks on a Paleolithic diet significantly reduced weight, BMI, waist circumference, systolic blood pressure (SBP) and plasminogen activator inhibitor-1 (PAI-1).” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  16. The Paleolithic Diet “In another non-controlled study in nine healthy overweight individuals where intervention food was supplied and weight kept steady, Frassetto et al found that ten days of a Paleolithic diet improved diastolic blood pressure (DBP), glucose tolerance, insulin sensitivity and lipid profiles.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  17. The Paleolithic Diet “In a randomized controlled feeding trial in domestic swine, we found higher insulin sensitivity, lower C-reactive protein (CRP) and lower DBP after 15 months of a Paleolithic diet, compared with a cereal-based swine feed.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  18. The Paleolithic Diet “In a non-controlled study of ten Australian Aborigines with diabetes and a mean BMI of 27 kg/m2, O'Dea found that reversion to a hunter-gatherer lifestyle during 7 weeks led to 10% weight loss and reductions in fasting and 2 hour glucose and fasting insulin.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  19. The Paleolithic Diet “In a similar study on healthy Australian Aborigines by the same authors, the insulin response to 70 g of starch from white bread was reduced, while the glucose response was not, after 10–12 weeks of reversion to a traditional lifestyle.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  20. The Paleolithic Diet “In an epidemiologic study, we found that traditional Pacific Islanders of Kitava, Papua New Guinea, had no signs of IHD, stroke or markers of the metabolic syndrome, possibly because of their traditional lifestyle.” CardiovascDiabetol. 2009; 8: 35. Beneficial effects of a Paleolithic diet on Cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Tommy Jönsson

  21. Diseases of Lifestyle Treating Acne with the Paleo Diet

  22. Dietary Role in Acne: The Evidence “The influence of diet on the induction and aggravation of acne has been a matter of intense debate over the last few years. The pioneering observation by Cordain et al., who demonstrated that acne is a disease of Western civilization and is absent in populations consuming Palaeolithic dietswithout refined sugars, grains, milk and dairy products, resulted in a paradigm change.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  23. Glycaemic Load and Acne Improvement in acne and insulin sensitivity after a low-glycaemic-load diet suggests that nutrition-related lifestyle factors may play a role in the pathogenesis of acne. American Journal of Clinical Nutrition, Vol. 86, No. 1, 107-115, July 2007

  24. Glycaemic Load and Acne Low glycaemic load diets may influence sebum production based on the beneficial endocrine effects of these diets. J Dermatol Sci. 2008 Apr;50(1):41-52

  25. Glycaemic Load and Acne “The randomized, controlled Australian study by Smith et al. provided the first clinical evidence for the beneficial therapeutic effects of a low glycaemic load diet on the clinical course and intensity of acne and sebum production. The randomized controlled South Korean trial of Kwon and co-workers in this issue of ActaDermato-Venereologica confirmed that glycaemic load plays a substantial role in the pathogenesis and treatment of acne.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  26. Glycaemic Load and Acne “Subjects within the low glycaemic group demonstrated significant clinical improvement in the number of both non-inflammatory and inflammatory acne lesions.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  27. Glycaemic Load and Acne “Remarkably, Kwon et al. now provide the first histopathological and immunohistochemical evidence that a low glycaemic load diet reduced the size of sebaceous glands, decreased inflammation, and diminished the expression of pro-inflammatory interleukin-8 and sterol regulatory element binding protein-1 (SREBP-1), the key transcription factor of lipid biosynthesis.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  28. Glycaemic Load and Acne “Compelling evidence exists that high glycemic load diets exacerbate acne by increasing the levels of IGF1. Smith et al. demonstrated that low glycemic load diet for 12 weeks decreased serum IGF-1 levels and significantly improved acne. Dietary intervention increases the nuclear content of Fox 01, thereby normalizing increased transcription of genes involved in acne.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  29. Glycaemic Load and Acne “Eating high glycemic index foods causes hyperglycemia. The pancreas responds to hyperglycemia by releasing large quantities of insulin to bring down the blood sugar levels. Large quantities of insulin causes blood sugar levels to fall down rapidly. Too low blood sugar levels trigger another stress response in adrenal glands. The adrenal glands release androgens that signal the liver to release some of its glycogen storages to raise the blood sugar to normal. Incidentally, low blood sugar levels also trigger serious craving for food. With these cravings, the tendency is to again eat food with high glycemic index and the cycle continues chronically.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  30. Glycaemic Load and Acne “The more the pancreas releases insulin, the less effective it becomes as a result of reduced sensitivity of the cells to insulin. This is called insulin resistance or reduced insulin sensitivity. To counter this effect, the pancreas has to release increased secretion of insulin from pancreas. Chronic and acute hyperinsulinemia initiates the hormone cascade that favours tissue growth by stimulating increased levels of free IGF1 and reducing levels of IGF binding protein3.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  31. Glycaemic Load and Acne “Because free IGF1 is a potent mitogen for virtually all body tissues, it promotes acne via hyperkeratinization. Reduction in IGFBP3 levels after hyperinsulinemia or after ingestion of high glycemic food also makes more free IGF1 available and upregulates cell proliferation.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  32. Glycaemic Load and Acne Summary • Eat a high CHO diet and insulin goes up • Insulin goes up and IGF-1 goes up • Insulin goes up and SHBG goes down • SHBG down means more available Testosterone and DHT • Increased IGF-1 means increased sebocyte production (oil) and increased keratinocytes at the hair follicle ostium • All of the above means more acne is susceptible individuals

  33. Glycaemic Load and Acne “Two randomized controlled studies, one of which is presented in this issue of ActaDermato-Venereologica, have provided evidence for the beneficial therapeutic effects of low glycaemic load diets in acne. Epidemiological evidence confirms that milk consumption has an acne-promoting or acne-aggravating effect.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  34. Dietary Role in Acne: The Evidence “RESULTS: At 12 wk, mean (+/-SEM) total lesion counts had decreased more (P=0.03) in the low-glycemic-load group (-23.5 +/- 3.9) than in the control group (-12.0 +/- 3.5).” Am J ClinNutr. 2007 Jul;86(1):107-15. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA.

  35. Carbohydrate Question and Acne “Acute hyperinsulinemia due to consumption of high glycemic load diet would cause an increase in IGF-1/insulin-like growth factor binding protein-3 (IGFBP-3) ratio, thus enhancing the effects of IGF-1.” BMC Dermatol. 2012 Aug 16;12:13. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. Ismail NH, Manaf ZA, Azizan NZ.

  36. Carbohydrate Question and Acne “Hyperinsulinemia resulting from high glycemic load diet would also increase circulating androgens and decrease sex hormone binding protein, leading to increased sebum synthesis, which was crucial in acne development.” BMC Dermatol. 2012 Aug 16;12:13. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. Ismail NH, Manaf ZA, Azizan NZ.

  37. Dairy Question and Acne “This study found that frequency of milk and ice cream intake was positively associated with acne vulgaris occurrence.” BMC Dermatol. 2012 Aug 16;12:13. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. Ismail NH, Manaf ZA, Azizan NZ.

  38. Dietary Role in Acne: Dairy Dilemma “Milk is a rich source of active IGF-1 and IGF-2 even after pasteurization and homogenization. High milk consumption is associated with a 10-20% increase in circulating IGF-1 levels among adults and a 20- 30% increase among children. Milk and dairy products increase IGF-1 levels more than other dietary sources of protein such as meat.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  39. Dietary Role in Acne: Dairy Dilemma “The major protein fraction of cow's milk is casein (80%), and the remaining 20% are whey proteins. The insulinotropic component of milk resides predominantly within the whey fraction, whereas casein has a stronger IGF-1 stimulating effect than does whey. Inclusion of milk and hyperglycemic foods in diet may have potentiating effects on serum insulin and IGF-1 levels, thereby promoting the development of acne.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  40. Insulin “Milk consumption and hyperglycemic diets can induce insulin and IGF-1-mediated PI3K ⁄ Akt-activation inducing sebaceous lipogenesis, sebocyte, and keratinocyte proliferation, which can aggravate acne. Occurence of acne as part of various syndromes also provides evidence in favour of correlation between IGF-1 and acne.” Indian J DermatolVenereolLeprol. 2013 May-Jun;79(3):291-9. :Role of insulin resistance and diet in acne. Kumari R, Thappa DM.

  41. Dietary Role in Acne: Dairy Dilemma “Until recently only a weak association has been accepted for the role of milk and dairy products in acne pathogenesis. There is, however, substantial epidemiological and biochemical evidence supporting the effects of milk and dairy products as enhancers of insulin-/IGF-1 signalling and acne aggravation. In fact, milk signalling potentiates the signalling effects of hyperglycaemic carbohydrates.” Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Melnik BC. ActaDermVenereol. 2012 May;92(3):228-31.

  42. Insulin and Acne “Acne appears to represent a visible indicator disease of over-activated mTORC1 signalling, an unfavour-able metabolic deviation on the road to serious common Western diseases of civilisation associated with increased body mass index and insulin resistance.” ActaDermVenereol. 2013 Aug 8. doi: 10.2340/00015555-1677. Acne: Risk Indicator for Increased Body Mass Index and Insulin Resistance. Melnik BC, John SM, Plewig G.

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