The International Network of Cholesterol Skeptics




   members   members´ publications   book reviews    discussions   unpublished    links


Discussions between members:

About cavemen´s diet

Nicolai Worm
Stephen Byrnes
Charles McGee
Malcolm Kendrick
Bogdan Sikorski
Stephen Byrnes
Paul Rosch
Charles McGee

Dag Viljen Poleszynski
Stephen Byrnes
Uffe Ravnskov
Stephen Byrnes
Joel Kauffman
Barry Groves
Stephen Byrnes
Uffe Ravnskov
Chris Allan
Malcolm Kendrick

Here is at first the letter that started the discussion, sent by  Nicolai Worm on Feb 12, 2002:  

Purdue News 
ave men diets offer insights to today's health problems, study shows
WEST LAFAYETTE, Ind. ­ Eat meat. That's the dietary advice given by a team of scientists who examined the dietary role of fat in a study that combined nutritional analysis with anthropologic research about the diets of ancient hunter-gatherer societies. But there's a catch: To be as healthy as a cave man you have to eat certain kinds of fish, wild game such as venison, or grass-fed meat such as beef. 
     The research was conducted by Bruce Watkins, professor and university faculty scholar at Purdue University and director of the Center for Enhancing Foods to Protect Health, and anthropologist Loren Cordain, professor of health and exercise science at Colorado State University and author of "The Paleo diet" (John Wiley & Sons, 2002). Watkins and Cordain conducted detailed chemical analysis of the meats people ate 10,000 years ago and compared those results to the most common meat people eat today.  
They found that wild game, such as venison or elk meat, as well as grass-fed beef, contain a mixture of fats that are actually healthy for you, and, the researchers say, lower cholesterol and reduce other chronic disease risk. 
     Recent studies have indicated that a healthy diet should contain a balance of essential fats. The two types of most concern are omega-6 and omega-3,  and both are essential for proper nutrition. Omega-3 fat, which is often found in high levels in certain fish, has been shown to reduce the risk of cardiovascular disease, but too much omega-3 can increase the risk of stroke. Omega-6 fat also is an essential fat, but too much omega-6 in the diet can contribute to inflammatory responses associated with of chronic disease.   
According to Watkins,
the analysis done at Purdue found that wild elk, deer and antelope from the Rocky Mountains region have greater amounts of omega-3 fatty acids and a lower ­ and therefore healthier ­ ratio of omega-6 to omega-3 fatty acids in muscle meats, compared to grain-fed beef. "Both grass-fed steers and the wild ruminants have a ratio of omega-6 to omega-3 fatty acids slightly above two in meat. In other words, two parts omega-6 to one part omega-3," Watkins says. "That ratio is much lower than the ratios of 5-to-1 to 13-to-1 reported in previous studies for grain-fed steers." Watkins says the low fat ratio of wild ruminants and grass-fed beef is good news for people who need to reduce their cholesterol. "The fatty acid ratio in wild ruminants is consistent with the recent American Heart Association recommendation to increase the consumption of omega-3 fatty acids found in certain fish in order to reduce the risk of cardiovascular disease," he says. 
     The results of the study were published in the January issue of European Journal  of Clinical Nutrition. The research was funded by the National Science Foundation, the Purdue University Office of Research Programs and the Pope & Young Club, a national conservation organization. Analyzing the foods that people ate 10,000 years ago is not a flight of scientific esoterica. The researchers say this finding has important implications for what we eat today. Although 10,000 years ago predates all modern civilizations, it is a small blip in the evolutionary timeline of humans. Some nutritionists believe that by studying what people ate in the Paleolithic Era, also known as the Old Stone Age, they can determine the proper mix of foods for modern man. 
     Cordain says anthropological nutritionists such as himself have studied the few isolated hunter-gatherer societies ­ such as the Nanamiut of Alaska, the Aborigines of Australia and the !Kung of Africa ­ that remained into the 20th century and found that modern maladies, such as heart disease, high cholesterol, obesity and diabetes, are rare in these populations.  "Over the past several decades, numerous studies have found that indigenous  populations have low serum cholesterol and triglyceride levels," Cordain says. This is despite the fact that their diets aren't going to reap praise from many modern nutritionists. "Previous studies by myself and colleagues had found that nearly all ­ 97 percent ­ of the world's hunter-gatherer societies would have exceeded recommended guidelines for fat," Cordain says. 
     Watkins says although this may be surprising to many people, it fits exactly with what research is showing about the importance of specific types of fat in the diet. "Current research is showing that, with the decline of fat in the diet, the amount of fat isn't as important as the relative amounts, or ratio, of specific fats in your diet. It's a qualitative issue, not a quantitative issue," he says. "By eating more of the good fat you can lower your cholesterol and reduce your risk of cardiovascular disease." This balance of fats has changed dramatically in the past century, he adds. "Generally, our modern diets, especially in the past 100 years, have changed to where we're consuming excess amounts of omega-6 fat. Omega-6 is found in high levels in many of the oil seed crops that we consume," Watkins says. "It's also found in the meat of the livestock that eat these grains, as this study shows." 
     Watkins adds that this research suggests new ways for potential diversification in agricultural production. "Our study points out that there are opportunities for ranchers and producers to develop niche markets for grass-fed beef that fit consumer interest in beef products that deliver special nutrients," Watkins says. "There may also be branding opportunities for products like the Laura's Lean Beef Products."
Writer: Steve Tally, (765) 494-9809;
Sources:    Bruce Watkins, (765) 494-5802;
Loren Cordain, (970) 491-7436;

Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease L. Cordain, Colorado State University, Bruce Watkins, Purdue University, M. Kehler, CSU, L. Rogers, Purdue, Y Li, Purdue
Hypotheses: Consumption of wild ruminant fat represented the primary lipid source for pre-agricultural humans. Hence, the lipid composition of these animals' tissues may provide insight into dietary requirements that offer protection from chronic disease in modern humans. 
Method: We examined the lipid composition of muscle, brain and subcutaneous adipose tissue (AT) from 17 elk (Cervus elaphus), 15 mule deer (Odocoileus hermionus), and 17 antelope (Antilicapra americana), and contrasted them to wild African ruminants and pasture and grain-fed cattle. 

Results: Muscle fatty acid (FA) was similar among North American species with polyunsaturated fatty acids/saturated acids (P/S) values from 0.80 to 1.09 and n-6/n-3 FA from 2.32 to 2.60. Marrow FA was similar among North American species with high levels (59.3 percent to 67.0 percent) of monounsaturated FA; a low P/S (0.24<0.33), and an n-6/n-3 of 2.24<2.88. Brain had the lowest n-6/n-3 (1.20<1.29), the highest concentration of 22:6 n-3 (elk, 8.90 percent; deer, 9.62 percent; antelope, 9.25 percent) and a P/S of 0.69. AT had the lowest P/S (0.05<0.09) and n-6/n-3 (2.25<2.96). Conjugated linoleic acid (CLA) isomers were found in marrow of antelope (1.5 percent), elk (1.0 percent) and deer (1.0 percent), in AT (deer, 0.3 percent; antelope, 0.3 percent) in muscle (antelope, 0.4 percent; elk, trace) but not in brain.  
Conclusions: Literature comparisons showed tissue lipids of North American and African ruminants were similar to pasture-fed cattle, but dissimilar to grain-fed cattle. The lipid composition of wild ruminant tissues may serve as a model for dietary lipid recommendations in treating and preventing chronic disease.

 Back to top


Stephen Byrnes:
The Cordain Camp support the Lipid Hypothesis 100% so they are not exactly allies. Cordain mistakenly thinks that the fats in wild game animals was primarily made up of MUFAs and PUFAs and very little SFAs. While its true that the muscle meats of wild game animals are non-marbled, it is not true that this was the only part of the animal that was eaten. He is also wrong in saying that the fatty acid profiles of wild ruminant animals can be affected by their diets; only the monogastric animals show this. The omega-3/6 ratio in ruminant animals stays pretty constant, no matter what they eat.
If you check out Cordain's book THE PALEO diet, you will quickly see all of the politically correct gobbeldygook about saturated fats and cholesterol clogging arteries and causing heart disease. Since Cordain cannot divorce himself from this view, he MUST come up with an explanation to rationalize the reality that hunter/gatherer peoples ate lots of animals foods, but suffered from little heart disease. His explanation, though, is off the mark. While Cordain is certainly correct about our ancestors being meat-eaters, he is wrong about the quantity and type of fat they ate on a daily basis. You may want to check out two articles co-authored by Mary Enig on this: "Guts and Grease: The diet of Native Americans" and "Caveman Cuisine"
Both are posted at in the "Traditional diets" section.
All the best,

 Back to top

Charles McGee:
Dear group: Eskimos are indeed an interesting group to look at. Weston Price visited there and because he told them to stay on their health maintaining high fat diet they told him how they prevented the disease the white man called scurvy. Everytime they killed an animal they removed the adrenal gland and cut a slice for every man, woman and child in the village and ate it raw. (Eskimo means eater of raw meat and, as Uffe knows, I picked up the nick name Puckick working in Alaska during college).  It is now known the adrenal gland has the highest concentration of vitamin C in the body. Outsiders went there, were kindly offered the raw adrenal slice, refused, and got scurvy toward the end of the long winter. For many years the medical staff of a hospital in Edmonton, Alberta, Canada, rotated through a hospital that served Eskimos north of the Artic Circle. Before 1955 the Eskimos remained free of diseases of physical degeneration. In 1955 the DEW line went into effect, involving the building of radar installations and airfields to detect Russina Nukes. The Eskimos gave up their hunting and gathering life style, moved to civilization, and became the labor force. Overnight they switched from an all fresh food raw diet to a diet of 100% processed foods. In a short time of 15 years women were getting gall bladder disease, children crooked teeth and acne, and men heart attacks and diabetes, all conditions formerly absent. The doctors wrote this up in a fairly major nutrition journal with the title, "When the Eskimo Comes to Town." Don't ask for the reference as it is buried away in old files in a locker and it is too cold here (North Idaho) to go looking for it. Maybe when it warms up. 

The anthropoligist Stephenson spend many winters living in the North where he ate the Eskimo high fat diet. He returned to New York and gave some lectures about his adventures and observations. Physicians couldn't believe how he remained healthy on the high fat diet and challenged him. As he had about a year's writing to do he volunteered to live under observation in a hospital 24 hours a day and eat the same diet for 12 months and be tested, etc. He stayed perfectly healthy as did all of his lab tests, much to the disbelief of the fat theory believing physicians monitoring him. 

Paul Dudley White, founder of the speciality of cardiology, wrote about 3 books for the public. He graduated medical school in 1910 and had read about the early and few descriptions of myocardial infarctions in Europe. He was looking for similar cases and found his first in 1921. He was asked one time what he thought about the cholesterol theory. He answered he didn't believe it because it was not consistent with the history of the disease. He said they didn't ask him anymore. The history of the disease he was referring to was that the very first MI confirmed with an autopsy was in England published in 1878 by Adam Hammer. That occurred near the end of a century in which tens of thousands of autopsies were perfomed in Europe during the explosion of pathologic examinations that led to naming most of our serious diseases. In a part of Austria everyone who died was autopsied by royal decree. During this same time period American pioneers were eating animals, cooking with lard, and bread spread with lard was a popular food. Guess what? No heart attacks until after 1900 and the MI was not coded as a separate cause of death until 1950 and by that time it was the most common cause of death. When I was writing one of my books I wrote the National Center for Health Statistics asking the question. I got a phone call back with that response. I have been curious about one aspect of the fat theory. We were taught in medical school that we are omnivors, able to eat all foods. We have the biochemistry to process carbs, proteins, and fats. Then suddently we are not able to process a list of high fat natural foods our ancestors ate throughout history with no evidence of harm. Shame on the cholesterol mafia.

  Back to top

Malcolm Kendrick:
Dear all,  

There may have been very few recorded cases of MI prior to the nineteen thirties. But John Hunter in 1793 described people with the symptoms of angina. In the mid-nineteenth centery. Virchow and Rokitansky had both identified atherosclerotic plaques (with cholesterol in them). I don't know if the plaques were thought to be the cause of death. In 1911 Osler described the typical victim of heart disease as (sic) Iron grey in complexion, a man who looks as though his engine is stuck at full ahead.)

 William Harvey, who 'discovered' how the CV system works, described the victim of heart disease as a man of stormy and agitated personality. He is thought to have died of a heart attack in 1628. In short, heart disease wasn't common, but it did exist. (I read, and lost, an article in which the arteries of Egyptian mummies were analysed, and showed signs of atherosclerotic plaques). 

Malcolm Kendrick

  Back to top

Bogdan Sikorski:
As correctly suggested by Stephen, that mob continue to disregard many facts on what constituted a typical diet of hunters-gatherers. It is now claimed that for instance Australian Aborigines ate very low-fat diet, based on a typical analysis of marsupial meat and "known" fact that fish were a large part of their diet. This of course is total rubbish. I belive the web site cited by Stephen also contains Mary's article on what really was eaten by them, written based on the research of Weston Price. Furthermore, these days a lot is being written on how bad was the Eskimo diet (apart from good effect of fish oils in that type of diet), but most recent epidemiological studies have described effects of what has happened to these people after introduction to "our" foods. I have an article given to me by Barry Groves (written in early 50's) in which the author is amazed how healthy these people were, before adoption of "healthy diet", considering how little carbs they had and their limited Vit C supply. Funny how until only recently Canadian government shot their dogs and prevented them from living their natural lifestyle, in return for some paid work and supermarkets. The same, in principle, goes for Australian natives. These days both of these peoples are obese and are sicker than their dogs, which somehow managed to stay closer to their natural diet.

  Back to top

Stephen Byrnes
In the hands of the nutritional "spin-doctors," all accurate food history and anthrolpology are routinely tossed into the garbage in favor of politically-correct ideas. Often, for example, it is typical for modern investigators to disregard or overlook insect consumption when assessing traditional diets. Insects are typically loaded with fat, including the grubs that were/are a feature of Aboriginal diets.

 Back to top

Paul Rosch:
Dear Chee Energy I think you are referring to Vilhalmur Stefansson's comments after his first expedition to the Arctic where he was impressed by the complete absence of cancer in Eskimos.  My recollection is that he later wrote a book entitled Cancer: A Disease of Civilization?.  Albert Schweitzer  similarly noted the absence of cancer in African natives on his initial visit to the Congo but its gradual emergence as natives " lived more and more after the manner of the whites" and adopted their diets and stressful lifestyles.
The first notation of such relationships was by Sir Robert McCarrison, a very alert and perceptive physician who had been assigned by the British Army to establish a hospital and health care delivery system for Hunza natives in the Kashmir around 100 years ago.    He traced family records, conducted detailed interviews, performed careful physical examinations, and kept meticulous records for almost a decade and was astounded by the magnificent physical and mental status of the very elderly.  diet was important but after reviewing all the information he had gathered, McCarrison concluded that the unusual longevity and extraordinarily good health of the Hunzas, well into the eighth and ninth decades, was due to the absence of the stresses of contemporary civilization, noting: ". . . and they are far removed from the refinements of civilization.  Certain of these races are of magnificent physique, preserving until late in life, the character of their youth; they are unusually fertile and long-lived, and endowed with nervous systems of notable stability. . .  Cancer is unknown." 

 Back to top

Charles McGee:
Dear Paul: 
Thanks for your response. I am aware of the extensive contributions of McCarrison. I have not heard anyone mention another nutrition-disease pioneer, British epidemiologist T.L.Cleave, who found that primitive people with adequate nutritional food supplies remained free of degenerative diseases until the entry of modern foods (he called the villains "refined carbohydrates"). From the entry of the refined carbs to the first observed cases of heart attacks, high blood pressure, diabetes, etc. took 20 to 30 years which obscured the connection, but he found no exceptions to the pattern in hundreds of   areas regardless of other changes going on.

Another pioneer was a Brit named Trowell who went to work in Kenya in 1930 and noted an absence of degen. diseases. He worked there 30 years and during that time the same diseases began to occur. When he returned to England he did a small study on about 15 people with hypertension and got about 12 of them off of meds. by having them switch to an all fresh food diet. His simple working hypothesis was the reversal of sodium and potassium levels in fresh versus processed foods, but this applied to all of the other minerals as well and at that time there was no way for him to have known.

 The general message from this is that a variety of diets kept people in primitive cultures free of degenerative diseases and at least 16 cultures had very high saturated fat diets. Of course, all the food was fresh, with whole grains, full levels of minerals, high levels of antioxidants plus B vitamins to prevent homocysteine problems, and adequate folate levels to prevent neural tube defects and fragile X syndrome (both linked to low folate levels). Missing were refined carbohydrates, oils containing trans fats (before margarine}, refined sugar, canned and frozed foods, in fact, no foods in containers at all.  

British physicians recorded the same findings when they surveyed the Bantu population in 1930 to see what diseases they were going to encounter in a new medical school about to open. Once again, no HBP, no evidence of coronary artery disease, diabetes, and strokes, all conditions it is easy to check for in the bush with only a blood pressure cuff, physical exam, EKG, and dipstick urine test for sugar.

 I saw the same pattern when I treated Ecuadorian Indians in in an Indian hospital in Cuenca, Ecuador, for a year (1965-6) 9000 feet up in the Andes.There were 320,000 Indians in the province and only one facility to provide medical care for them. Considered to be lower than animals by the city folk "Spanish" they lived in the countryside with no running water, no electricity, and didn't even cover their waste. They were entirely self sufficient for food and clothing. The only income was selling a few vegetables in the open markets for pennies with which they purchased batteries for transister radios so they could listen to an Indian radio station.

 Generally there were only about 40 patients in the hospital, almost all with trauma, burns, and complications related to severe shock with previous obstetrical complications trying to deliver in the countryside. No degenerative diseases ever seen, and very little cancer. Only one appendicitis case seen in one year. The young people grew up to have 32 straight, decay-free teeth and no acne. City kids hung out at the soda fountain and had crooked teeth, tooth decay, and were getting acne. I didn't appreciate what I was seeing until about a decade later.

 Perhaps we should have a contest to see who has the highest cholesterol level. Mine is 330. Can anyone of you skeptics top that? My level was 260 in the 1960s at a that time we were told normal was up to 300. I began to give up on the cholesterol theory in 1977 when I had dinner with Linus Pauling. I asked him if he wasn't taking a risk in eating his thick steak. He told me he believed if the body was well nourished with every thing it needed to function optimally then cholesterol would take care of itself and we didn't need to worry about it. By the way, he lived to 93.

  Back to top


Dag Viljen Poleszynski
Everyone:   After a lengthy debate with Loren Cordain, I have been unable to have him see the obvious: cave men sought out fat first and threw away lean muscle meat. A major flaw in the numbers Cordain presented is the amount of food one has to eat to fulfil his paleolithic prescription: 2.665 kg for 2200 kcal. With 77 kg and physically active I cannot eat more that about 1.2-1.5 kg/d during one whole day. For an active stone-ager eating 3000 kcal the only solution to fulfilling energy needs (lacking high-density grains etc) would be to eat substantially more fats. It would be interesting to hear if any of you can down 2.5-3 kilos of food during one day, and how in the heck could an athlete cover all needs with 15-20% fat (as suggested by Khalsa to be optimal), eating lots of veggies and fruits, and covering energy needs as high as 4000-5000 kcal/day?

  Back to top

Stephen Byrnes:
Dag and Everyone:    Cordain has been backed into a corner several times on this issue, most notably by Mary Enig and Sally Fallon a few years back when they engaged him in an online debate in the Paleodiet mailing list. He could never answer their objections, so Sally and Mary eventually dropped it.
You should know that several years ago, Cordain's estimates of actual fat intake by paleo peoples was much LOWER than his estimates today. After the debate with Enig and Fallon, he revised his numbers, but he STILL will not admit that the increase included any significant amounts of saturated fat! And his definition of "rabbit starvation" is a far cry from what Stefansson described among the Northern Canadian Indians and Inuit back in his book The Fat of the Land. Cordain, politically correct as ever, claims that the sickness and wasting that occurs when large amounts of lean animal protein are eaten occurs because the body has hit a "protein ceiling." REAL rabbit starvation, however, as defined by Stefansson happened when Inuit and/or Indians would not get enough animal fat to go along with their catches of lean meat, which were not preferred by these peoples.  SCB

 Back to top

Uffe Ravnskov
Dear Stephen and all   It is fascinating to speculate about the diet of man in prehistoric time. However, knowing how difficult it is to get reliable information about the diet of individuals living to-day, it seems a little absurd to guess what kind of food people ate 10,000 or more years ago, in particular which kind of fatty acids. And even if we knew, so what? Can we deduct anything about the influence of this diet on these peoples health, of which we know even less? Isn't it a subject much better suitable for a cosy after-dinner chat, than for creating scientific hypotheses? However, if you consider his recent papers good I would certainly like to read them.

The paper by Glew et al is a good example of another unfalsifiable hypothesis.
Best wishes - and beware of electronic microorganisms!

 Back to top

 Stephen Byrnes:
Uffe: It really is not speculation about what people ate thousands of years ago as prehisotric remains and tooth analysis can reveal what the diet was. As far as health impacts, I think it is relevant: all you need to do is look at modern-day peoples who are, for all intents and purposes, the equivalents of our Ice Age ancestors. The field of nutritional anthropology is not as murky as some think. 

 Back to top

Joel Kauffman
A colleague brought the book (see below) to my attention with great seriousness. I suggest it be handled as follows:    The Okinawa Program: How the World's Longest-Lived People Achieve Everlasting Health--and How You Can Too -- by Bradley J. Willcox, et al.
   One of the major “findings” in this book was that Okinawans consumed very little saturated fat (meaning fat containing saturated fatty acid [SFA]), and this was supposed to be a major benefit.  The main oil used in cooking was said to be canola oil.  Since canola oil is a recent invention, becoming common only in the last 20 years in Canada and the USA, it could hardly have been a benefit to Okinawans who are now very old.
 My co-workers at the University of the Sciences in Philadelphia, Mignon S. Adams and David C. Geliebter, spent a month in Okinawa recently, with special attention on food.   They did not see any canola oil in use.  The common oils were peanut (16% SFA), soybean (15% SFA), rapeseed (1% SFA) and lard (44% SFA).  Data are  mostly from Mary C. Enig, Know Your Fats, Bethesda Press, 2000.
 The Okinawans also eat significant amounts of pork and moderate amounts of chicken, both of which contain considerable SFAs.  This was confirmed by Stephen C. Byrnes, who lives in Honolulu, HI, and has friends raised in Okinawa.  They ate fish, rice and vegetables, but pork and lard “...have always been the mainstay of this people’s diet”.  Sally Fallon and Mary C. Enig quoted an Okinawan professor who wrote that the Okinawan diet was “greasy and good”.
 The glycemic index table was incomplete, missing all the good foods that have very low glycemic indices that diabetics can eat, such as nuts, cheese, fats, oils, and meat.   Diabetics have been punished for decades by being handed tables such as this where they might assume that foods not included should not be eaten.  Nuts, in particular, despite their carbohydrate content, have very low glycemic indices, and high nut consumption is strongly associated with longer lifespan (Hu FB et al., British Medical J. 1998:317:1341-5).
  These authors seems to have had a hidden agenda.  This book is certainly not recommended.
Joel M. Kauffman    Has anyone additional suggestions? 

 Back to top

23. Feb.

Barry Groves
The Stoneage diet" by Walter Voegtlin is a good reference work. But whether you can get a copy now may be problematic as it was published in the USA in 1975. In m y opinion, the 30% fat allowed in the Zone is much too low. It should be over 80%. In my opinion, The Zone is trying to be all things to all people - to be politically correct. It is heading in the low-carb direction, but playing safe by not going too high on fats. This is not healthy for anyone.     The amount of protein we need is approximately one gram per kilogram of lean body weight - whatever our evolutionary background. The only other macronurient necessary is to provide energy.     You should use carbs as an energy source as do the Japanese - if you have their evolutionary background, or you use fats as an energy source as should the northern Eurasians with an evolution through 2.5 million yearss of Ice Ages and a carnivorous background. Under no circumstances should the two protocols be mixed.    For those of us whose ancestry is northern Eurasian, the best source of energy is fat -- the more saturated the better as energy density is dependent on hydrogen saturation. This leaves carbohydrates in the position of being merely condiments -- something to make the meal more tasty.    Carbs should not be thought of as a major energy source for anyone whose evoltionary ancestry is northern Eurasian. It is the carb/fat combination that is at the root of the current health problems in these areas.     But that is what The Zone does.     The problem with a lot of the dietary advice given today is based on trying to correct a diet that is wrong to start off with. For example, it might be prodent to eat antioxidants with today's diet. But if you didn't eat anything that oxydised, you wouldn't need the antioxidants. Barry

 Back to top

Stephen Byrnes
I agree with your assessment of the "Zone diet" (but I doubt Barry Sears would ;)). I still think the protocol outlined by Allan and Lutz in "Life Without Bread" is the way to go for most people. I've had a lot of clinical success with lower-carb, higher fat diets. If people are having problems, it is usually due to some digestive defect like hypochlorhydria which is easily corrected with some HCL capsules.   Anyway, on Voegtelin's "Stone Age diet," the book is virtually impossible to find, but you can find an excerpt of the section comparing the digestive system of a human with that of a dog and a sheep at The chart shows that our  physiology is closer to a carnivore than a herbivore.

 Back to top

28. Feb

Uffe Ravnskov
More thoughts about the hunter-gatherer diet, based on the paper by Cordain et al, sent to me by Stephen (attached). The aim of the paper is to explain that although our ancestors ate much meat they did not get cardiovascular disease, as expected (?). To cite Cordain: “…increasing meat consumption in Western diets is frequently associated with increased risk for CVD mortality”. As far as I know there is little evidence if any that meat causes atherosclerosis or CHD (Jerome may perhaps correct me). The two references that Cordain uses to back up his allegation are at least invalid. One of them, by Hu et al (Am J Clin Nutr 1999;70:1001-8) effectively disproved that read meat is associated with CHD (RR 1.09; 0.91-1.30), although Hu try to say otherwise by making ratios of  red meat and chickens and other statistical humbug. The other is a 25-years follow-up of Seven Countries. Anyone who has read how Seven Countries was structured and has studied the data in depth cannot take that project seriously (See my book for details). Of relevance here: Do you really think that an analysis of the diet of a day or a few days reflect what these people have eaten the rest of the 25 years? And these food analyses were performed on “statistical subsets” of the populations only. Nothing was written about the size of these subsets although the dietary data are the most important part of that study. After having read most of Ancel Keys’ “scientific” papers I am confident that these subsets were very small. Note also that the analyses were group comparisons, not individual ones as in the many recent, large and contradictive cohort studies.

Cordain et al argue that our ancestors ate much animal food but had little CVD. Their main argument is analyses of the diet of present-day hunter-gatherer societies, where the average amount of animal food is 65% and the average amount of plant food is 35%. They find it curious considering that CVD is rare among these people.

As Stephen also pointed out, their paper seems to be an ad hoc modification of the current concept – they were saved from high cholesterol and CVD because wild animals’ fat has less fat than domesticated animals and the wild fat has relatively more MUFA. Whether this is true, I don’t know. But to use the average consumption of animal and plant food as a measure is grossly misleading. According to table 1 the amount of animal food in 13 present hunter-gatherer populations varied between 26 and 99 per cent, and the plant food between 1 and 67 per cent! As all of these populations have little CVD according to Cordain et al. the only valid conclusion from such figures is that it is highly unlikely that the diet has any importance for the development of CVD. Cordain et al also ignore some “ugly facts”, the African tribes who live almost exclusively on camels' or zebu cows’ milk (which is very fat!) but in spite of that have very low cholesterol, smooth arteries and very little CVD. Cordain et al also ignore the finding by Malhotra that southern Indians had seven times more CHD and died much younger than people from the north although the latter ate 19 times more fat, mainly of the animal variety. And those of you who have read my book know that this is only the top of the iceberg.

 Back to top

Chris Allan

As Uffe points out, the Seven Countries study was a sham. In fact, in the follow up book there was a lot of evidence that increased fat and protein consumption coupled with decreased carbohydrates was positive for disease reduction (Cancer and Heart Disease). Even though the authors reported the information and they even were forced to conclude that the changes in diet seem to benefit many populations, they still finished by stating that there could be an epidemic of Heart Disease in these countries in the years to come. This after more than 15 years of follow-up from the original study!!  

I found it interesting that the follow-up was/is ignored by the folks who still use the first study to implicate fat in heart disease. In the first book one can even find a few paragraphs that sugar was implicated in heart disease, but the Authors' dismiss this quickly. Why? It must be the classic issue that Keys was trying to prove a theory, and not observe and report objectively. This was probably the beginning of the problem we are in today. This is also about the same time funding for the NIH and the Heart Institute accelerated. 

 Back to top

Malcolm Kendrick
Dear all, Re: The seven countries study, I included a little section on the Seven Countries Study in my book. Sorry if it is bit long, but I though it may amuse you all.

The Seven Countries Study 

But what of the supportive data? Surely it must be based on something? Of course it is, and what it is mainly based on is Ancel Keys and his seven countries study - possibly the single most important piece of research in the development of the saturated fat hypothesis. This study ‘proved’ that the more saturated fat consumed in a country, the greater the rate of CHD. Or did it? 

If you chose, in the mid-nineteen fifties, to study the seven countries that Ancel Keys looked at. 

Former Yugoslavia

Then you could find an almost perfect correlation between saturated fat intake and CHD. 

However, if Ancel Keys had chosen to study:


 Then he would have discovered the exact opposite. Namely, the more cholesterol/saturated fat consumed, the less CHD. Indeed, if you were to have chosen any other seven countries in the world, apart from the ones Ancel Keys chose, you would get a different set of results. How Ancel Keys came to choose his seven countries will probably never be known – unless he makes a deathbed confession. 
As a piece of scientific research, the possibility that Ancel Keys introduced bias is so great that – were this study to be proposed today – it would be thrown out by any decent research committee. (Imagined conversation) 

Ancel Keys: I would like to carry out research into the correlation between heart disease and saturated fat/cholesterol consumption in different countries.
Member of research council: ‘Very good – how will you select the countries?’
Ancel Keys: I have already selected them.
Member of research council: How did you make the selection?
Ancel Keys: I just thought they seemed like good countries.
Chairman of research council: Jolly good, carry on!
Ancel Keys: Thanks.

 I can just imagine what would happen if I suggested a study on another seven countries, specifically designed to disprove the diet-heart hypothesis, having first chosen my seven countries, for my own reasons, I would be laughed out of court, and so I should be.

   If you think that I am joking about this, then read on, because I am deadly serious. Recently, Henry Blackburn, a doctor who worked closely with Ancel Keys, and became a personal friend, wrote a history of the Seven Countries Study. What does Dr Blackburn have to say about the lack of randomisation?

   ‘The study has been criticized for the method in which populations were selected for the study, and the way that the population (ecologic) correlations, with limited numbers of units, were carried out. These days, the configuration of populations for such internal and international comparisons is strengthened by the random selection of greater numbers of units. But the Seven Countries Study was state-of-the-art for its time, and the concept ahead of its time.’ Henry Blackburn M.D. Division of Epidemiology. University of Minnesota

   So it’s all right. Everyone admits that there was no randomisation in the seven countries study, but this doesn’t matter because it was ‘state-of-the-art for its time.’ No it wasn’t, people were carrying out randomised clinical trials at the turn of the twentieth century, and the first population study known of was done in 1666, in London, to discover the cause of an outbreak of cholera, a mere two hundred and ninety years before. Ahead of its time?

   More revealing perhaps is a short tale about the motivation for Ancel Keys and his Seven Countries Study.

   ‘In 1954, the fledgling World Health Organization called its first Expert Committee on the Pathogenesis of Atherosclerosis to consider the burgeoning epidemic of coronary disease and heart attacks. Several medical leaders of the time were assembled in Geneva: Paul Dudley White of Boston, Gunnar Björk of Stockholm, Noboru Kimura of Japan, George Pickering of Oxford, Ancel Keys of Minnesota, and others. As reported by Pickering, the discussion was lively, tending to tangents and tirades.

   Ancel Keys was in good form -- outspoken, quick, typically blunt. When, at this critical conference, he posed with such assurance his dietary hypothesis of coronary heart disease, he was ill-prepared for the indignant reaction of some.

   George Pickering, recently named Knight of the Realm by Queen Elizabeth, interrupted Keys' peroration. He put it something along these lines: 'Tell us, Professor Keys, if you would be so kind, what is the single best piece of evidence you can cite in support of your thesis about diet and coronary heart disease?'

   Keys, ordinarily quick on the draw, was taken aback. Rarely, of course, is there ever a 'single best piece of evidence' supporting any theory. Theory is developed from a body of evidence and varied sources. This is particularly true in regard to the many facets of lifestyle that relate to disease. It is the totality and congruity of evidence that leads to a theory -- and to inference of causation.

   Keys fell headlong into the trap. He proceeded to cite a piece of evidence. Sir George and the assembled peers were easily able to diminish this single piece of evidence, and did so. And by then it was too late to recover -- for Keys to summon the total evidence in a constructive, convincing argument.

   My theory is that Keys was so stung by this event that he left the Geneva meeting intent on gathering the definitive evidence to establish or refute the diet-Heart Theory. Out of this singular, moving, personal experience -- so my theory goes -- came the challenge, the motivation, and eventually, the implementation of the Seven Countries Study.’

   As Dr Blackburn reveals, point one: Ancel Keys was already certain that a high animal fat diet was the cause of heart disease – before he organised the seven countries study. More worryingly, Ancel Keys was so stung by an attack on him by Sir George Pickering that he vowed to go out and prove him wrong! Now that’s a good motivation for an objective, scientific clinical trial. Any chance that a man aiming for revenge could be tempted towards bias?

   Frankly, this whole trial should be consigned to the dustbin. The results themselves cannot be argued with. They are what they are. But in reality all that this study proved was that if you carefully choose seven countries where you already know the rates of CHD, and the level of saturated fat consumption, then you can demonstrate a close association between saturated fat consumption and CHD. That association, in those countries, has now broken down, and it never clearly existed for any other seven countries in the world.

   Finally, there was no association between CHD and saturated fat intake within the countries he chose to study. In Greece, the level of saturated fat consumption was virtually the same in all regions studied, yet the rate of CHD varied by a factor of seven. If it were not for the risk of libel, I would state what I really think of the seven countries study.