The Paleolithic diet presumes that foods eaten during the stone-age (Paleolithic era from 2.5 million years ago to 10 thousand years ago) are optimal foods for humans. The Paleolithic (Paleo) diet includes grass fed beef and other lean meats, fish, shellfish, fruits, vegetables,  eggs, nuts, but no grains, no dairy, no salt, no refined fats (butter or margarine) and no sugar or high fructose corn syrup.

Fanatical Diet (Lifestyle types)
There are three things one should never discuss in polite company, religion, politics, and diet. Getting into an argument with proponents of diets is like a democrat trying to convince a republican that Obama is ok. Each side will quote their own studies, statistics, and population studies. But the key to scientific study of the various diets is not what we presume from correlation, but from what we learn when that diet is placed into patients – in this case, the laboratory values of those who have the diet.

Diet proponents become fanatical about their diet (lifestyle) to the point of religious fervor. Seeking to prove that their diet is backed by science, proponents use population studies with associations that are only suggestive and not proof of causation. These associations become propaganda as the associations are repeated over and over, morphing from a suggestion to “proof.”

The Flaws of population studies or Correlation does not equal causation
The foundation of many diets are based on the correlation of what a population eats and what diseases they suffer from. In the Paleo diet the assumption about what they ate and the diseases they suffered from is a spurious correlation at best, and far from causation.

Population studies are flawed, as often we find that we don’t know as much about the population as the data might suggest. Take the Pima Indians of the Southwest. In 1990 a paper came out stating that the Pima Indians had a low incidence of fatal coronary heart attacks in spite of having a high rate of diabetes. The Pima Indians were called among the most studied populations, with an NIH post in Phoenix, and lots of studies showing the highest rate of diabetes in the world. When the population was examined more carefully, the Pima Indians had plenty of heart disease.

Step back from the most studied group in the United States with great statistics and physicians trained in modern medicine and then imagine making conclusions about what Chinese eat, or Mediterranean’s, or French. Those assumptions are more flawed, as are the statements about what diseases they do or do not have. Now step back further trying to determine what people of the Stone Age ate, what diseases they had, and we leave the tenuous role of suggestion and enter the role of outright guessing. Even if we have reasonable data (and often we don’t – even for the best studied people in the United States) the correlation between what people eat as a cause for what diseases they have is a fundamental flaw. Correlation does not equal causation.

The Best Diet or Lifestyle is?
When it comes to the best diet plan for a person – we just don’t know enough to say that one is better than another. There isn’t enough evidence to state that the Paleolithic (also called Paleo) diet is better than the Ornish, Southbeach, Pritiken, or pick one, or better than how you currently live your life.

We cannot broadly say that any given diet will prevent heart disease, cancer, arthritis, or even obesity. When someone tells you a diet can prevent such, they have gone from the realm of science to the realm of bs.

The Paleo Diet Premise:
The Paleo diet premise is that we should avoid certain foods because our body is not evolved to process those foods, and if it does process them it will lead to the chronic diseases of modern man – heart disease, strokes, cancer. Cavemen didn’t have those diseases, so we should eat like cave men. Of course, we don’t know about what diseases that cavemen had – especially when it comes to organ and soft tissue diseases, we just have a few fossils that we examine and look for evidence of known diseases. Would coronary artery disease show up in a fossil – nope? Would cancer show up in the fossil – bone cancer would (kind of a rare cancer) or cancer that went to the bone might – but it would be hard to tell if the fossil evidence.

We do know, from many hunter-gathering societies, that they live a short life, and not long enough to develop the diseases we associate with aging. All a person has to do to pass on their genes is make it into puberty, and to be effective to nurture the young, into the 30′s, and to see grandchildren and help child raising – into the early 40′s. That is what a simple civilization needs. After that, in any primitive society, the elderly become a burden – perhaps to be placed on an ice flow. People who live into their 40′s and 50′s may die of cancer, heart disease, or obesity- but they will have passed on their genetic code.

The Evolution of Homo Sapiens:
When Homo Erectus came out of Africa, they encountered a world that was much more varied in food sources than Africa. The brain of the human (H. sapiens) evolved, becoming much larger, and utilizing far more energy than the brains of the Australopithecus – about 10 percent more. More than any other species, humans evolved a brain that required more calories- and our brain metabolism accounts for up to 25% of our energy needs. Bigger brains and its increased requirements mean a richer diet- and modern hunter gathering species derive about half of the energy from animal foods – in contrast with other primates that have far fewer animal foods. While our ancestors the Australopithecus dined on plant foods, and had large mouths to grind up fibrous plants – humans are built, with smaller faces and jaws, to dine on energy rich animal foods.

The reconstructed skull of Lucy, Australopithecus- large jar and muscles for eating plants

The Human skull is larger, larger brain- and jaws for more energy rich foods

Humans were successful, as the fossil record shows, because they were “flexible” eaters, using a wide variety of dietary strategies. If there were a lot of Elk, then we ate elk- berries, we picked berries. To state that our digestive system evolved only to eat some few items found in the Stone Age – has been disproven on the face of it. Our ancestors in Africa didn’t encounter Arctic char, whales, seals, salmon – and yet when they moved from that warm climate to the frozen north, they adapted quite well to a very high fat diet of primarily animal based diet that was clearly not available in Africa. The findings of starch grains from wild plants in grinding tools from sites in Italy, Russia, and the Czech Republic from the mid-upper Paleolithic era suggest that the production of flour was present 30,000 years ago.

Contrary to what Paleo proponents state: people made flour 30,000 years ago

How to eat like a caveman
There are some things about the Paleo diet that people avoid:

Excess sugars including fructose
Excess Omega 6 oils – including soy
Processed wheat, grains, and gluten
Dairy

What is the scientific evidence for this? It’s the simple premise that modern man has lifestyle illness from altering food, taking in too many calories, and if we would return to our ancestors roots (pun intended) we would avoid these highly processed foods and not suffer from the holy trinity of diabetes, obesity, heart disease, and maybe even cancer. There is not a single shred of evidence to support the premise of this diet.

An entire dietary regimen has been formed with plenty of books and websites to guide you through this. It has become so popular that the question becomes not the flawed premise for the diet, but rather how the diet would compare to other diets. If you want to eat like a caveman, then shop on the outside of your grocery store.  Everything on the inside of your grocery store is generally processed foods, and everything on the periphery of the grocery store is generally not processed.  On the periphery you will find the vegetables, fruits, meat counter, fish counter – although you might get in trouble with dairy, and before you check out they might have a cookie or two – or there might be a bakery (a big no no among the non-Geico types). But lets be clear- whatever the caveman could get that they could eat- they would eat, and if a caveman were to be around today- wait, we have them – well, they eat Poptarts.

In one real scientific study patients with known heart disease who were randomized to either the Mediterranean-like diet (based on whole grains, low fat dairy products, fish, fruit, and vegetables) or the Paleolithic diet (no grains or dairy but plenty of lean meat, fish, fruits, vegetables, root vegetables, eggs, and nuts) and those who undertook the Paleolithic diet were satisfied with less food. There was also a decrease in leptin in the Paleolithic group by 31% and by 18% in the Mediterranean group.

There have been other studies that show that people who go with this diet have improved laboratory values – less triglycerides, lower blood pressure, some weight loss, that the diet has a better glycemic index (the food doesn’t increase blood glucose levels as much). This diet compared to a standard diabetic diet did better. Those studies are short term, with small numbers of individuals, and hints of laboratory values.

So before one assumes I am putting this diet plan into the trash bit along with Ornish- there is clearly some data here that shows good nutritional sense in the food.

While highly processed carbohydrates transiently increases blood glucose levels more than whole grains – it does not mean that bread is bad for a person. At least we don’t know enough about this to state that today. Clearly, people who eat a lot of flour based products can get fat quickly, and getting off the bread and bakery products will help reduce weight, decrease hemoglobin A1C levels, decrease triglycerides, and overall be healthy.  Some people need to be told to never eat them again – as some alcoholics must never drink again- and some people are able to moderate them so they do minimal damage to the body.

Only a few studies have examined the effects of the Paleolithic diet on laboratory values that we associate as increased risk for disease – but again, those were laboratory values, not a long-term follow up for disease.

The premise for the Paleo diet may be flawed, but here are the parts of the Paleo diet that most would agree with:

(a) Highly processed grains – white flour, rolled oats- do cause a rapid increase in blood glucose levels and the body responds to that by increasing triglycerides and ultimately fat.
(b) Fish – as long as it is not contaminated with mercury, is a protein source that is high in Omega 3 fatty acids, which have been shown to be beneficial. If you have some great fish three or four meals a week it works out well.
(c) Vegetables and fruits are the basis for most diets- thus a vegetarian could participate in a Paleo diet easily. Too many people do not eat enough fruits or vegetables or look to them as snacks.
(d) The trend away from cattle feedlots and desire to have grass fed rather than grain fed beef. Grain fed beef is fatter and more prone to being infected with Salmonella or E.Coli than grass fed beef.  There is a wider variety of taste with grass fed beef, and most who find grass fed beef end up preferring its flavor. Grass fed beef is best cooked with Sous Vide cooking.
(e) If you eat more calories than you burn you will gain weight. But it is more than just calories – it is also the types of calories. Eating high glycemic index foods mean you will spike glucose pushing it into cells, where it will be quickly transformed and stored as fat. Low glycemic index foods will be slowly burned  - thus, calorie for calorie with the Paleo diet plan you will tend to burn the fuel from the food as opposed to store it.
(f) If you eat a majority of your food with highly processed grains instead of whole grains you will have a faster rise in blood sugar. Some attribute this rise to increased obesity and an increased load on the pancreas.

Overall- this is not a bad diet program. Nothing in it would appear to cause nutrient deficiencies and there is some preliminary evidence that this diet keeps a person more satisfied with less food. It is a low-carbohydrate diet, and those diets, in comparison to other diets, tend to produce faster and longer weigh loss.

Here are a few scientific references- I’m sure we will add more as time goes on

Low incidence of fatal coronary heart disease in Pima Indians despite high prevalence of non-insulin-dependent diabetes. RG Nelson, ML Sievers, WC Knowler, BA Swinburn, DJ Pettitt, MF Saad, IM Liebow, BV Howard, and PH Bennett
Circulation. 1990;81:987-995

Food for Thought: Dietary change was a driving force in human evolution. Wm R Leonard. Scientific American. December 2002: 107-114.

A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in inviduals with ischemic heart disease. Jonsson, et. Al. Nutrition & Metabolism 2010, 7:85

Thirty thousand-year-old evidence of plant food processing. A Revedin, et al Proc. Nat. Acad. Sci, November 2010: 107:18815-18819

Dr. Esselstyn noted the risk of heart disease in rural China was low in the 1970’s – and presumed that they didn’t have a “western diet.” Now there are two flaws in his population statistics: First in the 1970’s in rural China most individuals were starving to death – it was the end of the cultural revolution and any source of food that could be found and eaten was. The second issue is if you examine data from The China Study you will see that heart disease mortality was lowest in the rural communities that were able to eat more meat. In The China Study (again, I promise this will be a topic later) – they used mortality statistics from the time during the end of the Cultural Revolution. Rural China was starving then, all trees had been used for fuel, there were virtually no birds left (combination of deforestation and hungry humans) and rice was used for the army.

Dr. Esselstyn then talks about Norway during World War 2, when they were occupied by the Nazi Germany, and how that heart disease diminished as the Norske were forced to eat a plant based diet. That was a great assumption to make, but when examining the data from Norway there are a few interesting factoids – Meat consumption dropped 60% but fish increased 200 per cent. Vegetables and potatoes increased but sugar decreased by half. And when the data is put to a microscope in 1942 and 1943 when mortality declined, animal proteins were still higher than before the war. It appears that Norway suffered from increasing fish (great source of Omega 3 fatty acids) and foraged for foods such as wild greens, grew and ate a lot of potatoes, but had a low amount of sugars and almost no margarine (I don’t know a respectable Norwegian today who cooks with margarine). The sad part of the war was the increase of mortality from infectious diseases – especially pneumonia (my mother’s cousin who fought for the resistance died of this, as did many of his comrades).

Norway in WW2 ate a lot of fish- and this roe was popular

He followed these patients for up to 12 years – his numbers are confusing as he started with 24 patients and six dropped out (leaving 18). One of the 18 died from his heart disease (leaving 17). At ten years there were 11 patients. They did angiography and reported a regression of 11 lesions with 14 remaining stable.

Angiogram- xray - of a plaque. Not enough to do surgery on though

When any study talks about a “cardiac event” it means to most of us a heart attack. If you have a small lesion in a coronary artery and then that lesion accumulates a blood clot that is what a heart attack is. The blood clot (from platelets – a sticky component of blood that helps you clot ) blocks the flow of blood to the heart muscle. If the clot blocks blood flow for a long time then the heart muscle dies and you have a myocardial infarction, if it opens up then all you have is a heart attack. This has little to do with the size of the lesion, and more to do with the complex chemistry of the coagulation system. Hence, taking aspirin a day or Plavix is more beneficial.

The other major problem with the study is that these individuals were on lipid lowering medications. Dietary reduction of lipid level (Cholesterol and lipoproteins such as VLDL, HDL) is about ten per cent on average, but never more than twenty per cent. However, lipid-lowering medications – such as Crestor – can remarkably lower levels of the lipids. In addition, lipid-lowering medications are best for reducing inflammation. They are anti-inflammatory to blood vessels, meaning in addition to lowering the lipids and cholesterol, their main effect is to reduce the chance of having a “coronary event.”

Crestor shown to be effective at decreasing the plaque in arteries

One of my cousins, preventing heart disease and eating fat

What we think we know about how the body reacts and what we really know are two different things – here are some popular myths through the years as they relate to diets.  The most dangerous assumptions about diets come from population studies, you have heard them,  this population did that, and here is why this diet is great…

Seven-Country Study:

Warning against all fats- he became the cover boy for Time in 1961

From the 1960’s through the 1970’s the primary focus of the American Heart Association to the Congressional Paper by McGovern in 1976 was cholesterol.  It was wrong – but the ramifications of this public policy live on in many nutritional books today. Ancel Keys, a physiologist, promoted this based on the “seven country study” where he concluded serum cholesterol was strongly associated with heart disease, therefore a diet low in cholesterol would reduce heart disease. The statistical data did not back up his conclusion- he left out the “French” paradox – and ignored the Japanese increase in meats after he war with a reduction in strokes and heart disease. We now know the “epidemic” of heart disease was more related to the increase in cigarette smoking than diet changes.

Now we have science (and my previous post have discussed this particular diet) – and science has shown that it is not cholesterol, nor is it dietary cholesterol, nor is it even saturated fat that is the problem. We  have also discovered that margarine- which is trans-fat, is probably one of the worse things that a person could have.

Keys later in life said cholesterol wasn’t so important. He then discovered olive oil, and was one of the founders of the Mediterranean Diet. He lived to be 101.

The China Study

Colin Campbell pooled blood samples from 100 remote villages in China, and based on the data came to the conclusion (which he had come to before) that those who had vegetable proteins lived the longest, and animal proteins were the primary cause of heart disease, cancer, and halitosis (ok maybe not halitosis).

The data in his study did not support his conclusions (which were remarkably made into a best selling book).  In fact, most of the data in the study, when critically examined came to the opposite conclusion. For example – the one village with the highest consumption of meat (twice that of even US populations) had the lowest incidence of cancer and heart disease.

Another bit of data – the higher the processed wheat and sugar in the diets- the greater incidence of heart disease.

For those who live in China – including remote rural China- they eat everything- all proteins, from animals, to insects, to anything that moves, walks, and crawls. Ask them what they eat for protein – and well, another story.

This has become the calling card for vegans everywhere- stating that this shows that their diet will allow them to live the longest and healthiest life.  Sadly- the study is horribly flawed and bias. A great review of this work is done by rawfoodsos.com

The Norwegian Study

Norway was invaded by Germany in World War 2 – the Germans confiscated all animal proteins to feed their soldiers  and Norwegian mortality True,  true and unrelated. Animal protein went down, fish went up 200 per cent, and sugars, flours, and processed goods were highly rationed. The other problem – mortality dropped in 1941 and Germany invaded in 1942. Other issues- in wartime, deaths from other causes – trauma (guns), pneumonia, and other infectious disease increase before a person has a chance to choke off the coronary artery.

Paleo-Diet

Ok, there are a few of these people who gather and hunt left but what we cannot conclude is that they were disease free, that they had few dental carries (cavities) and they lived in the garden of Eden. This is made up- totally made up. Sells a lot of books though.

Strong Heart Studies – the Pima Indians

When I arrived as a vascular surgeon to Arizona, I was told that the Pima Indians had something about them because they didn’t suffer from heart disease. In fact, it was such a strong issue that a study was made up – the Strong Heart Study.  This was at odds with medicine since the Pima Indians have the highest rate of diabetes in the world. Turns out, as they examined them – most Pimas die of heart disease.  Simply put- their hearts were no different than anyone else’s and their rate of death from heart disease was higher than the population.

The lesson from the Pima Indians is this—even with NIH people, and fully staffed health service- the statistics kept were not that great. Imagine a third world country, or even a number of studies done years’ ago- the statistics about what causes mortality is quite suspect.

So here is what we know from modern science and diets:

Conclusions from population studies are often flawed by the people who study them – and they come to conclusions that are often not backed by the evidence. Filled with confirmation bias, these studies are all but useless for making any conclusions to how food will affect health. Some useful things – fish are good, lots of sugar not so good, meat is ok.

With Evo we will examine some simple variables—body fat, muscle mass – some lipids and some liver profiles. Based on that we will see how his body is reacting to this. If we see anything that worries us, we will stop.

Thankfully Evo will not drink bad beer – only great craft beers.  Besides sausages- I hope to have him over to my house for some Wiener Schnitzel (it is German – and Evo will bring the beer).

I don't know much about beer - but I'll bet Evo likes this one

Who knows- perhaps the world needs more of the “Evo diet.”

Physician disclaimer time: do not attempt this diet on your own. You need a physician supervision for something like this- unless of course Evo and I write the book- in which case we will happily autograph books of  ”The Evo Diet” – please order ten at a time.

You can follow Evo’s diet journey on his blog:

http://funanymore.com/2011/09/27/brewdiet-the-beginning/

Heart disease happens when the arteries feeding the heart become infiltrated with plaques – and these plaques happen to contain fat, cholesterol, white blood cells. If the plaque builds up slowly the flow of blood to the heart diminishes and people develop chest pain or angina. If that plaque ruptures and causes the artery to close- that is a heart attack or myocardial infarction.

Plaque formation was thought to be because of a person’s diet – since the plaques had high levels of fat and cholesterol, it was thought that a diet that was low in fat and cholesterol would minimize a person’s risk of heart disease. Sometimes that is true- but not always- as the French have shown us- with a diet high in fat and cholesterol and one of the lowest levels of heart disease in the western world.

It turns out the instigator of plaque formation are the lipo-proteins that carry cholesterol and triglycerides. Think of LDL, HDL, VLDL, and IDL (low density lipoprotein, high density lipoprotein, very low density lipoprotein, and intermediate density lipoproteins) as boxcars that carry cholesterol and triglycerides. Those lipoproteins set off an inflammatory reaction in the blood vessel (they become oxidized) and that leads to plaque formation. The more of those proteins a person has, the higher the likelihood that they will develop heart disease.

Think of LDL as “lousy.” The HDL levels are associated with fewer tendencies for heart disease – but they still can cause inflammation of the artery, and a problem. Hence, artificially raising HDL levels causes more issues with heart disease (as was recently discovered in the niacin trials). HDL levels are seen in people who have more omega-3 fatty acids in their diets, but increasing their levels is still harmful.

The more lipoproteins your body makes the higher incidence of heart disease you will have.

It has only been recently that science has recognized that one must measure the lipoproteins directly. Not indirectly by measuring cholesterol – as the laboratories do today. In the recent article from the Journal of the American Medical Association, they measured LDL-cholesterol in people placed on diets rich in soy proteins, fiber, and walnuts – showing a decrease in the LDL-cholesterol – a classic mistake. LDL-cholesterol does not measure the total number of lipoproteins. The amount of lipoproteins one has depends on how much cholesterol and triglycerides the lipoproteins have to carry. If a person has a lot of cholesterol and/or triglycerides in the blood the body will make more lipoproteins. If you have too many, those lipoproteins will get into the wall of the artery and lay down their cholesterol and triglycerides (which are fats).

If you have a lot of triglycerides it will bump off the cholesterol and you will make more proteins to carry the triglycerides. Your cholesterol level will be low, but your number of lipoproteins will be high- and thus, even with low cholesterol you will have a high incidence of heart disease. This explains some of the seemingly contradictory data of people who had low LDL-cholesterol levels but a higher incidence of heart disease – when that blood was looked at later they were found to have a high level of the LDL proteins.

We still don’t understand everything about the biology of the formation of plaque but we do know this: genetics determines most of the level of cholesterol, and if your level is high reducing it with medication will reduce the incidence of heart attacks and strokes. If you have genetically high triglyceride levels, the same applies.

In terms of diet- dietary cholesterol has minimal impact on blood cholesterol. Triglyceride level can be greatly impacted by diet – however.

To reduce triglycerides in your diet, here are some suggestions:

* Eat fewer calories if you are overweight. Excess calories are converted into triglycerides and stored as fat.
* Avoid trans fats, found in some fried foods and commercial baked products.
* Replace saturated fat (found in animal fat and some tropical oils) for mono-unsaturated fat (found in olive/canola/peanut oils, etc.).
* Consume at least 2 servings of cold water fish each week, such as salmon, mackerel, tuna, lake trout, herring, and sardines (all of which are high in omega-3-fatty acid). *Include into your diet other foods high in omega-3 fatty acid, such as ground/milled flaxseed, walnuts, almonds, canola or soybean oil, etc.
* Avoid refined foods and foods that contain sugar (such as white flour, desserts, candy, juices, fruit drinks).
* Choose carbohydrates that have 2 grams fiber or more per serving, such as brown rice, whole wheat bread, and whole grain cereals.
* Consume at least 2-3 cups of vegetables and 1 cup of fruit each day.
* Follow your doctor’s advice regarding alcohol. Alcohol increases triglyceride levels for some individuals. If you have high triglycerides and do consume alcohol (such as red wine), it is recommended to limit intake to 5 ounces per day or limit it entirely.
* Exercise to burn excess calories, aiming for at least 30 minutes of physical activity on most days of the week.

Medications
People who have high triglycerides and low HDL or high LDL levels may require medications as well as diet modifications. Patients with triglycerides in the very high range (over 500 mg/dL) generally will require medications, because triglyceride levels this high may cause an acute inflammation of the pancreas.

The results, as they were with President Eisenhower- are not likely to be different.  Eisenhower ended up eating almost nothing but Melba toast and grapefruit, obsessed with his cholesterol level, and having more heart attacks until the last one killed him.

What is the evidence that a vegan diet is healthier for a person than a diet with animal proteins? None. There is no evidence that a diet that is based around plants or a diet with low animal fat does little.

Some will cite epidemiologic data- a poor source for data less than a level one.  If you cite epidemiologic data you have to explain all the data—and often they ignore the “French Paradox.”  Or ignore that while the Japanese eat little meat and have few heart attacks – their average consumption has increased over 22 percent with no increase in heart attacks (often people cite data from post World War 2 Japan, and not current Japan – and then ignore the data about stroke rate). When all epidemiologic studies are examined – one cannot justify a plant based diet on those.

Some cite the Journal of the American Medical Association (JAMA) study claiming that an animal based diet had more mortality than a plant based diet – but few have read the study.  While Dr. Ornish jumped on this study, saying it justified what he has been telling people- apparently he didn’t read the study either.

This study divided people into two groups- the low-carb group received 37 to 60 percent of their calories from carbohydrates (that isn’t low carbohydrate by any standard). The meat group was not divided out for those who smoked and were overweight (a higher portion of the meat group smoked and were obese). The vegetable group had 30 per cent of their calories from animals, as opposed to 45% for the meat group (so not really a vegetable group).  Once again, an epidemiologic study  and it is flawed.

What we do know from science about low-density-lipoproteins is that they fall into two groups- one group is far more deadly than the other, causing the majority of atherosclerotic plaques.  That is the group with the high tri-glyceride levels is the one that is deadly. Of this there is no doubt in the scientific community.  When the Very Low Density Lipoprotein and apo B – leading to high low density lipoprotein – leads the the increased in artery plaque leading to heart attacks and strokes.  The lower the triglyceride levels then the lipoproteins secreted by the liver become the subspecies of intermediate-density lipoproteins, which are far less cause of atherosclerosis than the others.  Where does the triglycerides come from? Not animal proteins, but primarily carbohydrates.

Bottom line from science – the more triglycerides – result in atherogenic small, dense LDL proteins – and this happens from carbohydrate rich foods.

What about Greece, and Southeast Asia, and Japan(after world war 2) . These populations barely had enough food to survive.  They didn’t use refined carbohydrates – and ate whatever they could. It was not the low-intake of saturated fat that protected them, rather the relative lack of a refined carbohydrate leading to low triglyceride levels. Still, those studies, championed by the late Ancel Keys, are still cited.  This in spite of overwhelming evidence to the contrary.

Back to President Clinton – a vegan diet will not save his heart. Saturated fat is not what led to the atherosclerotic plaques – rather, it was the abundance of triglycerides from highly processed and abundant carbohydrates. What he has done that will help him is, lose weight, have heart surgery, take medication –but  in terms of diet, President Clinton falls into what Eisenhower did, as well as every anorectic—when the only thing they can control is diet, they will fall victim to fads that sound healthy, are promoted by TV MD’s – but have no science to back them up.

If you want to be a vegan for health, there is no data to support that. In fact, vegans have a life expectancy that is less than pescetarians (fish eaters) and omnivores.President Clinton – a Vegan

The rotisserie is one method to make perfect chicken. This unit is at Wm Sonoma

Such dry chickens are not only unpleasant to eat- but are the types of meats that can become stuck causing what we call a food bolus.  With a food bolus you feel as if you swallowed a golf ball. Nothing else will go down. Sometimes you can’t even swallow saliva.

You may have experienced a partial one of these when you swallowed a piece of meat and you could feel it go down.  When it gets stuck- big problem.  My patients with the LAP-BAND must have moist chicken- dry chicken will become stuck and make an otherwise pleasant evening turn into a retching mess.

Chicken recipes they strive for this nirvana of chicken – sometimes with complicated instructions – but there are two methods to cook the perfect chicken. One is cooking the chicken Sous Vide, and then you have the perfectly cooked chicken needing only a quick fry to make the skin crispy. For those who have skinless chicken breasts (no accounting for taste) – Sous Vide is the perfect method to prepare the chicken.

For those who, think that a crispy chicken skin represents the best pleasure – cook the chicken on a rotisserie.  You can buy rotisserie chickens from the supermarket- but often the skin is moist with fat, and the breast is overcooked, although not dry.   If you have a home rotisserie unit you can save this most delightful part for yourself (and once you have had perfect chicken skin, crispy- you will never want to go back.

For those who believe that chicken skin is evil- I would ask you to produce one scientific paper showing such- you can’t find one. The reason you cannot find one is because they don’t exist.  They don’t exist because there is nothing wrong with chicken skin – nothing. It will not raise your cholesterol it will not raise your low density lipoprotein (LDL- remember, bad is lousy – so lousy for LDL  and “happy” for HDL).  You might read “summary “ articles from National councils or consensus reports- but there is not one shred of evidence in the scientific literature that the skin of chicken is “bad” for you – in any manner, anywhere.  Or you can listen to Rocco – a chef with no medical training who wrote a best seller, or you can listen to Dr. Oz, who can’t cite a reference either.  Or you can enjoy chicken skin knowing that a guy who does weight loss for a living says you can eat it.

Buy a rotisserie unit.  There are a bunch of them out there- it is become quite popular,  although I cannot tell you the plus or minus of any one of those units- I can tell you that many do not make the chicken hot enough to crisp the skin.  What to do? Borrow one from a friend- ask around (most of them are in closets) and try one.  If a local fancy food store is demonstrating them- try their product.

I have a 1957 Roto Broil 400 – it is as old as I am but works great (like me).  There are a bunch of great brands out there today- and if any of you have them and they work- please comment.

My Roto Broil 400 was made the year I was born, 1957. Still works great

Until then- your mom was right- the best thing is in the skin  – but not the vegetable skin – it is the chicken skin (oh, and pork belly skin is pretty good too).

Recipe for these is pretty simple.  Have a fresh, whole chicken – remove all the giblets and other parts.  Rub the chicken with extra virgin olive oil. Season the chicken with salt, pepper, and garlic granules.  No need to stuff the chicken.

Truss the chicken- and place in the unit for 15 minutes per pound.  Warning- chicken skin is addicting.

If you have a home rotisserie unit and it works well for you – please comment! Let me know the name, the make and how you make your perfect chicken.

When it comes to finding simple things to lose ten pounds in a year, often the answer is easy.  It means changing your tastes – and finding something that is a lower calorie alternative or substitution for what you normally drink.

Soda pop is nothing but pure liquid calories – and often I see people walk around with a huge container filled with soda from some convenience store.  Did you know that a can of soda is about 100 calories for 8 ounces? There it is– a simple way to save ten pounds in a year.

I don’t think that even diet soda is a great thing for the health-conscious consumer- but it is a step to better health.

Still, be on the look out for liquid calories that add up quickly for your weight gain.

The 20 ounces bottle of Sunkist soda is 325 calories! That isn’t “natural goodness” in there– that is the same amount of calories as over a dozen chocolate chip cookies.

Snapple 20 ounces is 250 calories. Drink one of those a day above what you burn for calories and at the end of the year you will have gained 25 pounds!

And don’t forget that cup of latte you get – well, the Starbucks Frappuccino (13.7 ounce bottle) is 290 calories! A simple cup of coffee with a teaspoon of sugar and creamer is 25 calories (add ice in the summer to make a cold coffee drink).

So, when it comes to liquid calories- water is best, calorie free, and will quench your thirst. If you “must” drink soda– don’t drink the kind with sugar or high fructose corn syrup – instead, drink zero calorie soda.

Other healthy alternatives include Propel Fit Lemon, only 25 calories, or Desani Plus Pomegranate Blackberry, zero calories. Sobe Lean Mango Melon is 12.5 calories.  And for your water you can always purchase packages of Crystal Lite to place in the water– zero calories!

Remember, changing 100 calories a day is 10 pounds in a year. So think about those liquid calories – and try some new ones.

Thinking of skipping meals? Think Again! from McMedia ProducerGirl on Vimeo.