from Ingrid Naiman
This will be one of those meandering posts in which seemingly random dots eventually connect in a way that makes a picture.
So, once upon a time, a patient came to my clinic determined to solve her terminal cancer prognosis through diet. She read so assiduously that I hired her and gave her a practically unlimited budget for buying books. She was a fast reader and quick study so when she first came up for air she said, “Is there anything upon which everyone agrees?” The easy answer would have been “No” but I left some gaps around which a few threads could be woven together. I said, “Well, most people agree that white sugar and white flour are not good for anyone. After that, it is more or less a free for all.” We have the raw foodists and the “man discovered fire for a reason” badgering us with their arguments. Therefore, ultimately, everyone has to cut through the jungle himself/herself.
People like to suggest that cancer is a disease of civilization but there is actually very little proof for this theory since cancer was found in the bones of dinosaurs who most likely were not foraging in dumpsters. In reality, for countless years, the incidence of cancer was about the same, 25% of people would eventually develop cancer and presumably die of it . . . though, so far as I know, there is no proof that people die of cancer. The exceptions were the Hunza people and some felt that Eskimos did not have cancer before the advent of processed foods. It quite possible that before the advent of processed foods, there were no diagnoses either.
The place in the body where the cancer develops has some epidemiological variations. For instance, nuns do not develop uterine-cervix cancer. If you are interested, you can read about chimney sweeps as well as various cultures around the world and see who develops which type of cancer. Recently, however, the pundits are saying that cancer is on the rise. Superficially, it looks this way because we are seeing a tremendous shift in the age of onset of cancer: more children and young adults as compared to 20, 30, 40, or 50 years ago. However, the global figure of 25% might not hold either, not because the incidence of cancer has increased but the previous number one killer was malaria; and it is much easier to control than cancer though I know a couple of patients who thought otherwise.
There are so many theories of diet that I want to toss out a few to help people make sense of some of the latest and greatest hype. First, the theory that we are here today because our ancestors were less prone to folly than the present generation is worthy of thought. All of us are deeply disconnected from our cultural roots and diets. In the early part of my career, I used to say that we have all evolved some resistance to certain microorganisms because we have co-existed with them for generations, but none of us inherited any genes that help us deal with chemical pollution. In the scheme of things, we probably could not be expected to evolve coping skills for ten thousand or perhaps a hundred thousand years, but we have been challenged to do otherwise. It simply is not possible.
A few more examples might serve to support the thesis I am struggling to present. As noted in recent emails, spaghetti — aka noodles — arrived in Europe thanks to Marco Polo. Tomatoes and potatoes came from the New World. Lots of us came from the Old World and we brought some dietary habits with us and adapted somewhat to two main influences: local foods like corn and eventually processed foods. When I was first studying dietary influences, Germans were the largest immigrant group in the U.S. I rather doubt this is still the case, but what we call a hamburger or frankfurter is prepared in a vastly different way than in Europe. Putting a hot dog on a white bun with ketchup is not the same as eating a sausage with mountains of sauerkraut. Wolfing it down with a coke or light beer is different from a bitter beer, the point being that without the sour and bitter components, the rest of the meal is almost impossible for most people to digest properly. Yet, what is the annual consumption of such mainstays in the standard American diet (SAD).
The direction I am going is not towards what is good or bad about any given food but taking one part of an indigenous diet out of context of the greater part is reckless. For instance, one can be a vegetarian but if the way one decides to become a vegetarian is to eliminate meat from the diet but not replace it with anything suitable, nutritional deficiencies are sure to arise. So, if we want to be vegetarians, we have to study the diets of people who have been vegetarians for centuries and find out how they manage their protein requirements.
In recent years, countless people have been tested for food allergies and been told that they are allergic to wheat and corn. We could write this off to GMOs except for the fact that genetically modified wheat does not have USDA approval. Despite this, it was recently discovered in a field in Oregon and Japan responded immediately by canceling imports. This is all relevant in the face of 71 senators blocking the effort to permit labeling of GMO foods. Oh, and Monsanto lost its corn battle in the EU:
Depending on your sense of time, wheat is not part of the native diet of anyone since it has only been cultivated for 12,000 years or thereabouts. For geneticists, that timeline is ludicrously short. They look at the paleo diet and consider this as normal for homo sapiens. Archaeologists may or may not concur with the assumptions of those espousing this diet. The theory is that all humans arose from tropical Africa and spread out to various other places. They were hunter-gatherers who lived mainly on fruit and a few other wild plants and animals.
It’s a colorful theory but skirts the evidence of highly advanced civilizations that were built in a manner that suggests the ability to cultivate food and transport it. If one lives in a hut in the forest, one can forage for wild plants and hunt, and we might all have some genetic components that are consistent with this life style, but there were also very sophisticated communities in which thousands of people lived in much closer proximity to each other than cavemen.
There are very few straight facts in today’s world, but there are lots of quaint theories. One of them is that the cultivation of wheat made cities possible. Wheat is easy to grow, easy to store, and relatively easy to transport. This meant that wheat could sustain large numbers of people in concentrated areas. It also made it possible for armies to be much more mobile. I might therefore suggest that wheat has not just some kind of hypnotic effect on our sensory organs but an underlying tendency to foment aggression. This might be a leap for some but wheat contains opioids that are addictive. All other things equal, which they rarely are, wheat would have a numbing effect that would promote lethargy and apathy, not to mention food craving. However, because of processing and nutritional deficiencies, the erosion of inhibitions can result in much more disruptive behavior. Also, many people have adverse reactions to gluten, not just the usual celiac disorders but also impairment of brain function. Foods that supposedly pacify are those with high quality dietary fats such as seeds and nuts as well as peas and lentils and my favorite: artichokes. Not surprisingly, brain and liver food and herbs also have many beneficial effects on both behavior and health.
Those who are gluten intolerant have no kind words for wheat, even if the bran hadn’t been removed. The bran is nutritious but it turns rancid so most flour is made without either the germ or bran. This is a nutritionally deficient food that is convenient for bakers and doctors who need more patients.
So, now to keep this complex subject as simple as possible, let’s look at the list of grains with gluten and those that are gluten-free.
Grains with Gluten: wheat, including spelt, kamut, farro, and durum as well as products like bulgur and semolina; barley, rye, and triticale.
Gluten-free Grains: amaranth, buckwheat, corn, millet, quinoa, rice, sorghum, teff, and wild rice.
Oats are gluten-free unless contaminated with wheat when growing. Not everyone agrees on terminology about what is a grain, a cereal, a plant, etc. The workaround for this is to consider what is used as a staple and fudge a bit. Technically, however, amaranth, buckwheat, quinoa, and wild rice are pseudocereal grains.
Every grain is “whole” at one point. This is called a kernel and it has three main components: an outer husk which is the source of fiber. This is what is labeled bran when packaged. There is a germ which is the embryo that has the potential of becoming another plant. It is a source of B vitamins and proteins, minerals, and healthy fats. It is removed in processing. Then, there is the endosperm, the part used as a food supply for the germ. This is starchy and comprises the bulk of the kernel. It does contain some nutrients but less than the whole grain.
Whole grains are more nutritious unless rancid and that “if” is important.
Now, to connect the paleo dot. Thanks to the Human Genome Project and its various spin off descendents, we are looking at humanity in new ways. First of all, the idea that our history is a mere 6000 or so years old is obsolete. In fact, it is argued, the bulk of our genes might be more than a million years old. In any event, it is maintained that we haven’t changed much in the last 20,000 years. Agriculture is believed to have been introduced 10,000 years ago and given how meaningless 100 centuries is in the broader scheme of things, our bodies haven’t yet adjusted to the novelty of either cereal-based diets or processed food.
Where this thinking leads is that we have ancient genes and some that are probably well-adapted to the present; but in a crisis, a switch is flipped and a gene that wasn’t previously expressed becomes active. This is alleged to be the cause of many chronic diseases such as cancer. According to the same thinking, the cure is in a diet that is more ancient. Naturally, this starts by eliminating everything that is processed because these are the newest and dare we say the “baddest”. Using this logic, all processed grains would go and so would dairy, the reason being that humans only began drinking the milk of other animals when the age of agriculture transformed us from hunter-gatherers. Interestingly, or ironically, these same medical speculators suggest that the closer we are to tropical Africa, the more gluten and lactose intolerant we are whereas by the time one gets to the North, a far greater tolerance for both wheat and dairy is exhibited.
The dairy argument is particularly interesting because it suggests that the gestation period for humans ought to be 21 months. Other species are born with the ability to walk but not humans. I suppose we could be compared to horses or elephants, but I know lots of birds who need to stay in the nest before they will be able to fly. Anyway, the purpose of drinking our own mother’s milk is to continue the gestation until we are actually developed enough to exhibit the motor skills of other mammals. Obviously, anyone can have a theory, but what is interesting in these speculations about our non-recorded history is that we have countless genes that are not expressed. We actually have no idea what would happen if we flipped some switches, but in the meantime, it is proposed that our traditional diet was composed mainly of fruit and that this is practical in Equatorial regions but not when the winters are harsh. In any event, the cure for the diseases that are caused by inadequate adaptation is to revert to a more ancient diet that is heavily based on fruit. In fact, the most astonishing cancer cures I have seen were based on grapes, not wheatgrass. I am not putting down any diet, just saying that after more than four decades of working with people with cancer, the most remarkable turnarounds, even for very advanced cases with many metastases, were to rely exclusively on grapes. However, I think many other fruits offer the same potential.
I am also convinced that the reason fruits like amla and bilwa and haritaki and bibhitaki and even pomegranates and sea buckthorn berries are so remarkable is that they not only are rich in antioxidants but they possess a wisdom that is beneficial for our health.