The previous post was concerned with the problems with nutritional science in general. In this instalment, I plan to look at how these issues, and others, pertain to the science used to validate the concept of the paleo diet.
The basic argument for eating a paleo diet goes something like this:
“Our ancestors ate a hunter gatherer type diet comprised of wild game, fish, eggs, fruits and vegetables with small amounts of nuts and seeds. Grains, legumes, dairy, vegetable oils, processed foods and other products of agriculture and the food manufacturing industry were absent from their diets.
These same ancestors were free from the diseases of civilisation – They did not suffer from heart disease, diabetes, obesity, auto-immune disorders, cancer or mental illness (as are contemporary hunter gatherers still alive today).
We should therefore attempt to emulate their diet as closely as possible, in order to achieve optimum health and longevity”
I know this, as I’ve said it myself many times in the past.
If you were paying attention to the last post, however, you will have spotted one major issue with this concept:
This is observational evidence.
What we should really say is that within indigenous populations, eating a hunter gatherer type diet comprised of wild game, fish, eggs, fruits and vegetables with small amounts of nuts and seeds, free from grains, legumes, dairy, vegetable oils and processed foods, is correlated with the absence of the diseases of civilisation.
I find it ironic that the paleo community love to chant the mantra “correlation does not imply causation” each time a new shaky red meat kills you observational study is released, yet fail to apply the same logic to the basis of the paleo concept itself.
Confounding Factors
A good observational study attempts (though it is often nigh impossible) to control for confounding factors. What possible confounding factors could there be that might muddy the waters of this paleo diet/disease correlation?
Lifestyle
Our Hunter Gatherer ancestors (and contemporaries) lived very different lives to us.
Stress
Our ancestors were not rudely woken by alarm clocks, only to sit in traffic for an age before spending all day staring at a screen stressing over deadlines and upset clients. They did not spend hours watching TV or reading blogs on the Net. They did not have to worry about mortgages, job interviews or exams. They were not concerned with ensuring they kept up to date with the latest fashions and technologies.
Although they may well have faced regular incidences of acute stress – Life or death situations – Their lives were relatively free of any form of chronic stress. They had much more leisure time, with an average time of only around 8-12 hours devoted to actually hunting and gathering (an activity many now consider a leisure activity!).
Although both the introduction of agriculture, and then industrialisation of food are both strongly correlated with a steep rise in degenerative disease, one could also argue that they are strongly correlated with a dramatic rise in chronic stress.
It has been documented by the likes of Dr Weston A. Price and others, that when traditional peoples switch from an ancestral diet, to the foods of modernity, they typically see a rapid degeneration in health. However, it must also be noted that they invariably undergo massive cultural change, and with it undergo huge amounts of stress – Often with outsiders coming in, destroying local habitats, introducing infectious diseases and generally wreaking havoc! Imagine aliens invading and completely turning your world upside down, totally changing your diet, and half of your friends and relatives dying of a strange disease. Stressful at all?
More and more research is showing stress to be a major contributing factor to Western Disease through its effect on inflammation. How are we to know it is not this change which is driving the obesity and degenerative disease epidemic rather than dietary changes?
Sleep
Electric lights, TVs, Computers and the like, coupled with early morning starts mean that the vast majority of us are chronically sleep deprived.
Though it may not have been a classic 8 hours straight sleep now held to be the norm, our ancestors certainly got more than us – Having the freedom to sleep and wake as and when they felt like it, rather than when society dictates. As with stress, sleep is a growing area of research which is known to have wide-ranging impacts on our health and well-being.
Activity/Movement Patterns
Though they may have had a much shorter “work week”, and spent a lot more time sleeping, our ancestors were much more active than us, in a far wider range of activities. Day to day life would involve walking, climbing, balancing, carrying and lifting, with occasional bouts of high intensity activity during hunting expeditions, or while avoiding being hunted!
Today the average person does less than 30 mins of activity per day, a known contributing factor to the dilapidated health of our society.
Sunlight
The mainstream is slowly catching onto the fact that Vitamin D deficiency is endemic in modern society. Our ancestors spent their lives outside with most of their skin exposed to the sun. Now we live and work indoors all day, and when we do go out we cover up with clothes and “protect ourselves from the sun” with sun creams and lotions.
Environmental Factors
We are now exposed to a myriad of chemicals that our ancestors were not. Pesticides and herbicides on foods, BPAs from plastics, exhaust fumes from traffic, and who knows what chemicals leaching into the water table from the mining and chemical industries. Is it not possible that these all have an adverse affect on our health?
On the flip side, we now live in a much more sterile world – Disinfectants, an aversion to dirt, and indiscriminate use of antibiotics can lead to dysbiosis of our microbiome, which is now being linked to many, if not all aspects of degenerative diseases.
Genetic Factors and Lifespan
A frequent argument against the paleo diet, is that as average life expectancy of hunter gatherers was only around 30 years, the incidence of degenerative diseases is obviously going to be lower, as people would have died before the diseases would have had chance to develop.
The paleo rebuttal is that average life expectancy was low due to high infant mortality rates. Those that did survive into adulthood, and avoided nasty accidents or infectious disease, lived long and healthy lives, and maintained their strength, health, vitality and mental acuity all the way to the end of their lives.
One problem with this argument, is that it does not take into account the fact that some modern humans make it through to old age relatively unscathed by modern living, and that the major predictor for this is genetics, not lifestyle. Everyone knows of someone with “good genetics” who has lived to a ripe old age despite living a hedonistic lifestyle.
Imagine 10 pairs of identical twins are born, one of each pair is dropped off in the jungle somewhere to live with a tribe of hunter gatherers, the others stay in the West and live modern lives.
Of the hunter gatherers, 5 don’t make it past the first 2 years because of infections and illness, 2 die in early childhood, 2 more die in hunting accidents in early adulthood, and only one wily, resilient individual makes it through to old age.
In the modern world, meanwhile, thanks to vaccinations, emergency rooms and a generally much safer environment, all the babies make it through to old age.
Many of them have become old and infirm, both mentally and physically, but one is still as sharp as a fox and strong as an ox, despite his 40 a day habit and love for straight whiskey. Is it not possible the paleo baby made it through to old age in great shape primarily due to these same genetics, and the diet was coincidental?
Free images from FreeDigitalPhotos.net
Diet Does Matter – But What Aspects?
Undoubtedly, all the above factors have a significant impact on one’s health, well-being, physique and longevity, to the extent that it becomes impossible to distinguish from epidemiological evidence alone exactly what is causing what.
This does not mean that diet does not matter, however. On the contrary – I believe it to be at least as important as any one of those other factors.
Though scientists, doctors, government agencies and paleo bloggers may all disagree with one-another about what we should eat, pretty much everyone is in agreement that diet has a significant impact on our health.
The question is, if a paleolithic type diet is better for our health than a modern Westernised diet, what factors is it that make the difference?
Is it that we are missing crucial nutrients previously supplied by our ancestral diet, or is it that our modern diet is too high in anti-nutrients, plant toxins and industrial chemicals? Does food reward play a role? Macro-nutrient ratio? Processing techniques? Animal husbandry practices?
Hardcore advocates of the paleo diet might argue that it is because we don’t know exactly which elements of an ancestral diet contribute to its health promoting properties, that we should simply try and emulate it as closely as possible.
I take issue with this approach for a few reasons however:
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There was no single paleo diet
Ancestral diets varied hugely, as did the lifestyles and the genetics of the people eating them, so which diet do you emulate?
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The “paleo diet” followed by most modern Westerners bears little relation to any ancestral or traditional diet ever eaten by indigenous peoples
Grass fed beef steak with leafy greens seems to be a paleo diet staple, yet I’d argue it has seldom ever been eaten by true hunter gatherers. Ethnographic research I’ve seen shows rodents and insects eaten nose to tail to feature much more prevalently, and if veg was eaten it was starchy roots held in highest esteem. Larger animals were a rare treat, and if they were caught, it was the organs that were prised, not the muscle meat.
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The optimum diet may depend on your lifestyle
People often reference the Inuit, and how they do very well on a super low carb diet. People fail to comment however that they aren’t into triathlons or ill advised high intensity cross training programs either (nor that many of them smoke 40 a day, a lifestyle habit you’d be unwise to emulate!).
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Hunter-Gatherers eat what is avaiable, work hard to get it, and appreciate every mouthful
Now, before you interject, one could argue (correctly) that although the diets of ancestral/indigenous peoples are extremely varied, they do hold many common factors. Namely an absence of Krispy Kreme Donughts and KFC, instead being comprised solely of plant and animal foods in a relatively unprocessed state, so we should do the same.
Our ancestors, however, never had to deny themselves anything – Ignorance is bliss as they say! It is well documented that the stress of dieting can have profound negative impacts on your health. Not eating bread isn’t an issue if it hasn’t been invented and you’ve never heard of it, but if you have to walk past a bakery everyday, or sit at the table with your friends while they eat a delicious pizza, this could be a different story.
Other common arguments for the paleo diet rely on logical fallacies, for example:
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The longer a food has been in the human diet, the better it is
The argument holds, that the longer we have consumed a food for as a species, the better adapted we must be to eating it, and therefore the more suited we are to eating it.
The problem with this argument is that all foods were new at some point in time, and in many species it is the discovery of a new food source that enables a species to make great advances.
Humans are no exception, and it is now widely accepted that it was the introduction of meat to the diet that led to the first great leap forward in intelligence.
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The less processed a food the better it is
In his fantastic book, Catching Fire; How Cooking Made Us Human, Richard Wrangham puts forward compelling evidence that it was the cooking and processing of food, leading to its increased digestibility, that allowed our digestive tracts to shrink, in turn allowing our brains to grow.
A raw food diet may produce effective weight loss in the short term, but in the long term is very ill advised as we are now adapted to a cooked food diet. Does it really follow that processing to a certain food to a point led to the evolution of smaller stomachs and bigger brains, but over processing leads to obesity and metabolic syndrome?
Conclusion:
I could go on with many more criticisms of the “science” behind the paleo diet, but as this post is now well overdue already, I’m going to call it a day here (I think you’ve probably got the point by now!).
Despite what might seem like an almighty diatribe against the paleo diet, I must at this point make it clear again that I’m certainly not suggesting you all give up eating real food and switch to a diet of pop tarts and pasties.
My aim is simply to point out that:
- There is no one “Paleo Diet”
- There is no optimum diet for all people
- Just because the Paleo Diet worked for you, doesn’t mean it will work for everyone
- The Paleo Diet doesn’t necessarily have to be an all or nothing approach
- Diet alone is not a panacea
In the following and final instalment, we shall be looking at how to make rational, evidence based decisions on what to eat, enabling you to find your own optimum way of eating, not based on dietary dogmatism or shaky pseudo science.
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While I agree with all of you bullet points, I do have to say that following the general priciples of the paleo diet has a) helped me lose weight b) made me feel energetic c) reduced my allergies (a very odd and totally unexpected result) d) helped food make more sense to me. I don’t follow paleo strictly, nor do I believe it’s for everyone, and yes, I love a delicious pizza from time to time, but I think eating lots of fruit and vegetables, healthy portions of lean meats, and nuts and avoiding dairy, useless carbs (breads and other simple carbs), alcohol (haven’t been able to do this myself yet), and overly processed foods is a great way to eat. In a way I think it’s a shame that this diet is called the paleo diet because I could care less if ancient people ate it, and I agreee that this is spurious logic at best to promote this diet because ancient people may have eaten it. What I like about it is it’s sensible: fruits and vegetables in abundance, lean proteins, nuts in moderation and avoidance of lots of foods that offer little nutrition and are irritants to many people who may not even know that they are sensitive to them.
Hi Krusty,
Thanks for the comment.
I’d have to agree, as far as diets go, one could do a lot worse that following a Paleo Diet, and hopefully my articles critiquing it have not been overly negative.
My own personal way of eating could very well be construed as “Paleo”, with the majority of meals I eat still being comprised simply of meat/fish with vegetables.
I think though, it is still important to keep things in perspective, and be realistic about the potential benefits/limitations of any diet, and the Paleo Diet should be no exception. This article isn’t really aimed at people like yourself who approach the diet sensibly – (i.e. lots of veg, and not afraid of the occasional pizza), but more at the zealots who believe it’s OK to gorge on mountains of meat and fat everyday, and that anyone that looks at a muffin will go to hell!
I find your point d) very illuminating – One can find similar testimonials as yours for pretty much any diet – from low fat, to vegan, to low carb to macrobiotic. I think a large portion of the benefits come from simply being more mindful of what we eat, and taking time to consider what it is we are about to consume before we do so.
Anyway, thanks for taking the time to read the article and comment. Good luck with your continued Paleo journey. (P.S. I’ve got a couple of older articles on Alcohol and diet which you might find interesting also)
I eat a lot of fat on a daily basis. If I don’t get my energy from carbs where else is it supposed to come from?
I feel safer eating butter, tallow and lard from pastured animals than i do eating rice, grains and wheat, all of which cause weight gain (i have to starve myself on a carb diet to lose weight) and also shoot my blood sugar A1C levels sky high.
Not to mention I also have noticed numerous health benefits removing carbs from my diet, better skin, less anxiety, more stable energy without ups and downs, better gum health, better digestion.
The list goes on.
I have no idea if it is the right thing to do following a high fat diet, but if the argument is listen to your body, my body appears to be very happy.
Again, if you cut out sh1tty carbohydrates what else can you replace them with ? You have the choice of highly processed vegetable oils which are unstable when heated, or animal fats which have been comsumed for millions of years without causing health issues.
Nick
Thanks for your comment Nick.
Cutting out carbs is a well proven method to lose weight and improve health. As is cutting out fat.
Both have been shown to be more or less equally effective in terms of weight loss and health improvement, though the actual reason seems to be because both methods result in the spontaneous reduction of calories.
Cut either the carbs or the fat from a meal and you reduce both the calorie content and the reward value.
There are millions of people around the world who subsist primarily on grains and legumes, and yet lead long, healthy lives and don’t suffer from weight issues. The carbohydrate and gain hypothesis have been thoroughly debunked elsewhere though, so not going to get into that here. Stephan Guyanet’s site is a good place for an in-depth look.
If you do choose to avoid grains, it’s unlikely you’ll be deficient in anything, but eating plenty of veggies, nuts and tubers in addition to meat and fat is probably a good idea to avoid deficiencies.
White rice is also hypoallergenic, so can be a good source of pure calories providing your covering all your nutrient bases from other nutrient dense foods.
Check out my series of article “What is Food?” for a much more detailed look into my thoughts on nutrition if you are so inclined
I agree. So much contradictory opinions! In the end I just decided to listen to my body’s intuitive messages(as opposed to my mind’s desires or conditioning. My body is wise and knows itself better than anyone else does. Education is important so my mind can understand what my body has been trying to tell me all along. Eating a moderately lw carb diet works best for me along with intermittent fasting.
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Thanks for your good sense, as ever, Simon. Personally, I feel even less kindly disposed than you towards Paleo theory, having moved from passionate Paleo practitioner to a nearly polar opposite position, the more I considered all the available evidence.
Here’s just one of many questions that ought to cause Paleo acolytes serious cognitive dissonance (but you can bet it won’t in most cases!):
All the data we have of any depth and quality indicates the subpopulations that enjoy the optimal combination of health and life expectancy now are settled agriculturalists living on traditional diets largely composed of the products of cultivation: why then prefer the less-than-optimal diets (or for that matter, lifestyles) of hunter-gatherers?
Wishing you lifelong health (most probably, as a white Anglo-Saxon, on some version of the Mediterranean Diet)
Ivor Goodbody
Hey Ivor,
Thanks for your comment. I too kind of made that polar transition, though to be honest, I think we’ve probably both made such a shift, not down to the nature of the diet itself, but to the holier than thou, all non-paleo dieters are wrong, and will die obese and riddled with disease, before going to hell attitude of many of its followers.
There is nothing wrong with the diet itself per se – eating a diet comprised solely of high quality meats and fish, with loads of fruits, vegetables, nuts and seeds is all well and good. It’s just that it is rather unnecessary.
It’s funny, I’m now “ex-paleo” and “ex-vegetarian”, though in reality probably 90% of my meals could be classed as one or the other, or in many cases both. I just no longer feel the need to label them as such, prescribe any magic properties to them, or convert unbelievers to their virtues…
Have a good day 🙂
A commendably relaxed attitude : < ))
The trouble for Paleo warriors, I think, is that they haven't really got much discretion over the "holier than thou" approach. After all, Paleo is a theory that farming is what did the damage to our diet. Take that away, and there's really no reason to use the word – or the concept – Paleo (which I think is why we now so often hear the weasel-word formula "Paleo template").
But it's a theory that just doesn't stack up when, for example, the world's longest-lived subpopulations eat diets largely composed of grains and legumes, and all but one of them drinks alcohol.
Worse than that, it's a theory that may actually be denying people some of the foods that are BEST for their health.
And worse than THAT, the emphasis on meat, other than the wild variety, may even be risking HARM to their health, however high the quality of the farmed product, according to much observational evidence.
Still and all, these days I try to follow your very wise policy of eating what I think is optimal for me, rather than trying to convert unbelievers to its virtues. I have a hard enough time trying to explain to puzzled friends why I eat as I do!
Wishing you lifelong health
Ivor Goodbody
He he – you’ve just made me think of that meme “I don’t think that word you are using means what you think it means” or something along those lines.
I think giving any diet, any kind of name, is bound to lead to trouble. People identify with it, they become “Paleo/Vegan/Petearian/Weston Price/Whateverthenextoneis”, and then can no longer be objective when it comes to assessing any new information.
It’s a shame, as it was a lot easier back in the day when I could just say “I eat paleo…” 😉
Mind you, as I now live in the Mediterranean, I suppose I can say I eat a Mediterranean diet regardless of what I eat (observation indicates that this is a diet which involves deep frying everything in site, and adding copious amounts of sugar to everything else).
Another thing of course, is that the term Paleo has become pretty much meaningless. A diet full of bacon and steaks is far removed from that of any hunter-gatherer.
I also think that there are few or the original proponents of the diet who actually recommended eating huge amounts of meat – it’s more that people hear what they want to hear. “OK, I can’t eat bread, but red meat is OK after all, cool, I’m just going to have double burgers without buns everyday…”
This is not so dissimilar to many people’s reactions to the mainstream health advice to cut down on fatty foods, but who do so by consuming “low fat processed junk” rather than eating more fresh fruits, veg, wholegrains and legumes which was probably more what the original hopes of the diet were.
Personally, I don’t think there’s a real fear of most paleo dieters denying themselves nutritionally, I do however believe that they are denying themselves a lot of tasty treats. Bread, cheese, beer, wine, cakes, pizza, ice-cream. Mmm.
I’m think Stefan Guyanet’s food reward theory is pretty convincing, and that most likely the main problem with the neolithic diet, is that we’ve created foods so tasty, that we overeat them.
To suggest we have to cut out all of these foods altogether, is more than overkill.
In defence of the Paleo Warriors, I am sure that the majority have good intentions. Most have switched their diet from SAD, lost lots of weight, and feel a million times better than they did before. They just want to try and help other people do the same, which is commendable (at least, I know that was my motivation when I was a Paleo Warrior myself).
Hope that makes some kind of sense!
Out of interest, what is it about your diet that puzzles your friends, if you don’t mind me asking?
Ah yes, the “puzzle” of my diet.
After much experiment (still ongoing!), I’ve currently settled on an all-plant diet, with daily beans and homemade bread, apart from daily helpings of full-fat yogurt and oily fish three times a week. (I will eat good cheese and wild meat if offered. I almost never eat eggs or drink milk.)
People’s puzzlement largely centres around the following:
* I avoid all sweeteners. This prompted one friend to ask: “What about pleasure?”, as though unsweetened food cannot have a pleasant taste. And of course, if your palate is accustomed to heavily sweetened food (sugar with your pasta sauce, signore?), it doesn’t. I once served some friends a dessert sweetened only with banana; I was the only one who could taste it. I haven’t made that mistake twice. Now I serve heavily sugared treats while I eat fruit.
* A relative – and doctor, no less – sneered: “Oh that’s right, you don’t eat NORMAL foods”, when I refused the offer of a sandwich made with white bread and processed meat. Unfortunately, she had a point. It is no longer normal for people in developed countries to eat a diet of unprocessed or even minimally processed foods. It makes life less convenient, something that puzzles people in too much of a hurry to care about diet.
* People never understand why I don’t drink. They simply can’t imagine life being any fun without it. (In fact, I do include alcohol in my diet, but never in company. As a rule, the British simply have no idea how to drink moderately, or allow others in their company to do so.)
* One former nurse and health visitor – with special training in infant nutrition, no less – once glanced apprehensively over a plate I’d piled high with vegetables, nuts and seeds, and asked: “Where’s the protein?” Just one among the many “fatheads” in my life to equate protein with animals.
* Perhaps the most disturbing queries to me are those that reveal most people have no real desire to survive into old age. When I tell them I want to live to 120, again and again I get the response: “What’s the point?” It saddens me to know that the responders are either engaged in such self-destructive behaviour they will die prematurely of largely avoidable illness, or, in most cases, will survive much longer than they ever anticipated, into an old age plagued by frailty and several chronic diseases. I often think their puzzlement might vanish if they could only understand that to be old is not necessarily to be sick and weak. But I’ve long since given up trying to persuade them. Instead, I simply explain that’s my own hope and aim.
Wishing you enduring health
Ivor
Forgot to add: you make a good point about the current Mediterranean diet – one confirmed by much current research showing how far Italians and Greeks have moved from their traditional fare.
When I say “some version” of the Med Diet, I have in mind the sort of simpler peasant fare documented in the 50s and 60s in Southern Italy, Crete and the Greek islands. It seems it can still be found in isolated locales, eg mountainous inner Sardinia, Ikaria.
It’s also possible that war and immediate post-war deprivation played a part in the healthiness of such regimes, via caloric and/or protein restriction.
Wishing you lifelong health, naturally
Ivor
I was of course being facetious when saying the “Mediterranean diet” that I see is largely fried food and added sugar.
While it is of course true that these foods are popular (it still amazes me that freshly squeezed orange juice here is served with a couple of bags of sugar!), I still think in general the state of affairs over here is much better than in the US or UK.
Of course, there are overweight people – as with the rest of the world, real food is more expensive than junk, so it’s usually the less privileged who suffer the most.
My observations of the most positive differences however:
1) Portion sizes – Foods and drinks are consumed in much lower volumes, portions have not yet become universally supersized.
2) People cook – There are still green grocers, fish mongers, butchers everywhere, and in my area, real bakeries which bake real bread. People buy fresh ingredients, and make them into home cooked meals which are…
3) People eat together – …usually eaten as a family together at the dinner table. The thought of microwaving individual meals to be eating separately in different rooms is total insanity to most people over here.
4) A more sensible approach to alcohol – Personally, I believe that most likely, any benefits of alcohol consumption come from the social aspect, rather than any chemical properties of the alcohol itself. I totally understand your point of view regarding the excess however – I didn’t drink for around 2 years in the UK at one point, as the circle of friends I was with had an all or nothing approach which was far from healthy, in the long or short term.
For me, having sharing some home cooked tapas and a few glasses of wine on the terrace in the sun, with good friends, is what the Mediterranean diet/lifestyle is all about. I for one certainly hope to keep doing it for another 80 years or so 😉
You said: ” Personally, I believe that most likely, any benefits of alcohol consumption come from the social aspect, rather than any chemical properties of the alcohol itself.”
I devoted quite a lot of thought and research to this, before deciding to drink/eat alcohol alone. Obviously, I came to the opposite view. Take a look at this, from a science journo who wrote a book “drawn from an in-depth study of around half-a-million scientific papers about alcohol”:
http://www.dailymail.co.uk/health/article-2512175/Alcohol-good-health-Leading-science-writer-claims-tipple-prevent-cancer-help-improve-sex-life.html
There are several studies here where there is an apparent physical or medicinal effect of alcohol that cannot be accounted for, or is less plausibly accounted for, by social contact than by some chemical action of the alcohol, eg the Oregon study in which drinking was associated with improved bone density, confirmed by later and larger studies.
A cardiologist relative of mine is convinced the benefits come from ethanol, and the type of alcohol doesn’t matter. But I reckon he’s biased by his preference for beer, whereas the research leans much more strongly towards the special benefits of red wine! I’m also aware of some research which suggests that it may be the polyphenols, not the alcohol, that matters:
Purple Grape Juice Improves Endothelial Function and Reduces the Susceptibility of LDL Cholesterol to Oxidation in Patients With Coronary Artery Disease
http://circ.ahajournals.org/content/100/10/1050.full
Grape Polyphenols Reduce Blood Pressure and Increase Flow-Mediated Vasodilation in Men with Metabolic Syndrome
http://jn.nutrition.org/content/142/9/1626.full
“Red grape juice may be quite equivalent or even superior to red wine with a comparable content of bioactive flavonoids/anthocyanins”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1082893/
etc etc
These questions remain open, of course. In the meantime, enjoy your glass or several of wine on that sunny terrace. (What country are you in, incidentally? Last time we spoke, you kindly offered me a malt whisky if I ever came Manchester way. I take it that’s off the table, unless you’re splitting your time between the UK and the continent!)
Wishing you lifelong health (hic), naturally
Ivor
I too have devoted a lot of time into researching the health effects of alcohol.
I am a big fan of good quality ale, wine and whiskey, so have a bit of a vested interest in the subject, making me very tempted to succumb to confirmation bias and jump up and down with joy at all of these “alcohol is good for you” headlines which crop up from time to time.
I am still reticent to do so however for a number of reasons:
1) All the studies which point to benefits of alcohol are either epidemiological, or RCTs in vitro/in animals/looking at “health markers” rather than actual real world outcomes. While these are all very interesting, they are all prone to many problems.
Red wine always does very well in these epidemiological studies, initially this was thought to be down to reservatrol, once this was debunked, scientists then turned to polyphenols. I however think it’s as equally likely that it’s because A) Drinking a nice glass of red wine is enjoyable and relaxing, especially when shared with a loving partner or good friends, and B) The kind of person who drinks a glass of red wine, is very different from the kind of person who drinks a can of kestrel super strength.
2) Teetotallers (in our culture) are strange
I’m not having a pop at non-drinkers, I just mean that they are culturally unusual, and therefore are likely to throw up odd ball results.
7th Day Adventists are known for the abstinence from alcohol, and it doesn’t appear to do their health or longevity any harm.
3) As yet, while there are plenty of hypotheses as to why moderate alcohol consumption might be beneficial, these are all still only hypotheses, yet to be confirmed. I for one, think it equally likely, that the benefits come from the relaxation and stress relief effects.
As someone who does enjoy a drink, of course, I am happy to rest assured in the knowledge that it appears my moderate consumption is most certainly not going to have a negative affect on either my health nor life expectancy, and that possibly, just possibly, it may have a beneficial effect.
I don’t, however, feel that the evidence is anywhere near strong enough to say that “if GPs fail to recommend alcohol to at least some of their patients, they should be had up for medical negligence” – I guess I’ll never get to write a column for the daily mail 🙁
My position now, having been misled by “science” (aka bad science reporting) so many times in the past (saturated fat will kill you, carbs will kill you, wheat will kill you, food x,y,z is the elixir of life and a panacea, etc), that I would never again eat or not eat (or do or not do) anything, purely for long-term benefits, without incontrovertible evidence (i.e. smoking tobacco or bear wrestling).
OK, maybe I’d wrestle a bear. Maybe I’d smoke a pipe just beforehand too. Or perhaps smoke the pipe whilst wrestling the bear, but I digress.
NB – I now live in Barcelona, Catalunya. You are still more than welcome to share a whiskey (or wine or craft beer), but you’ll have to travel a little further!
Incontrovertible evidence? You’re a bolder man than me! I’ll (try to) continue to be comfortable with perennial uncertainty:
“What can you do? There’s the rub. The most important take-home message with diet and health is that anyone who ever expresses anything with certainty is basically wrong, because the evidence for cause and effect in this area is almost always weak and circumstantial, and changing an individual person’s diet may not even be where the action is.”
― Ben Goldacre, Bad Science
Wishing you lifelong health, naturally
Ivor
Perhaps you misunderstand me, as I don’t think there’s anything bold about my actions – on the contrary, I’d say the opposite!
I 100% agree with the comment from Ben Goldacre, which is precisely why I would never again include a food, or exclude a food from my diet, purely based on its purported health effects, be they positive or negative.
Perhaps the better name for my new diet, would the the agnostic diet!
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