Is Meat Unhealthy? Part IX

Welcome to the last post in the series.  Time to summarize and wrap it up!

Respect

I respect each person's right to choose the diet they prefer.  This includes vegetarians and vegans, particularly because most of them make daily sacrifices to try to make the world a better place for all of us.  I'm an omnivore, but I sympathize with some of the philosophy and I often eat beans or lentils instead of meat*.

Our history with meat

Our ancestors have probably been eating some form of meat continuously for at least two hundred million years.  However, the quantity has waxed and waned.  The first mammals were probably largely carnivorous (insectivores).  Yet our primate ancestors went through a 60-million-year arboreal phase, during which we probably ate fruit, leaves, seeds, insects, and perhaps a little bit of vertebrate meat.  We only outgrew this phase in the last few million years, when we developed the tools and the brains to pursue prey more effectively.

During our 2.6 million-year stint as hominin hunter-gatherers, we ate an omnivorous diet, although we really have very little idea how much meat it contained (it probably varied by time and place).  Historical and contemporary hunter-gatherer cultures are all omnivorous, and typically eat significant to substantial quantities of meat, suggesting that our ancestors may have done the same.  Non-industrial agricultural populations eat as much meat as they can get, although they usually can't get as much as hunter-gatherers.

If there is such thing as a natural human diet, it is clearly omnivorous.

Meat, obesity, and chronic disease

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We Do Science Interview

I recently did an interview with Laurent Bannock, an expert in sport and exercise nutrition.  His podcast We Do Science has rapidly become quite popular, due to Laurent's credibility and the interesting guests he interviews.  We covered body composition, metabolically healthy obesity, the relationship between BMI and mortality, calorie counting, body fat regulation, and other related topics.

If you've already listened to several of my interviews and are starting to find them repetitive, you might enjoy this one because we cover some new ground.  Laurent was a gracious host.  Follow the link below to listen:

Neurobiology of Obesity, with Stephan Guyenet

What is the probability that you are NOT diabetic if your fasting blood glucose is 110-126 mg/dl?

Often I hear from readers who have changed their diets and lifestyles toward a more evolutionarily sound direction () that their fasting blood glucose (FBG) readings have gone up. Frequently numbers in the range 110-126 mg/dl (6.1-7 mmol/l) are mentioned.

If you have a FBG reading of 110-126 mg/dl (6.1-7 mmol/l) very likely your doctor will tell you that you are either diabetic or well on your way be becoming diabetic.

Diabetes is a condition that in humans is most frequently associated with damage to the beta cells in the pancreas, significantly impairing insulin secretion. With limited insulin, glucose levels tend to go up, leading to high FBG levels and high glucose peaks after consumption of carbohydrates. The latter, high glucose peaks, appear to be particularly damaging when happening regularly over time.

What is the probability that you are NOT diabetic with this FBG reading?

I put together the table below, based on data from a widely cited meta-analysis () conducted by the research group called The Emerging Risk Factors Collaboration. It shows the distribution of FBG levels in urban settings among individuals who do not have diabetes.

The numbers in this table are fairly consistent with those from various other surveys of large numbers of individuals in urban settings.

The study mentioned above also tells us that the incidence of diabetes in urban populations is in the neighborhood of 6.8 percent. This may not sound like much, but as disease incidences goes, it is very high – approximately 1 in every randomly selected group of 15 people has diabetes.

The vast majority of those diagnosed will have diabetes mellitus type 2, which tends to develop over time and be associated with the metabolic syndrome ().

We know from Bayes' theorem, which is a fundamental element of the increasingly popular Bayesian statistics, that the probability of an event A given that an event B has occurred [denoted P(A|B)] is given by:

P(A|B)=P(B|A)*P(A)/P(B).

In the equation above, P(B|A) is the probability of event B given A, P(A) is the probability of event A, and P(B) is the probability of event B.

To answer the question posed in the title of this blog post, we need to calculate the probability that a person will have no diabetes given that he or she has a fasting blood glucose of 110-126 mg/dl.

Replacing A and B in the equation above with “NoDiabetes” (short for not having diabetes) and “FBG=110-126 mg/dl” respectively, we arrive at the formula to calculate the probability that answers the question:

P(NoDiabetes|FBG=110-126 mg/dl)=P(FBG=110-126 mg/dl|NoDiabetes)*P(NoDiabetes)/P(FBG=110-126 mg/dl).

From the table above we know that P(FBG=110-126 mg/dl|NoDiabetes)=7 percent. From our previous discussion, we know that P(NoDiabetes)=(100-6.8)/100 =93.2 percent.

Finally, the study tells us that P(FBG=110-126 mg/dl) is 9.1 percent. This includes individuals with diabetes (2.1 percent) and without diabetes (7 percent).

With these numbers, we can calculate the probability that a person will have no diabetes given that he or she has a FBG of 110-126 mg/dl:

P(NoDiabetes|FBG=110-126 mg/dl)=0.07*(1-0.068)/0.091=0.72.

That is, if your fasting blood glucose is in the 110-126 mg/dl range (6.1-7 mmol/l) then the probability that you DO NOT have diabetes is 72 percent. It would be much safer to bet that you do not have diabetes than that you do, even at that relatively high range.

Surprising eh!?

The above discussion not only highlights the lack of reliability of fasting blood glucose levels for diabetes diagnoses in the 110-126 mg/dl range (6.1-7 mmol/l), but also begs the question – what could cause high fasting blood glucose levels in healthy individuals?

Some of the folks I heard from have gone through insulin sensitivity tests (see, e.g., ), and were found to be insulin sensitive (in at least one case, highly sensitive), even though their baseline glucose levels are generally high. This goes against the possible speculation that they are prediabetics well on their way to becoming diabetic.

One possibility has been discussed in a previous post, which also mentions what could happen with HbA1c levels ().

Food Reward Friday

This week's lucky "winner"... the Cinnabon cinnamon roll!!!

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Can High-Fiber Foods Fight the Metabolic Syndrome?

The metabolic syndrome (MetSyn) is a cluster of signs including abdominal obesity, insulin resistance, high blood pressure, and blood lipid disturbances.  MetSyn is the quintessential modern metabolic disorder, and it affects about one third of Americans.  Many MetSyn diets recommend eating high-fiber foods, and research on the role of the gut microbiota in body weight and health tends to support this recommendation.  Yet these diets are complex, so it's difficult to attribute positive effects to the high-fiber foods specifically, and some people have questioned the benefits of dietary fiber.  Do high-fiber foods really improve MetSyn and promote weight loss?

The study

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Sweet Potato Chocolate Spread

What if I told you that 2 tbsp of this spread provides you with all the vitamin A you need in a day? Sounds too good to be true? Well it isn't. Other than being delicious, sweet potatoes are packed with this super important nutrient that keeps your eyes in good condition and your skin beautifully radiant. Plus this recipe is so simple and quick to make and only requires five ingredients! No excuses!

Ingredients:

2 medium-sized, peeled sweet potatoes (380 g)

3 tbsp melted cacao butter or coconut oil

10 dates (100 g)

2 tbsp cacao or cocoa powder

Pinch of salt


How to:

1. Cube the sweet potato and steam until entirely soft and easy to pierce with a fork, approximately 15-20 minutes.
2. Transfer the cooked sweet potato to a medium-sized bowl, add the remaining ingredients and blend with a hand blender until smooth. This could also be done using a food processor.
3. Spoon up the chocolate spread in a mason jar or any airtight container of your choice and store in the fridge.

Enjoy this spread on peanut butter sandwiches, your oatmeal or eat it straight from the jar with a spoon! (That's what I do...)

Chocolate love from Tilda ♥

Is Meat Unhealthy? Part VIII

Health can be defined as the absence of disease, and that is the lens through which we've been examining meat so far.  However, most of us have a broader view of health that also includes optimal growth and development, physical and mental performance, well-being, fertility, immunity, robustness, and resilience.  What role does meat play in this broader view of health?

Non-industrial cultures

One of the things I keep coming back to in this series is the strong natural affinity that our species has for meat.  Every culture that does not prohibit meat consumption for religious reasons (e.g., Indian Hindus) seeks and eats meat avidly.

A key fact that stands out from my recent conversations with anthropologists is that hunter-gatherers and subsistence agriculturalists place a high value on meat, even if they already have regular access to it.  Here's an excerpt from a paper by Kim Hill, Magdalena Hurtado, and colleagues (1):

Observations of the exchange rate between other foragers and their agricultural neighbors indicate that meat is worth much more than carbohydrate calories (e.g., Hart 1978; Peterson 1981). Hart, in his study of exchanges of meat and casava between Pygmy foragers and neighboring agriculturalists, found that approximately four and one half times as many calories of casava were exchanged for each calorie of meat given. In addition, it appears that almost everywhere in the world meat calories from domestic animals are probably expensive to produce relative to plant calories, and yet subsistence farmers continue to use at least some of their "cheap" plant calories to produce "expensive" animal calories (see Harris 1985 for discussion)

Why do humans around the globe value meat so much?  This strongly suggests that we've evolved an affinity for meat because eating it provides a reproductive advantage.  In other words, meat may increase our "Darwinian fitness".

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