Episode 84: Nutrition Science: Our Insight Into the Confusion and Conflict

Thanks for joining us for episode 84 of The Ancestral RD podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“Please do a show exploring why two opposing groups of doctors, researchers, and readers of medical literature in the alternative health community are at each other’s throats. One the one side are doctors like Taubes, Attia, Perlmutter, Fasano, Hyman, and Rosedale who point to dietary carbohydrates and grains as a major cause of metabolic disease and dysfunction. On the other side are people like Jaminet, Kresser, Wolf, Masterjohn, Aragon, Guyenet, Pardi, and yourselves who argue that a moderate carb diet usually without grains, except for white rice is healthier for the large majority for the population.

Are these 2 groups of people even reading the same studies? Are the studies themselves good science? Good clinical research is exceedingly and difficult and expensive. Is it about calorie balance, or calorie partitioning? Is it possible that a healthy diet depends drastically on your genetics and ability to self-regulate your endocrine system?”

Are you frustrated with trying to get a definitive answer on what diet is best? In the modern arena of nutrition science filled with conflicting information, one person’s research or experience claiming that a certain diet is optimal for health is almost always confounded by another person’s evidence refuting it. The majority of us don’t have the time to sort through the confusion. If this is you, don’t miss today’s podcast!

Join us today as we shed light on multiple factors that affect a person’s perspective on diet and nutrition. We discuss why people come to differing conclusions from the same research studies, the problem with making long term dietary recommendations to prevent disease based on results of short term therapeutic diets, and how the study of ancestral nutrition can fill in the gaps of current research. You’ll come away with new insight into the evolving science of nutrition and better understand that there really is no singular dietary approach that is best for everyone at every time.

Here’s what Laura and Kelsey will be discussing in this episode:

  • The state of modern nutrition research
  • Why people can come to different conclusions about research studies
  • The issue of bias in nutrition research
  • The problem of self-reporting dietary intake in getting valid clinical research
  • The confounding variables in nutrition research that make valid conclusions difficult to obtain
  • Why a short term diet to treat a health condition should not become evidence for a one-size-fits-all long term approach to prevention of a disease
  • How looking to ancestral nutrition fills in the gaps of current research
  • The importance of studying the diets of multiple cultures when using the ancestral approach to human nutrition
  • The significant benefits of  personalization in dietary approaches
  • Our approach to nutrition based on ancestral diets and individualization

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone. Welcome to episode 84 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is Kelsey Kinney.

Kelsey: Hey guys.

Laura: So Kelsey, we’re just coming out of Thanksgiving weekend as we’re recording this. How was your holiday?

Kelsey: Super fun, but I’m totally exhausted. I was in North Carolina actually.

Laura: Woo-hoo!

Kelsey: Yeah, around Lake Norman. My step mom has her family basically has a house there that they grew up in. I had never been before. This was the first time and it’s gorgeous. It’s like right on the lake, they have a boat, nice house. All my family stayed there. I was there from Wednesday, or I guess really like Tuesday night. Technically really Wednesday was my first day and then we left on Saturday morning. But my family is a little crazy in the sense that when we’re all together, we just stay up really late playing games or watching movies.

Laura: Party animals.

Kelsey: Yeah, seriously though. It gets a little exhausting after a while. I was up probably until like 2 am every night.

Laura: Wow.

Kelsey: Which is a little crazy. Yeah, I’m like in recovery mode at the moment. I spent all day yesterday just laid out on the couch watching TV and doing some Black Friday, Cyber Monday shopping and stuff. But yeah, really fun, good food. My step mom is a crazy cook so there was a lot of food. I think we had 3 different kinds of turkey. There was a roasted turkey, a smoked turkey, and a fried turkey.

Laura: Wow.

Kelsey: Yeah. I tried all different kinds of turkey and tons of food. I think there was like about 25 people at our Thanksgiving dinner, which was a lot.

Laura: That is a lot.

Kelsey: But it was really fun.

Laura: Which of the turkeys was your favorite?

Kelsey: I actually like the roasted the best.

Laura: Really?

Kelsey: Yeah. I don’t know, everybody seems to like the fried, but it makes it too crispy on the outside. It ruins the skin for me.

Laura: Oh, yeah. What about the smoked turkey? I had a smoked chicken at a meal the other day and I was like this is so good. I feel like a smoked turkey would be good too.

Kelsey: Maybe it’s the way that it’s smoked, but sometimes I feel like it adds too much of that smoky flavor and I don’t like that. That’s good for like barbeque, but outside of barbeque I’m like no thank you.

Laura: Yeah, maybe not for Thanksgiving.

Kelsey: Right. Yeah, roasted, the classic is the best in my opinion. How about you?

Laura: Sounds like your meal was a little bit more complicated that mine was because it was just my parents, me, and my fiancé came down from Ohio. We just did this pretty simple meal. We didn’t even have a whole turkey. We had a turkey, I don’t know what to describe it as. It was like the breast meat on the rib bones or whatever. Then we had a couple of legs. It was almost the amount of a whole turkey, it just was like cut up into parts.

Kelsey: Right.

Laura: Then we had a couple of side dishes. So nothing really crazy. I used to get really into Thanksgiving a couple years ago, and I would do all this planning, and come up with all these recipes to do, and all of that. I don’t know what it is over the last couple years, I’ve just kind of lost interest in doing all of that. Maybe it’s just because when you cook all day and it takes you 20 minutes to eat, I’m just like why did I just do all that? And then all the dishes you have to do.

Kelsey: What was the point?

Laura: Yeah, and it’s funny because when we were driving over to my parents’ house, we both all live downtown and so we noticed that there was a couple of restaurants open that were having people walk in. Of course most of the people going in were like probably 70 years and older or something, but we were thinking why would anyone want to be eating out on Thanksgiving? Then after we spent all day cooking this super simple meal, and then like I said, it only took us a few minutes to eat, I just started to realize that eating out on Thanksgiving might not be that bad of an idea especially if it’s hours of cooking. If you don’t have that many people to feed, it almost seems kind of pointless.

Kelsey: Yeah.

Laura: We had a good time and I got to spend some time cooking with my mom. Of course every time we’re over there my dad finds some kind of home improvement project to get my fiancé involved in. It’s funny because he’s such a good sport, but it’s like at some point it would be nice for us to be able to be together while we’re there. But I don’t know, we’ll see what happens. But it was fun and we had a good weekend. We spent a lot of time with some friends in the area that haven’t seen my fiancé and we had a little get together for the Ohio state football game on Saturday. They won that and it was a very exciting game in the last quarter, so that was fun.

I’m similarly tired. We didn’t stay up as late as you did by any means. I think we were usually in bed before midnight. But whenever my fiancé is in town, it’s kind of like go, go, go. I don’t sleep very well because I’m just like, I don’t know, I think part of me is like why should I be sleeping if this is my 5 days I get to spend with him this month?

Kelsey: Mm hmm.

Laura: I had to get a lot of catch up sleep last night and I’m definitely feeling it this morning. But I’m glad that we both enjoyed our Thanksgiving. Like I said, ours was super simple. I’d say the best thing that we had was a homemade pecan pie that it was like super sweet. I think next time we make it we’ll probably put bourbon in it to make it kind of balance the sweetness a little bit. But pecan pie is definitely one of my favorites.

Kelsey: Yeah, I had some of that too because somebody brought some homemade. I love it so much. It’s so good. It’s well worth whatever “badness” is part of that food. I don’t care, it’s delicious.

Laura: Yeah. Well and it’s funny because I mentioned a couple episodes ago, or maybe it was the last episode, that I did a cake tasting. Actually we had 2 more cake tastings this week. That’s another thing, I’m like so over cake at this point. I sent all my extra cake home with Josh because it was like I don’t want this. He’ll eat the whole thing in like one sitting because he’s quite tall and he’s active. But we had 2 other cake tastings and the funny thing is even eating the super sweet pecan pie, I was actually okay with that. I felt a little over sugared, like my heart was racing a lot after eating it in the first like 20 minutes, but other than that I felt okay. I’m still trying to figure out why the cake in general is what kind of gives me a stomachache if I eat it on an empty stomach. Maybe it’s just eating it on an empty stomach that’s a problem.

Kelsey: Right.

Laura: But it’s one of those things that I’m like there was definitely a lot of sugar and a lot of wheat in that pie product that we made, so I still can’t figure out what the problem with the cake is. But like I said, it could just be on an empty stomach that it’s a problem.

Kelsey: Yeah.

Laura: But anyway, enough about Thanksgiving. I wanted to mention as far as updates are concerned since Kelsey and I almost never have anything interesting going on, at least stuff that would be interesting to our listeners. I wanted to let you all know that I was offered a monthly guest writing position, I don’t know if it’s even a position, it’s kind of a contract job…for a website called “Girls Gone Strong.” If you’re familiar with that site, it’s pretty popular. There’s a lot of really awesome women that write about a variety of health related topics, both physical health, and mental health, mindset, that kind of thing. Have we had Jen Sinkler on? Or did we just have her contribute to our….?

Kelsey: That’s a good question.

Laura: I know that she contributed to our “Paleo Rehab” program. I’m not sure we’ve had her on the podcast.

Kelsey: Yeah, I feel like we haven’t.

Laura: She’s really cool. This woman that I did a group program with as a participant, Neghar Fonooni, is one who writes for that group. I guess the owner of the business is Molly Galbraith. She’s really cool. We haven’t had her on, although I feel like we should try to get her on at some point.

Kelsey: Mm hmm.

Laura: But yeah, lots of really awesome, inspiring women that write about nutrition, fitness, and mindset health related topics. I’ve written one article for them. I believe it was on, what was it? Under eating, which is a big surprise, right? That’s like all I write about. But that had been a really popular article and so I guess they asked me if I wanted to do, I guess it’s like every 3 to 4 weeks or something I have a due date now.

Kelsey: Cool.

Laura: The first couple of topics…or maybe it’s more than that. Let me see. It’s actually probably closer to every 5 weeks. But they have the first 4 topics through the end of March is when my last due date is. You’ll see those kind of coming up over the next couple of months. The first one that I’m going to be wring about it how to bust through a fat loss plateau, which is always interesting.

Kelsey: Mm hmm.

Laura:  I feel like I work with a lot of clients that get stuck with weight loss and there’s a lot of different things that can impact that. That will be what my first conversation is. I feel like that’s going to publish right around New Year’s, which is kind of appropriate timing.

Kelsey: Yeah.

Laura: So many people start to get back on the fat loss wagon when it’s New Year’s. But other topics that they’re having me write about are things like natural sleep aids. Sleep aids won’t be like medical or anything like that, but it’ll be food and possibly some supplements and things that can be helpful. Then I’m going to write about dietary fats, so kind of a summary article about the different types of fat and where they come from, and which ones you should eat more of, less of, that kind of thing. Then the last topic I have lined up is how nutrition needs change during pregnancy.

Kind of a variety of topics and definitely ones that I am interested in and have written about before. I did an interview with, it think it was Women’s Health magazine about eating for better sleep, so I have some ideas about that and I’ve written about that before. It’ll be maybe some new things in there, but definitely topics that I’ve covered in the past.

I was just really excited because like I said, I really admire the women that run that group, especially the owner of the company. The audience that they get is like perfect, it’s just the exact kind of audience that I like to work with. It’s really awesome to be able to have my work exposed to those people. Maybe it’ll maybe kind of kick me in the pants a little bit to get me writing again since it’s been so long since I wrote.

Kelsey: Yeah.

Laura: Having deadlines and having other people expecting my work is always helpful for that.

Kelsey: Mm hmm.

Laura: Lately I’ve been having some trouble self-motivating to do that kind of stuff, but one day I think I’ll be back into it. It’s just very busy. I have like a second job right now planning a wedding.

Kelsey: Yeah, I think this is a good kick in the pants.

Laura: Definitely.

Kelsey: I think it’s obviously a really great website and I’m sure some of our listeners have heard of it and probably read some articles there. I think you’ll be really good voice to add to that group for sure.

Laura: Yeah, and then if you guys haven’t heard of this website, it’s just GirlsGoneStrong.com. They have a Facebook page. I think they have at least 200,000 likes on their Facebook page, which is pretty cool. It’s always nice to write for a source that has that much exposure.

Kelsey: Mm hmm.

Laura: Even with our audience it’s like I love how tight knit our audience is, but as far as numbers is concerned, we’re not anywhere near the 100,000 to 200,000 mark.

Kelsey: Right.

Laura: It’s always nice to be able to have that opportunity to get my work out in front of a bigger audience.

Kelsey: Awesome.

Laura: Like I said, I really like that audience because the topics that they cover at this site are really well lined with the kind of stuff that you and I do.

Kelsey: Mm hmm.

Laura: It might not be quite as technical in a lot of ways, but it does definitely promote a more healthy approach to diet and exercise in a way that’s not overly restrictive. I send my clients there and I share a lot of their posts because I just really like the work that they do, so I’m excited.

Kelsey: Yeah, that’s awesome. Congrats.

Laura: Well, enough about me. Let’s hear a word from our sponsor and then we’ll get into our show for the day:

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Laura: Okay. Our question today is a very interesting one. Potentially controversial, but what we’ll see what people think. This person asks:

“Please do a show exploring why two opposing groups of doctors, researchers, and readers of medical literature in the alternative health community are at each other’s throats. One the one side are doctors like Taubes, Attia, Perlmutter, Fasano, Hyman, and Rosedale who point to dietary carbohydrates and grains as a major cause of metabolic disease and dysfunction. On the other side are people like Jaminet, Kresser, Wolf, Masterjohn, Aragon, Guyenet, Pardi, and yourselves who argue that a moderate carb diet usually without grains, except for white rice is healthier for the large majority for the population. Are these two groups of people even reading the same studies? Are the studies themselves good science? Good clinical nutrition research is exceedingly and difficult and expensive.”

Laura: That’s very true.

“Is it about energy balance or calorie partitioning? Is it possible that a healthy diet depends drastically on your genetics and ability to self-regulate your endocrine system?”

Laura: Lots of different questions in there. And it’s funny because I forget how old this question is, but this one includes I think that’s Robb Wolf. The person just wrote the last name, so I assume we’re talking about Robb Wolf and not like Liz Wolfe or something, which is funny because I’m looking at all these names and literally all of them are men, except for us.

Kelsey: Yep.

Laura: Anyway, that’s a side note. I think that’s it’s Robb Wolf. I’m not sure if Robb is recommending more carbs or not right now. Honestly, I haven’t really been following a lot of these people’s research recently just because of how busy we’ve been, at the end of the day sometimes it’s like am I really learning more? Is this helping me become a better practitioner if I’m reading all these kind of one sided arguments about things? Sometimes it’s helpful because different recommendations can be used to kind of guide our work with clients depending on what the person’s situation is. I do try to read the different approaches, but at the end of the day, sometimes these particular figureheads will take very strong opinions about certain things that I don’t necessarily think is always true.

To be fair, I think a lot of the names on here, they do actually take a pretty balanced approach, like obviously Chris Kresser is really good at being balanced, Chris Masterjohn. I do think Robb Wolf is very good at being balanced even if he does tend to go more low carb in general. Guyenet is very objective.

Kelsey: Mm hmm.

Laura: Paul Jaminet is very objective. Dan Pardi is very objective. I don’t personally get into the work of Taubes, Attia, Perlmutter, those kind of people very often, so I can’t say whether or not I think that they’re very objective. It’s just the ones on the other side on the list just happen to be the people that I’m more familiar with.

Basically my point is that even though there is kind of one strong opinion on either side that that we’re talking about, we’re really talking about low carb on one side and moderate to higher carb on the other, I don’t necessarily think that all these people are…I wouldn’t necessarily consider them at the other’s person’s throats necessarily, at least anymore, at least from what I’ve seen.

Kelsey: I know. I’d say too though, the way that this person is separating these people into these groups, the conversation I’m seeing here is more actually like should everybody be on a low carb diet versus is there a large variety of macronutrient ratios that people can thrive on? I think Kresser, Jaminet, although Jaminet is more on the side of the moderate to higher carb diet.

Laura: Mm hmm.

Kelsey: People definitely like Chris Kresser, Chris Masterjohn, I think their idea is more like there’s no one size fits all versus this other side of Taubes and Perlmutter who are kind of talking more about most people are going to do better on a low carb diet. Would you say that’s like how you’re viewing these groups of people as well?

Laura: Well, it does tend to be the message that I’ve seen. Now again, I don’t really follow their work very closely so it’s possible that they also have a more nuanced view of the recommendations. I do think Peter Attia…I say don’t quote me on this, but technically you can quote me on this because I’m saying it. But some of the stuff that I’ve seen, it seems like he’s more about low carb for obesity and metabolic syndrome.

Kelsey: Mm hmm.

Laura: That’s kind of where his special interest is, cardiovascular disease, that kind of thing. But there are definitely some names on that list that would recommend low carb for everyone.

It was interesting because at the Weston Price Conference I was with Chris Masterjohn at one of the talks that was given. I won’t specifically say who gave the talk or what the talk was about, but I do remember that this person as part of their talk said that we all knew that the reason for obesity and weight gain in this country was basically the carbohydrate insulin hypothesis. That’s like a summary of what this person said. They kind of just threw it into their slides because it wasn’t really super relevant to the topic that they were talking about, but it was kind of included in there. I remember Chris and I looked at each other like I don’t really think that’s an assumption that we’re all making.

Kelsey: We don’t all agree with that.

Laura: But it was just funny because it is interesting that some people really do just stick to that hypothesis. I’m not saying that there isn’t a benefit of a low carb diet for people who are obese, or that they don’t help certain people get better insulin sensitivity, or that there are not short term beneficial approaches. I just mean that I think to make this sweeping statement that we all know that carbs cause obesity basically is just not accurate.

Kelsey: Right.

Laura: I think part of the problem is that like this person said, good clinical nutrition research is very difficult to do, it’s expensive, it’s usually funded by people that have a level of bias. Which they try to be neutral in these studies, but if Coca-Cola is funding this study on sugar, then yeah, there is going to be some bias in there.

There’s also bias about what gets reported, usually lack of results, so if the hypothesis isn’t supported or there are no significant results in research, unfortunately those topics tend to not get published because it’s not interesting even though it is good data.

Kelsey: Right.

Laura: If you find that making this change to your diet doesn’t make any impact, it’s helpful to have that information, but those kind of studies don’t get as much attention or don’t sound as sexy when they’re trying to get published. A lot of the studies that get published are ones that do show a significant difference in the treatment versus the control group. But sometimes those studies are not done super well or they weren’t conducted for a long enough period of time, or there was confounding variables that weren’t controlled for.

In nutrition research, there’s different types of research that can be talked about. There’s epidemiological studies, which is more of an observation of a population. There’s actual experimental studies, which is really, really hard to do in humans.

Kelsey: Mm hmm.

Laura: And a lot of times they have to do that in animals because you just can’t control every aspect of a person’s diet or lifestyle and be able to show a specific cause and effect relationship whereas with animals they can be very controlling. If you get a study that shows a result in a rat, then yeah, that’s helpful information to help build hypotheses, but I don’t think that’s necessarily something that you can automatically just translate into how that would affect humans.

I think the research itself is not great. I think the state of nutrition research, I mean it’s a very young science if you think about it. It’s only maybe in don’t know 100 or 200 years old at the most, whereas most science is thousands of years old. We are definitely in very infant stage of this topic of science. But then also I just think there’s a lot of special interest that go on in research. There’s the fact that the government makes strong recommendations that aren’t necessarily research based, but for whatever reason have not been reversed or they haven’t said, oh sorry we’re wrong, this is the actual information.

Kelsey: Right.

Laura: I think there’s a lot of problems in just the greater picture of science research. But that doesn’t necessarily explain why people fall into such strong camps. We don’t necessarily have to talk about individuals that have been listed in this person’s question because you can think about the doctors, or not even the doctors, but the different groups that promote veganism, for example like the Physicians Committee For Responsible Medicine. Do you remember the doctor that’s like super….?

Kelsey: I know, I’m blanking on his name, too. I know exactly who you’re talking about.

Laura: Well there’s a handful of them that are really into low fat, vegan, plant based diets. There’s that whole section of the physician community that would be saying both of these groups are wrong, both the Taubes etc. group and the Jaminet, Kresser, Masterjohn group.

Kelsey: Yeah.

Laura: What do you think about, do you think it’s an issue that the research isn’t good enough?

Kelsey: I do actually, yeah. I think the research is a big part of it because you can kind of come up with whatever hypothesis you want and then kind of pick the studies that fit within that for you.

Laura: Mm hmm.

Kelsey: I think there’s a lot of reasons for that, many of which you just talked about. I think one of the problems especially within these two groups that we’re discussing here, the carbs versus low carb groups, I think one of the big problems is that people in general are terrible at telling you what they ate. A lot of this stuff comes down to like okay, we’re talking about weight loss and things like that, you need to know how many calories someone was eating. Of course that includes carbs and non carbs that they’re eating, but we need to know overall that these people were generally eat the same amount of calories.

When people go to write down food diaries and stuff, and Laura, I’m sure you see this in your own practice as well, there’s a certain degree of difficulty that goes along with that. You have to be pretty dedicated to track your calories and do it well. If you’re just in a study, you’re probably getting paid to be in the study, but it’s not something that most people in a study are going be super great about because chances are they’re not really motivated all that much to be as accurate as possible weighing every single thing that they’re putting in their mouth.

Laura: Yeah, I mean it’s hard.

Kelsey: Yeah. It’s hard for people who are motivated to do it, never mind people who might not be. I think that is probably is a really, really issue in getting good clinical nutrition research. Just because I think it’s just really, really hard unless you’re literally feeding your participants every morsel of food that’s going into their mouth and you weighed and measured that yourself. There’s just no way to know an exact amount of calories that somebody has eaten. That becomes a big problem when you’re talking about weight loss, and that’s what a lot of these studies are on.

When we’re talking about a high carb diet or a low carb diet versus a high fat diet, a lot of those studies are looking at okay, if we assume that these people, and we’ve done our best to make sure that they’re eating close to the same amount of calories, the one group is eating a higher carb diet and one group is eating a lower carb diet. Then they look at how much weight people lost. I think it is really difficult to know for sure that they were eating kind of the same amount of calories if they’re doing the tracking.

I think that’s a big problem and there’s not a really great way around that other than of course like I said, if you’re weighing, and measuring, and giving these people the food that they’re supposed to be eating. But outside of that, it’s really tough to know the exact amount of calories someone is eating.

Then the other part is that there are so many other variables. When you take out carbs, you’re then adding something else. You’re usually swapping that for fat. Are they swapping it for what we would consider good fat? Saturated, monounsaturated, those kinds of fats? Or are they putting in a lot of vegetables oils which would totally at least in our eyes, confound that study and make that group maybe do a lot more poorly in that situation. When it comes to food, it’s not like you can just say like in other studies, okay, we’re giving this one medication to this group and we’re not giving it to this group. When you take something out or you give something, you’re swapping it for something else, and that thing can have an effect on your results as well.

Laura: Mm hmm.

Kelsey: I think nutrition research in general is just so complicated because there’s so many variables that it makes it really, really difficult to get, in my eyes, very valid conclusions coming from these studies. You can kind of take a study and say okay, this fits with my hypothesis because this low carb group did better than the high carb group. But we don’t know the other variables necessarily because sometimes they don’t mention them. It may not even be a thought in the researchers’ mind, like we swapped out this kind of fat when we put them on a low carb diet. They basically don’t tell you a lot of times what kind of other food they’re eating because that doesn’t tend to matter to those researchers a lot of the times because they’re looking at macronutrient ratios. They’re not really paying attention to the quality of the food, what types of food, the variety of food someone’s eating. Those things typically aren’t reported.

I think you can kind of just choose studies that fit with your hypothesis pretty easily. Then for example, if somebody who is saying that a low carb diet is better for you, they could take a look at a study that did not show that was the case and say well, the problem with that study, the reason I’m not viewing it as valid is because they probably gave the group on a low carb diet tons of polyunsaturated fats which are really bad for them, therefore this study is invalid. I’m going to just say that it doesn’t count because (A.) it doesn’t prove my point that low carb diets are better, and that’s because (B.) they are using improper or unhealthy, in my eyes, fats to get this person on low carb diet.  So it doesn’t matter, I can just throw that out and I’ll only choose the studies that say yes, a low carb diet is better.

Laura: Mm hmm.

Kelsey: At least for me, I really do think that the research is a big part of why you can come to so many different conclusions looking at it. It does make it really difficult to decide what is true and what’s accurate. Like you said, it’s in its infancy, so hopefully we can figure out some better ways of figuring this stuff out. But for the time being, I do kind of feel like you can really make your point with the science whatever your point may be.

Laura: Mm hmm.

Kelsey: But I think because of that, because it’s so difficult to look at the research and know what is best based on that, I tend to, and I think you do too, Laura, look back in history at our ancestors. What kind of foods were they eating? What did they thrive on? When did that change and why do we think that changed? I think that gives a lot of really good information when we can’t get that information from the research.

Laura: Definitely. The other problem with some of the research or clinical experience that would drive someone to suggest a one size fits all approach is that a lot of these physicians that take a very strong either low fat vegan or very low carb ketogenic type approach for everyone are saying that it’s a way to prevent disease is that a lot of the diets that are promoted are better at fixing problems than they are at preventing problems.

If you think about obesity and metabolic disease, that kind of thing, if somebody is having elevated blood sugar all the time and that’s causing insulin resistance, and causing them to gain weight, and develop diabetes, that kind of thing, if you put them on a very low carb diet, then removing carbohydrates is going to drop their blood sugar. So yes, that is a way to help with that immediate problem. However, I think the problem that I see in a lot of my clients and a lot of our listeners, readers, that kind of thing, is that that treatment, that dietary treatment for a specific condition is then recommended as a preventive strategy.

Kelsey: Right.

Laura: So if people are worried about gaining weight, somebody says well we have this diet that we use with people and it helps with weight loss, then that means that you should follow this diet so that you don’t gain weight or develop blood sugar issues.

It’s kind of scary because I’ve actually worked with clients who were not overweight, and lot of them were women, and they were told because they had maybe like a slightly elevated hemoglobin AIC number, or they had some reactive hypoglycemia, or jut whatever was going on, and then they had a practitioner or someone recommended a very, very low carb diet to them because they were saying that’s why you have blood sugar problems is because you’re eating carbs. I just don’t find that to be actually what happens from a practical clinical perspective. If I’m looking at the way my clients respond to dietary changes, I rarely have someone not be able to tolerate at least a moderate carb intake that’s from a balanced diet.

Kelsey: Mm hmm.

Laura: Whereas I recently had a client who ironically is in the NTA program and her teacher was telling her that she should go low carb because she was having some blood sugar dysregulation, but it was just completely inappropriate for her. And this teacher she said is very much into the insulin obesity hypothesis and he himself is on a ketogenic diet, and it just was like very clear that the bias was there that that’s the way he approaches all nutrition recommendations.

Kelsey: Right.

Laura: So for this client of mine who was having some issues with amenorrhea, and adrenal dysfunction, and she had been underweight for a while, it just did not make sense at all for her to cut carbs out of their diet. And frankly, she got much better results by doing a moderate carb, calorie appropriate, well balanced diet.

Kelsey: Mm hmm.

Laura: I see a lot of this taking a treatment type of diet and saying that that’s the way you prevent a problem in the first place. I don’t want to sound overly anti low carb because honestly you can say the same thing about these low fat vegan doctors that are saying that this is how you treat heart disease.

Kelsey: Right.

Laura: That’s a very common recommendation as well. I’m not saying that they haven’t had good results with their patients. They have a lot of data showing that they were reversing the atherosclerosis and heart disease process in these people. But the problem is you’re taking on a western diet that are probably eating tons of refined carbohydrates, polyunsaturated vegetables, the standard western diet and then they put them on this very plant heavy, fiber rich, low fat, so you’re pulling those vegetable oils out, this diet that’s going to at least remove some of the bad things like refined grains, and sugars, and vegetable oils.

And then even if you’re eating a low fat vegan diet, you’re probably in a much lower calorie amount than what you were when you were eating a western diet. If you’re taking things out that are inflammatory, I don’t recommend a vegan diet for the long term, but if you’re eating a high plant based vegan diet, then you’re getting probably a lot of good micronutrients that you weren’t getting before if you weren’t really eating any vegetables. From a short term treatment perspective, yeah, it may work. I think that’s the problem is that people use these treatment diets in the short term as evidence for a diet that everyone should follow over the long run for preventing disease.

Kelsey: Mm hmm.

Laura: I just don’t think that’s appropriate. I’m not saying that some people can’t benefit from a low carb diet. There’s definitely people out there that maybe don’t tolerate carbs well or they’re super sedentary so they don’t need as many carbs. But I just really don’t like seeing these recommendations that are based on a treatment diet that then get promoted to every single person no matter what they’re health issues are, what their gender is, they’re age, they’re activity levels. It just doesn’t makes sense.

Kelsey: Right.

Laura: I think that’s where a lot of these stronger recommendations go wrong. I don’t want to single people out. I’m just thinking the one person on here who’s I guess not actually the one person, but one of the people listed on here. Dr. Perlmutter is well known for his work with brain conditions and Alzheimer’s, that kind of thing. Maybe a very low carb diet in someone who has Alzheimer’s is really effective because the thought is that Alzheimer’s may be kind of like a diabetic type process. Again, more of a treatment approach to prevent the continued worsening of Alzheimer’s or actually reverse some of that issue, but that doesn’t necessarily mean that everyone should be low carb to prevent the development of Alzheimer’s.

Like I said, I don’t want to single people out. I think Dr. Perlmutter has great ideas and certainly has a very successful program for people with those cognitive issues, but it is an issue when those treatment diets then become a recommendation for everyone no matter what their issue is.

Kelsey: Yeah. I think you bring up a good point about that short term versus long term. Again, that’s a real problem in the research as well because we’re not doing really long term studies on people doing these interventions where they’re on a low carb diet or they’re on a vegetarian or a vegan diet. We don’t really see that long term impact that people like me and Laura are seeing in clinical practice where we come across a patient who has been on a vegan diet for 25 years and they’re having tons of health issues. The research doesn’t see that stuff.

Yes, you can get these really kind of miraculous seeming results when you put somebody who’s on a western diet onto a vegan diet or onto a low carb diet. But like Laura mentioned, there’s a lot of variables that are changing when you change somebody from a western diet to one of those diets. In the scheme of things, changing someone from a western diet to a vegan or a low carb diet most of the time there’s going to be a lot of good things that happen because they make that change. That’s what you’re seeing in that short term. You’re seeing those results eating more plant matter, or eating less sugar, that kind of thing. Yeah, it looks really awesome on paper. It looks amazing, it looks like a miracle that you can kind of reverse these diseases. And yeah, you can, but that doesn’t mean that even that person needs to be on that kind of diet forever necessarily, and it certainly doesn’t meant that everybody else regardless of their health condition needs to be on a diet like that.

Laura: Mm hmm. Like you said earlier, I think that’s a big reason why we go back to the ancestral approach where we look at what types of diets were cultures thriving on for 100s of years before the industrialization of our food supply. With macros, if we’re just going at a real macro level of looking at this, there’s a huge range.

I think one of the problems is that a lot of people will pick one culture to focus on. For example, the low carb group tends to use the Inuit or anyone in the kind of more arctic type of climate as an example of these cultures were super healthy, and they were eating mostly fat, and all that.  They’re looking at this very specific population in a very unique climate that maybe isn’t optimal. It may just be that’s what they needed to do to survive in that climate. And yeah, they were eating tons of fat and tons of animal products, but they were eating lots of organ meats, and they were eating the intestinal contents of the animal.

I think to look at one single culture and say that’s what we should be doing is kind of myopic. If you start to look at cultures around the world, for any diet that you recommend, like if you recommend low carb or low fat, or vegan, or paleo, or whatever, you can always find a culture that had really good health eating something totally different.

Kelsey: Mm hmm.

Laura: That’s why I like to look at that stuff because I think it allows us to take a more nuanced and inclusive view of human health and what humans can thrive on. You have the Maasai or the Inuit eating lots of animal foods and low carb and doing really well. Then you have people the Japanese or people in Asia that are doing lots of rice, or the Pacific Islanders doing lots of sweet potatoes, that kind of thing. You have people in Europe that did tons of grains and dairy, like wheat products and dairy, bread and cheese. And that’s the kind of thing that if you look at all these different cultures, there’s lot of examples of them eating very, very different diets.

That’s why I like to look at, okay, what’s similar across these diets and what’s different, and what does that mean for individuality? Does that mean people can thrive on any of these diets? Or is there a way to figure out what their best diet is? Is there certain basic features of a healthy diet? And once you get those taken care of you can kind of mix and match how you want to approach it, which is kind of how I think both of us approach nutrition where we say, okay, there’s basic needs and then anything above and beyond that is kind of based on what you prefer, what your lifestyle is like, what your genetics are like, etc.

I think you can get really in the weeds with looking at all this research. Yeah, it’s great to have the research to support your recommendations. But at the end of the day, if anyone’s telling you that there is some specific that everyone should be on for good health and it’s very extreme in any sort of direction, then I would argue that it’s probably not seeing the whole picture.

Kelsey: Yeah, I totally agree. Honestly I would run far away from anybody who says something like that, especially if it’s a practitioner of yours. I hate to say that because I don’t want to encourage people to walk away from their health practitioners, but I do think that it tells you a lot about somebody if they think that every single person will benefit from being on one particular, and most times extreme, type of diet. Because even if they’re pointing to like Laura was talking about the Inuit as an example of why a low carb diet is what everybody should be eating, even if you do a low carb diet right now, you are not going to be eating like an Inuit is eating. Low carb is just one factor of that diet. Like Laura mentioned before, they’re eating things like organ meats, intestinal contents, they’re getting a lot of other really important nutrients from other things that we aren’t replicating when we try to do that diet in our modern world. I think it’s just unfortunate that I think a lot of people are being recommended these really extreme diets as a way of preventing health issues.

Obviously Laura and I are in a sense biased in the way that we do this because this is what we use in our practices, but this is honestly what we’ve found to be the most useful, which is to take a look at all of these different cultures and say yeah, people can survive on many different types of macronutrient ratios. We tend to pick out the similarities between all of those diets and say okay, these must be the important parts of these diets because everybody’s doing this. Then from there, we personalize that to, like Laura said, an individual’s genetics. I would add to that whatever disease processes they’re already dealing with. I think that can make a big difference because yeah, if somebody’s got really high blood sugar, they’ve got diabetes or something, I do think a low carb makes a whole lot of sense in that scenario. We have seen that from research that shows that people with blood sugar problems are going to generally do better on a low carb diet. But you have to individualize that and you have to personalize that to other lifestyle factors and everything.

You can’t just say okay, everybody with this condition is going to do best on this exact type of low carb diet or whatnot. You really do have to personalize it to the actual person, and their lifestyle, their genetics, and of course any diseases that they have. That’s the approach that Laura and I take. At least we think it works well because we’ve seen it in our own practices. Of course that’s kind of what we’ve stuck with. That’s not to say that that’s what we started with either. I think both Laura and I kind of started in that low carb crowd and we’ve slowly crept over to this side. Obviously we’re happy where we are at least for the moment, but that doesn’t mean we’ll stay here either. If we see things that change our mind, I like to think that we’re both really open to new science and new observations that can change the way we think about food.

Laura: Yeah, definitely. Hopefully that helps this person understand what the different factors are that can affect somebody’s perspective on diet. At the end of the day, you do have to remember that people are running businesses and having a very solid, consistent, easy to follow message is very helpful when you’re running a business.

Kelsey: Mm hmm.

Laura: That can definitely drive the desire to come up with the one size fits all approach, which is unfortunate, but it definitely makes sense when you’re trying to sell something to a public which tends to like things to be simple.

The way and Kelsey approach things unfortunately is not simple and it makes things much more complicated, which it can become difficult to individualize to the point where some people might need it, but I think it’s well worth it, and you get much better results, and there’s much less restrictiveness and disordered eating potential, and a lower risk of nutrient deficiencies when you’re trying to include as many different foods as possible.

Kelsey: For sure.

Laura: Great. Well, thanks for joining this week everybody. We always enjoy having you here and we have been really appreciating all the questions that have been sent in. If you do have a question that you’d like to submit, go to TheAncestralRDs.com and click the contact tab and you can submit your question that way and we may answer it on the show. But anyway, thanks for joining us and we will see you here next week.

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