100 Million Years of Food (27 page)

This brings up three important questions. First, is it the low-fat and low-meat diet that does the trick in reducing heart disease, or are the lifestyle interventions of exercise, stress reduction, smoking cessation, and group therapy the real key? In conversation with Dr. Ornish, I point out the “Spanish paradox”: Spanish people consumed 30 percent more fat in 1980 than they had in 1966, particularly saturated fat (a 48 percent increase), yet heart disease decreased over the same period; in Japan, there was a similar postwar increase in fat and cholesterol consumption while heart disease also dropped. Dr. Ornish responds, “One has to be very careful about drawing conclusions from just looking at one factor in a population when there are so many other things that have been changing during that time as well.” Fair enough—the authors of the “Spanish paradox” study themselves were skeptical that increased consumption of fat in Spain led to decreased heart disease, suggesting instead that increased antioxidants in the Spanish diet from eating more fruits could have been the real reason behind lowered rates of heart disease (wine and sugar consumption dropped slightly). Conversely, perhaps the belief that saturated fat is artery-clogging was so deeply ingrained in the minds of the study's authors that the possibility of saturated fat lowering heart disease was literally unthinkable and heretical to them. Increased fat in the diet may replace foods more dangerous for heart health; for example, carbohydrate-rich diets (the Spanish diet in the 1960s was based heavily on bread, potatoes, pulses, and rice) raise serum triglyceride and VLDL (very-low-density lipoprotein) cholesterol levels, both major factors for heart disease.
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The second important question to ask: Does a low-fat, low-meat diet reduce overall mortality? After all, it's not very encouraging if we avoid the risk of heart disease but increase our risk of dying from something else. When I showed a video of Dr. Ornish to one of my friends in Los Angeles, she said, “Oh, he looks healthy. He's the same age as you?” She scrutinized the screen. “He has a lot of hair.” I'm forty-one. Dean Ornish is
twenty
years older than me. So perhaps he has figured out the secret to long, healthy life. In some respects, Dr. Ornish's suggested diet looks similar to the diets of the peoples with the greatest longevity (Okinawans, Nicoyans in Costa Rica, Sardinians, Ikarians) and indeed of most people in the world prior to industrialization. It's low in meat—our preagricultural ancestors did a pretty good job of hunting out the big mammals, and climate change mopped up the rest—and high in plant foods. Also, as discussed earlier, the link between low protein intake and longer life has been studied and demonstrated in various animals, and it's likely that the human life span may benefit from low protein (especially low animal protein) intake as well.

This link between protein restriction and longevity is also consistent with evolutionary biology: Nature favors longer life spans in animals that don't have adequate nutrition to compete and reproduce at an earlier stage in life. To put it another way, eating meat and fat may help you be fertile, attractive, and strong at a younger age, but it will also help you into the grave a bit faster.

When I suggested the evolutionary biology scenario to Dr. Ornish, he was not fond of this interpretation—“I'm not sure that natural selection explains everything,” he says. He believes that his diet promotes health at all stages of life, young and old, but I doubt any sumo wrestler or weight lifter would win a title on Dr. Ornish's low-fat, low-animal-protein diet. Girls who eat a lot of meat and dairy tend to reach menarche (their first menstrual bleeding) at an earlier age, and girls who have early menarche tend to die younger; women who lack body fat are more likely to be infertile.
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Additionally, a diet that promotes a long life span in youth may not necessarily be an effective diet for an elderly or sick person. The major health risks for a younger person stem from chronic diseases like cancers and heart disease, which develop over the course of decades. For an elderly person, by contrast, the important task is to weather any illness that strikes, in which case eating more animal protein may promote longevity. Also, people who are moderately overweight tend to live longer, as previously discussed, and one possible reason is that metabolic reserves may enable sick people to overcome disease.

The third question to ask with regard to a low-meat, low-fat diet: Is it easy to follow? A typical set of meals for Ornish and his family might include whole-grain cereal with soy milk and fresh fruit, whole-wheat toast, and pomegranate or orange juice, along with a cup of tea or coffee; alternatively, he might fix an egg-white omelet with spinach and mushrooms, or low-fat cheese or turmeric (reputed to have anti-inflammatory benefits). As a treat, Ornish and his family indulge in whole-grain pancakes or waffles with a little maple syrup. The family takes daily multivitamin and fish oil supplements. For dinner, they serve vegetables like corn, broccoli, and cauliflower (cooked in a steamer to preserve most of the flavor and nutrients), along with a few prawns or some fish. He argues that foods can taste delicious without adding a lot of fat, salt, and sugar, which he believes mask the true flavors of food.
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Some health professionals bemoan the difficulty in getting patients to comply with Dr. Ornish's relatively bland, low-fat, low-salt, low-sugar fare. Still, it seems reassuringly familiar, the kind of food that most doctors and nutritionists today would recommend.

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At the opposite end of the dietary spectrum are the nutritional activists who advocate a high-fat, high-meat diet. On a shimmering blue morning, a woman with a tidy press of white curls greets me at her farm. Sally Fallon Morell is the co-owner of and the force behind P. A. Bowen Farmstead, a sixty-acre farm an hour's drive from Washington, D.C. Sally proposes that we tour the cheese-making operation housed inside. We don white coats and hairnets, dip our plastic shoes into antiseptic pools, and stroll through sparklingly clean rooms holding racks of cheddar and blue cheese in various stages of processing. Leaving the building, we walk along dusty roads to the pasture area, where chickens roam in grass recently vacated by cattle and feed on maggots that have emerged from the cattle dung. We pass a fish pond stocked with bass, sunfish, catfish, koi, and minnows, along with a handsome flock of sturdy Silver Appleyard ducks, then trudge over to a patch of forest where a herd of hogs, a heritage breed of Berkshire, Tamworth, and Spotted Pig, grunt excitedly in response to Sally's shrill call. Besides one day providing meat, their job is to clear undergrowth, eventually rendering the forests suitable for the cattle to range through. When we amble over to a herd of grazing cattle, Sally pauses to enjoy the sight.

I've been walking around in a button-up shirt and stiff black dress trousers under a hot sun, so I'm relieved when we return to the main farm building. Today is the weekly chicken slaughter day. Under the shade of a roof, a team of men and women, young and old, work on a mini assembly line, slitting, bleeding out, scalding, and gutting a pile of chickens as country music pipes in the background.

When Sally decided to throw her full effort into this farm, some people raised eyebrows—after all, she grew up in an affluent Los Angeles suburb and is in her midsixties; her husband, a farmer from New Zealand, is eighty-eight, though vigorous. The farm is still in its early stages and has yet to turn a profit—but how can it? She feeds the chickens grass peas from Pennsylvania instead of cheaper genetically modified soy; she doesn't use antibiotics on her cows; she doesn't pasteurize her milk; her animals are all free-range. It's a noble effort, but she admits to “sleepless nights.” As she says, “I'm the one who wakes up in the middle of the night. I have tremendous sympathy for farmers.” Her husband helps with tractor work, but Sally is the one who pours her money and soul into the farm.

Sally Fallon Morell is a fighter in another way; she's perhaps the most controversial nutritional activist in the United States today. The bestselling book that made her famous is provocatively titled
Nourishing Traditions: The Cookbook That Challenges Politically Correct Nutrition and the Diet Dictocrats
(written with Mary Enig, a nutritionist and biochemist, and first published in 1995)
.
The introduction ranks among the most rousing and incendiary calls to arms ever penned in a cookbook. Sally and Mary take aim at the nefarious “Diet Dictocrats,” whose sundry ranks include “doctors, researchers, and spokesmen for various government and quasi-government agencies,” such as the Food and Drug Administration, the American Medical Association, the National Institutes of Health, medical schools and nutrition departments, and the American Cancer Society and the American Heart Association, which are “ostensibly dedicated to combating our most serious diseases.”
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Sally and Mary's book made waves by insisting that a healthy diet includes a lot of fat (including saturated fats), cholesterol, salt, calcium, raw milk, and fermented foods, and few to no soy products; basically, it's a traditional American farm diet. In the book, Sally approves of the “five
B
's”: bacon, butter, beef, sourdough bread, and blue cheese.
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(When I meet Sally on her farm, she points out that beans are also praiseworthy.) Further fanning the flames of controversy, Sally and her colleagues offer legal assistance to farmers who sell raw milk—illegal in parts of the United States and all of Canada and Australia, but legal in most of Europe—and argue for the merits of a raw-milk formula over breastfeeding for women who are deemed unsuitable for breastfeeding.
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Though one might naïvely suppose that Paleo/low-carb practitioners would be close allies in the promotion of animal-rich fare, Sally has castigated the Paleo diet for excluding agricultural products like grains, beans, and dairy, and for being too miserly with allotments of fat and salt. As she wrote on her foundation's Web site, “What does it do to the psychology of a growing child … to deny them ice cream (homemade, of course), whole milk, sourdough bread with butter, baked beans, and potatoes with sour cream?” She contends that children “need to grow up on a diet that says, ‘Yes, you may,' not ‘No, you can't.'”
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The passage is a beautiful example of the impassioned and intuitive arguments that have made Sally and her food activist organization, the Weston A. Price Foundation, a force to be reckoned with in the nutrition wars convulsing the American dietary landscape.

One aspect that has drawn the ire of traditional and Paleo followers is that Sally and her coterie have claimed the mantle of Weston A. Price. Price was a Canadian-born dentist who practiced in North Dakota and Ohio. Beginning in 1931, accompanied by his wife, he examined the link between dental health and food among various groups around the world, including the Swiss, Celtic fishermen, South Pacific Islanders, African tribes, and native groups throughout the Americas. Weston A. Price concluded that the introduction of Western processed foods, particularly sugar and flour, hastened the development of cavities. Conversely, a diet consisting largely of traditional food, from fish to moose to coconuts, protected against cavity formation and promoted good physical health overall.

To go from the conclusion that almost all traditional diets free of white flour and sugar were healthy to the assertion that a healthy diet is only one that includes relatively high levels of fat, cholesterol, and calcium is an interpretation of Price's observations. By comparison, another organization that has adopted Price's name, the Price-Pottenger Nutrition Foundation (formerly known as the Weston A. Price Memorial Foundation), makes the case that healthy traditional diets include “minerals and fat-soluble vitamins found in butter, sea foods, fish oils and fatty animal organs,” “raw, unaltered proteins from meats, sea foods, nuts, raw dairy and sprouted seeds,” and “sweeteners rarely and sparingly.”
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This is a milder, more inclusive set of criteria than the Weston A. Price Foundation's, but how many Americans have heard of the Price-Pottenger Nutrition Foundation? With such a blasé stance and no engagement in mudslinging, PPNF is like a prim wallflower at a college party, destined for obscurity. Moreover, a diet of bacon, butter, beef, sourdough bread, and blue cheese resonates with more Americans than, say, a traditional Okinawan diet of sweet potatoes, bitter melon and copious greens, fish, soybean products, and small amounts of pork, never mind the science supporting the Okinawan diet.

Weston A. Price, the dentist, was correct in surmising that traditional diets from any part of the world were effective in protecting the health of the eaters. The specific traditional American farm diet proposed by Sally—the six
B
's of bacon, butter, beef, sourdough bread, blue cheese, and beans—would have been suitable under the tough, vigorous working conditions of early American farmers. One only needs to glance at photos of early farmers to see that these were lean, healthy people, unfamiliar with obesity and its related diseases. For sedentary Americans today, a low-fat, low-meat diet like that proposed by Dr. Ornish is more likely to be healthy with respect to chronic diseases, because his diet is less energy-dense—little sugar or fat—and has less animal protein, but sustaining the willpower to deny oneself delicious fatty, salty, and sweet fare can be a monumental feat. The binge eating or compulsive snacking that results when willpower breaks down can undo all the possible advantages of a low-fat, low-meat diet. The better route, as I will explain, is to shift our lifestyles so that more moderate exercise is included in our daily routines, allowing us to eat with less guilt or fear of harmful consequences.

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Mark Sisson bounces into the Malibu café looking like a movie star: loose T-shirt, long wavy white hair, well tanned. He orders an omelet with avocado, bacon, chicken, feta cheese, mushrooms, and onions. The dish is served with potatoes, but Mark mostly ignores these. A former long-distance runner, triathlete, and Ironman competitor, Mark is the author of
The Primal Blueprint,
a guide to a Paleo lifestyle, and maintains an influential blog on Paleo matters. Like Sally, Mark eats a lot of fat (50–60 percent of his calories) and likes his dairy, but unlike her, Mark bemoans America's addiction to simple carbs: “I think of potatoes much the same way that I regard most grains, which is it's sort of a beige food that's a source of cheap calories that convert to glucose pretty quickly.” He regards his plate. “I don't include potatoes in my eating strategy. But mostly because I'm just not impressed with the way they taste. You have to put on a whole bunch of stuff on them to make them taste good.” Mark goes on to recount his disdain for agricultural staples like wheat and oatmeal, which also require much flavoring to make palatable and are too easily converted into glucose.