The science as expected ranged from outstanding to mediocre, but I was really encouraged by the presence and enthusiastic participation of a number of quality researchers and clinicians. The basic concept of ancestral health is something almost anyone can get behind: many of our modern health problems are due to a mismatch between the modern environment and what our bodies "expect". The basic idea is really just common sense, but of course the devil is in the details when you start trying to figure out what exactly our bodies expect, and how best to give it to them. I think our perspective as a community is moving in the right direction.Not surprisingly, the carbohydrate and insulin controversies loomed large over the AHS once again. Several of the talks were aimed at defending the carbohydrate-insulin hypothesis of obesity, and it was clear that a subset of the low-carb community was reacting tothe writing myself and others have published on this subject in the last year.
I don't feel the need to further explain why this idea doesn't have much traction among obesity researchers (i.e. the idea that elevated insulin due to carbohydrate consumption is the central cause of common obesity), but those who are interested can read what I've written about it previously. In particular, I periodically update the key post "The Carbohydrate Hypothesis of Obesity: a Critical Examination", and it now has a section addressing the most common arguments in favor of the insulin hypothesis, so if you haven't read it in a while, have a look.
The "safe starch debate" was kind of entertaining. There was a panel of people basically debating whether or not starch can be part of a healthy diet, moderated by Jimmy Moore (who I think did a good job). The fact that this debate even took place is absurd—this is the kind of thing that makes it so hard to get research funding to study the Paleo diet. But in the end, thanks to Chris Kresser and Paul Jaminet, carbs prevailed. One of the most surreal moments happened right after Kresser brought up the Okinawans, the longest-lived culture and one of the healthiest in the world, and cited a paper showing that their traditional diet was ~85 percent carbohydrate, mostly from sweet potatoes. Shanahan and Rosedale decided, based on thin air, that the Okinawans actually didn’t eat much carbohydrate, and Shanahan even went so far as to say “I don’t believe you”, even though Kresser was staring right at the citation on his laptop! This is the kind of head-in-the-sand approach to science that we need to move beyond in the ancestral community. It was also amusing to watch Rosedale proclaim that we should get over our obsession with the Kitavans, to scattered applause. I suppose if there were a culture that was lean and healthy eating cake for breakfast and driving from the house to the mailbox to get the mail, I might want people to stop talking about it too.
Food reward also came up a few times in the talks. From a scientific perspective, the discussions on food reward ranged from reasonable to bizarre. On the reasonable side, Andreas Eenfeldt made an important point that I've tried to convey on my blog at times. It's basically this: if you think junk food is fattening (regardless of why), and you think one of the reasons people eat junk food is that they're drawn to it and they like it, then you believe food reward contributes to obesity. For example, if soda weren't tempting and enjoyable to drink, people wouldn't choose it over water. Regardless of whether you think it's the excess calories, the sugar, or something else that's fattening at that point, food reward is what got it to your lips.
On the head-scratching side, there was J. Stanton's talk. Stanton spent about half his talk flailing around at my writing in a thinly veiled manner. He even went so far as to label food reward the “naïve hypothesis”. Yes, an entire field of full-time researchers is naïve; good thing we have a fantasy novel author to point it out to us. He seemed so focused on tearing down the food reward hypothesis that he undermined his own ideas in the process. For example, he showed data on trends in fast food spending and total away-from-home food spending (which are data that I've presented on several occasions and which Jeremy Landen and I introduced to the community), and attempted to argue that they don't line up well enough with obesity trends to support a connection. Besides being a rather imaginative interpretation of the data (see graph below), particularly considering that obesity can take many years to develop, this was counterproductive since one of his central messages revolves around explaining why junk food isn’t satiating and therefore leads to overeating and presumably fat gain. So is it fattening, or not? And if it isn't, why should we care about how satiating it is? I probably would have let the whole thing slide if he hadn't repeated the absurd and hateful “moral failure” meme-- that the food reward hypothesis implies that obese people are gluttons and sloths. Haters gotta hate I guess...
My talk was titled "Digestive Health, Inflammation and the Metabolic Syndrome", and it contained a fair amount of information I haven't covered on the blog yet. I started off by stating that I wasn't going to talk about carbs, which got a laugh. I'm sure many people were glad for the break, and so was I. The talk went well and I think it was well received. It will eventually be freely available online. The Q and A was interesting too. Robert Lustig asked why I hadn’t mentioned fructose. In retrospect, you can always think of better ways to answer a question than you did when you were on the spot. My response was OK, but I think I was a little bit more dismissive than I should have been. Basically, it’s not that I think fructose is irrelevant to the metabolic syndrome, it’s just that 1) it doesn’t strike me as central to the main focus of the talk, and 2) it’s a complex issue that I didn’t have time to get into. I could make a whole presentation or three just about fructose.
Other talks I enjoyed were by Chris Kresser on iron overload, James O’Keefe on the harms of excessive exercise (and the massive benefits of moderate exercise), Maelan Fontes Villalba on antinutrients, Lynda Frassetto on Paleo diets and blood glucose control, and Chris Masterjohn on oxidative stress and carbohydrate intolerance. Chris Masterjohn in particular hit it out of the ballpark—he was right on the cutting edge, and he has a way of cutting through the BS without offending anyone. Unfortunately I missed most of the talks I was interested in, for various reasons, but they will all be freely available online thanks to AHS and Harvard!
After the conference, I visited my parents in Virginia for a few days. We had a nice relaxing time together. We gorged on tomatoes, watermelon, and cherries from the garden, and swam in the river. We also went foraging for pawpaws in the forest (see photo below of my dad shaking a pawpaw tree). Pawpaws are one of North America’s largest indigenous fruits, but most people have never heard of them. They grow on smallish trees, have creamy orange-yellow flesh, and taste like a cross between mango, banana and cantaloupe, with a slightly astringent edge. If you live in the mid-Eastern or central US, you may well have them in your neighborhood.
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