A Gibbous Moon Doth Shine

As I ran this evening along the path beside the lovely Cooper River, a shining gibbous moon was on the rise.  It seemed to pull me on, moving with me as I ran, never getting closer nor farther.  More than half, but less than full, it presented a beautiful picture in the sky. I got spellbound as I ran, but coming up to a busy intersection, I was snapped back to full alert state.  It was a subtle reminder, though, how the seasons are changing. There I was at 7:30 in the evening, and already the sun had set and the moon was clearly visible.   It has been warm this week, the warmest week of the summer.  I’ve been finishing my runs soaking wet from sweat.  When I take off my socks I can wring out a cup of sweat between the two of them.

The sound of cicadas would be impossible to describe to someone who had never heard one.  It is an unmistakable sound, though, and so typical for this time of year.  It is never one cicada, it is a crowd of male cicadas sending their messages to females that they are present and ready to mate.  The loudness of the song, and its constancy are remarkable.  As I ran along I listened for the much more delightful sound of a cricket chirping, but my search was unsuccessful.  If there was one it was drowned out by the blaring cicadas.

We are in the last throws of summer.  As the evening sky comes earlier, I am reminded that soon I will need to wear a head lamp.  While a definite safety feature, there is not much that is fun about wearing a headlamp.  It creates a sharply demarcated cone of visibility around my feet and a few yards in front of me, but shuts out the rest of the view.  Early morning runs on the weekends, also, will be dark, although made more pleasant by the lack of traffic compared with the evening weekday run.

Eating in the summer is always fun.  The fresh vegetables from local farms, the peaches, the tomatoes, and the small but significant harvest from our backyard garden make summer meals a festival.  My favorite, the blueberries, seemed to last particularly long this year.  I admit to being a blueberry addict.  I bought several ten pound boxes of them at the height of summer, and washed and froze them for my habit year round.

With colder days and longer nights, there is also an urge to indulge.  Football games with beer and nachos, colder temperatures driving up the appestat, and the diminishing supply of fresh garden produce yielding to potatoes, squash and other filling foods makes for a challenge against fitness.  With a marathon coming up in November, and my desire to be fit into the New Year, I must redouble my efforts at this time to stay the course, get in the runs, watch the calories, and not yield to temptations.  On the positive side, though, my hops are ready to harvest, and there will be another good Backyard Homebrew in the making in the near future.

A Handful of Nuts….

Pecan Tree

Pecan Tree, East Ranch, Madill, Oklahoma

A handful of nuts.

A Handful of Nuts

A report was published in the New England Journal of Medicine (NEJM) on November 21, 2013, entitled “Association of Nut Consumption with Total and Cause-Specific Mortality.”  This really caught my eye for a few reasons.  The primary reason was I wondered how it was possible to do such a study.  The second, and perhaps the more important, was I wanted to know if eating nuts could really have an effect on one’s mortality.  The third was whether the study would have been published if they had not proven their hypothesis, i.e., that eating nuts is good for you.

The study has a very impressive pedigree.  It was performed and written by researchers from Brigham and Women’s Hospital and Harvard Medical School, the Dana Farber Cancer Institute, and Indiana University.  It was funded by the National Institutes of Health (the NIH), and the International Tree Nut Council Nutrition Research and Education Foundation.  I was unaware of the Tree Nut Council, but it is an interesting note that they would be funding research showing nuts are really good for you.  On the other hand, the report states “the funders of the study had no role in its design or conduct; in the collection, management, analysis, or interpretation of the data; or in the preparation, review or approval of the manuscript.”

How was it possible to do this study?  The study was done by examining nut consumption in two very large groups of people for whom intimate details of their lives are available.  One is a group called the Nurses’ Health Study, a group of 121,700 female nurses living in 11 states in the U.S.A., enrolled in 1976.  The other is the Health Professionals Follow-up Study, a group of 51,529 male health professionals from all 50 states, enrolled in 1986.  Food frequency questionnaires were regularly filled out by these participants, and were the basis of the data collected.  The examined group was pared down to those for whom good data was available.  People with known heart disease, stroke or cancer were excluded.  Ultimately, they studied 76,464 women, and 42,498 men.  So they had significant numbers of participants to study.  They report that food frequency data was collected from these people using questionnaires administered every 2-4 years, starting with the women in 1980, and the men in 1986.  They asked how often during the preceding year did the person eat a one ounce (28 g) serving of nuts:  almost never, 1-3 times a month, once a week, 2-4 times a week, daily, or more often.  They also asked if the nuts were peanuts (a legume), or tree nuts.  The end point of the study was death.  So, if you were participating and died during the study, your nut consumption, cause of death, and other factors were then compared against the group still alive.  They found some very interesting things about nut eaters.  As a group, they tend to be leaner, less likely to smoke, more likely to exercise and more likely to take a vitamin supplement.  They also consumed more fruit and vegetables, and drank more alcohol.  In other words, they were very much like my running friends.  The researchers state, though, that they were able to tease apart these other factors in order to look at nut consumption alone as a predictive factor.  They found that how often one ate that handful of nuts was inversely proportional to their chance of dying during the study.  This was expressed as a hazard ratio, a way of comparing relative risks, but not the absolute risk, of an event occurring.  During the years of study, 30 for women, and 24 for men, 16,200 women died, and 11,229 men died.  That is around one in four participants in the study, which seems a high number.  The ones who ate the most nuts, more than one ounce a day, had a hazard ratio of dying of 0.8, or 20% lower chance than those who never or rarely ate nuts.  When they examined peanuts versus tree nuts, the reduced risk of mortality persisted.  Brief mention is made in the report that most major causes of death, including heart disease, cancer and respiratory disease, were decreased in the nut eaters, hence the reference to “cause specific” in the title.

They point out some of the strengths and weaknesses of such a study.  The study included a large number of enrollees, so presumably the statistics are meaningful.  They were careful to include methods for ensuring that the data were as reliable as possible, and that their statistical methods compared apples to apples, so to speak.  However, the study is an observational study, so while it can show an association, it cannot show cause and effect.  Another point not mentioned, is that the number of enrollees who died was significant, and makes me think a good number may have been older when they were first enrolled.  Another criticism of the study is that a large percent of the nut eaters were also, in general, more likely to exercise, eat a Mediterranean diet, and be thinner than the nut avoiders who, perhaps, were also were more likely to consume Ho-Ho’s, who knows.   While they state they were able to separate out these variables, intuitively it seems that if someone eats a healthy diet, exercises, and is thinner that person is less likely to develop diabetes, heart disease or cancer. In a related study published in the NEJM February 25, 2013, “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet,” a group of Spanish researchers showed that in a study of people at high cardiovascular risk, but without known heart disease, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of cardiovascular events.  This was a prospective study, meaning the study participants were divided into two groups, and studied going forward, rather than observed after the fact.  In fact, the study was stopped at 4.8 years due to the significance of the data being collected.  Of course, that can skew a study also.  It is possible for the healthy eaters to catch up to the poor eaters in their heart disease and mortality given a little more time.

What does this tell us about the value of a handful of nuts, and its effect on our well being?  The researchers give several plausible explanations why nuts may be good for us in general.  They contain unsaturated fatty acids, high-quality protein, fiber, vitamins and minerals.  They also contain certain phytochemicals (plant-based chemicals such as carotenoids, flavonoids and phytosterols) which may be healthful.  They cannot say, based on their research, that if one starts eating a handful of nuts on a daily basis, that person will avoid heart disease or cancer.  If you are my age, 59, much of your fate may already be cast, with regards to eating habits, atherosclerosis, and other long term health issues.  But that doesn’t mean there is no benefit.  In fact, changing one’s dietary ways at any time could have good effects, too.  In general, from numerous other studies cited by the two papers described above, eating a Mediterranean diet which includes olive oil or nuts is a very healthy type of diet.  Does your olive oil need to be “extra-virgin”?  Extra-virgin is cold-pressed and is the first pressing of the olive.  It is less processed than its non-virginal counterparts, and so has more of the natural substances intact.  There are lots of oils that claim extra-virgin status, which don’t quite live up to the name or reputation.  One must shop carefully.

I feel the benefits of a handful of nuts daily are there, but may not be as important as the overall habit of adherence to a Mediterranean diet.  I know at this time of year, close to Christmas, with cold weather and snow, and long nights with short days, the lure of all sorts of dietary indiscretions is strong.  Yet, be mindful of what you eat, as it does become you.  And grab that handful of nuts…

Pecan Tree

Another Pecan Tree

Citations:

Ying Bao, M.D., Sc.D., Jiali Han, Ph.D. et. al., Association of Nut Consumption with Total and Cause-Specific Mortality.  NEJM, 2013, 369:2001-2011.

Ramon Estruch, M.D., Ph.D., Emilio Ros, M.D., Ph.D., et. al., Primary Prevention of Cardiovascular Disease with a Mediterranean Diet.  NEJM, 2013, 368:1279-1290.

Paleofantasy: a book report

Paleofantasy

What Evolution Really Tells Us About Sex, Diet and How We Live

by Marlene Zuk

Published Feb. 2013 by W.W.Norton & Co., 328 pages

paleofantasy

 

 

 

 

 

When I was in high school, first learning about genetics, things seemed fairly simple and straightforward.  Blue eyes, a recessive trait, required two genes, one from each parent, specifying blue eyes.  Otherwise, the eyes would be brown, being from a dominant gene.  Since then, with the explosion of scientific knowledge of molecular biology and the analysis of the entire human genome, the world of genetics and evolution has, well, evolved, to put it in the phrasing of Dr. Zuk, a professor of Ecology, Evolution and Behavior at the University of Minnesota.  But it is as if we have just dipped our toe in a vast and unexplored ocean, which was previously unknown.

I picked up this book at my favorite book shop in the U.S., Northshire Bookstore in Manchester, Vermont, while on a ski trip in February.  The title captured my interest.  There is a huge “Paleo” movement at present, based on the theory that our genes adapted to life of the paleolithic time, that is, from about 2.5 million years ago to about 10,000 years ago.  This covers a lot of time, from when earliest human-like creatures developed, to the development of modern homo sapiens.  A search on Amazon for books with paleo in the title yields 2,719 titles, very few of which have to do with actual paleontology.  They are almost all about eating paleo, living the paleo lifestyle, and there was even a paleo cookbook for your dog.  The concept is that humans evolved before the era of agriculture, caught their meals in bursts of speed chasing down animals, gathered vegetable food from nature, and walked and ran barefoot.  Thus, the argument goes, we are best suited for this type of food, and life, and that our genes are ill equipped to handle crops such as grains, non-meat sources of protein, and running long distances, especially in shoes.  There are also devotes to various concepts of how stone-agers lived in family units, or groups, how they coupled up and reproduced, and whether there was pairing for life versus multiple partner life.  The purpose of devoting oneself to a paleo lifestyle, then, is to be in harmony with ones nature and genes, to be healthier, leaner, fitter, sexier, have less immunological problems, and presumably, to be able to run injury free.

Dr. Zuk starts off with a brief description of human evolution.  She explains some of the complexity of the evolutionary process, that many human ancestor lineages were changing in different ways, that we share an enormous percent of our genome with earlier species right down to bacteria, and that evolutionary change is not always change for the good.  She points out some of the complexity of genes being favorable or unfavorable for survival.  For example, if a trait is unfavorable, and results in loss of that trait, other genes will be lost along with that  trait due to their being linked together.  She gives specific examples. She also documents that there was not just one paleolithic lifestyle; there were many different routes taken along very different paths.

Her second major point is that evolutionary change can happen quickly or slowly, and may occur without any type of survival pressure.  An argument of the paleo adherents is that our genes were fixed back in pre-modern times, and that the last 10,000 years is too short a time to allow for adaption to new foods, and new ways of living.  She rebuts this with specific examples of changes that have occurred in that relatively short period.  Blue eyes, mentioned above, came about in the last 10,000 years.  Lactose intolerance seems to have a lot to do with where and how one’s group survived, and is also very recent.  It has the complex nature of being caused by a lack of a gene to inhibit built in turning off of another gene which inhibits lactase production as one matures, lactase being the enzyme required to digest lactose.  She mainly discusses genetic changes which are changes in gene expression, as opposed to major gene alterations such as occur with mutations.  In other words, she’s not talking about how we got to be human, but rather how our genome is modified over time to adapt to our surroundings.

The following chapters deal with diet, food procuring methods, exercise or physical activity including running, sex, monogamy versus multiple partners, family structure, child raising, susceptibility to diseases, and how we protect ourselves from disease.  Her discussions of these topics are backed up with scientific studies, and she cites the literature from which she makes her arguments.  She also points out where the science does not support the claims made by paleo adherents, thus the “Paleofantasy” of the title.  In many ways, she does not try to say that the “paleo” approach to diet or exercise is harmful, just that it is not based on real scientific reasoning.  As with any devoted scientist, she includes a lengthy bibliography which she used to form her arguments, as well as a notes section and an index.

Her writing style was an interesting, and sometimes to me, annoying mix of sound scientific argument with a conversational tone that seemed unnecessary.  It was like watching a really good Nova TV show on a particular topic, and then having a few lines from the sitcom “Cheers” thrown in.  She uses the word “well” a lot, as I used it above in the first paragraph.  I enjoyed the humorous touches, though, and I think she would make a very entertaining teacher in the classroom.  The title of the book is clearly meant to titillate, listing sex as the first major topic, when it’s really primarily about diet.  She got most of her information regarding the paleo lifestyle from the internet and popular books, which makes sense, since it’s not a scientific discipline, but it does make comparisons of real research with what paleo advocates consider perfectly logical thinking a bit one-sided.  This is not meant to be a book for scholars, but for the lay public, and I think she has accomplished that very well without sacrificing the scientific complexity which makes this topic so interesting.

I learned a lot reading this book, about evolution and current thought about genes and molecular biology.  I think she makes very sound arguments that, while living a paleo lifestyle may not hurt you, you won’t necessarily be any better off for it.  She successfully defends her thesis, that the paleo movement is based on fantasy, not fact.  Reading the comments about her book online, there were obviously many adherents of the paleo life who were not only unconvinced by her arguments, but found her book essentially sacrilegious.  In fact, a number of commentators remarked that they would not read the book. For me, it was an exciting look at topics which are themselves changing rapidly as new research is done in the areas of evolution, genes, reproduction, disease, disease prevention, fitness and longevity.  I think anyone who is interested in these topics will find this book fascinating and a good read, as long as you can, well, ignore some of the style issues.

Vlad Averbukh, 29, a follower of the paleo diet, eats raw meat along the Hudson River in New York in 2010. Emmanuel Dunand/AFP/Getty Images

Vlad Averbukh, 29, a follower of the paleo diet, eats raw meat along the Hudson River in New York in 2010.
Emmanuel Dunand/AFP/Getty Images

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