How I Ended Up Here

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Three years ago, if you’d told me I’d be starting a blog about diet and nutrition, I probably would have thought you were nuts. I’m a Neurologist, and my primary interests lean towards disorders of higher cortical function (language, memory, learning, etc.). That said, I do tend to be intellectually restless, and the internet is filled with intriguing diversions. Such was the case with my own detour into the topic of ancestral health and nutrition, which began a couple of years ago with an innocent encounter with Kurt Harris’s Archevore (then “PaNu”) blog. When I first stumbled upon it, I had no idea that my entire conception of chronic disease was about to be turned upside down. But his ideas were too compelling to ignore, despite being completely at odds with what I thought I knew about diet, nutrition, and disease. For years — since early in medical school I suppose — I’d generally accepted the conventional nutritional dogma as truth, which was that a low-fat, low-cholesterol, high-carbohydrate diet was the cornerstone of healthy eating. This is generally treated in medical circles and popular culture as established, proven fact.

But it isn’t.

In fact, it’s completely, utterly, horribly wrong.  And it has created a public health nightmare.

Like many who’ve followed along this path, I was profoundly influenced by Gary Taubes’s Good Calories, Bad Calories, a book that may one day be widely regarded as the spark that ignited a paradigm shift. It is an eye-opening and disheartening account of how science — in this case the science of nutrition — can be perverted by the corrupting influence of hubris, greed, carelessness, corporate interests and hasty, misinformed public policy making. It also so thoroughly dismantles the saturated fat/cholesterol/heart disease hypothesis that it is impossible for anyone with a half-open mind to come away believing any shred of it.

Yet, the fat/heart disease hypothesis is at the heart of mainstream nutritional dogma. It is the foundation upon which everything has been built for the past forty years, and almost all research published since the hypothesis gained widespread acceptance has been interpreted through the distortion of its lens. Without it, we wouldn’t have the public-health-disaster that is the USDA food pyramid, nor would we find ourselves in the midst of an ever-expanding epidemic of diabetes and obesity.

In spite of how far afield we’ve gotten ourselves, I remain confident that in the end good science will prevail. At some point, the mainstream nutritional edifice has to collapse under the weight of the evidence against it — a process that in some respects has already begun. It is my hope that the internet can accelerate this process. The more voices of reason and thoughtful dissension there are, the faster this will happen.

Which in the end is how a Neurologist starts a blog about nutrition.

Righting the Ship

Thankfully, we have a very reasonable guiding principle from which to re-build our foundation. It is a principle that has been conspicuously absent from the field of nutrition over the past several decades, despite the fact that it has been instrumental in fueling the advances that have been made in the biological sciences for over a century. It is the principle of evolution by natural selection.

Over two million years, the human species has roamed planet Earth. And for the vast majority of that time, the human diet consisted of the animals we killed and the plants we foraged. Those who thrived on these foods lived long enough to pass their genes on to subsequent generations. Those who didn’t perished. In this manner, the human genome became exquisitely adapted to the diet of the hunter-gatherer. Not surprisingly, humans on this diet are lean, fit and free of chronic illness. They are physical specimens worthy of our species’ position on the top of the food chain.

The diet of our hunter-gatherer ancestors didn’t include wheat.

It didn’t include refined sugar.

It didn’t include vegetable and seed oils.

These items were introduced only very recently in the course of human history — roughly 10,000 years ago — through the adoption of agriculture.  10,000 years is a blip on an evolutionary scale, nowhere near enough time to adapt to such a radical change in our internal metabolic environment.  Moreover, there is minimal selection pressure for such adaptation to occur, since the diseases wrought by the modern diet do not affect fecundity. And the health consequences of this transition are clear, as demonstrated by numerous observational accounts of modern day hunter-gatherer societies who transition to a post-agriculural diet. The very same diseases that strain our bloated healthcare system — diabetes, heart disease, obesity, hypertension, cancer — are all a consequence of this nutritional transition. They are “diseases of civilization,” and as such are all entirely preventable.

Alas, preventing them requires that we first correctly identify their root causes. The evolutionary perspective provides us with an ideal framing device for doing so. It is a perspective supported by sound a priori reasoning, compelling observational evidence, basic science, and an impressive and ever-expanding collection of anecdotal experiences.

Naturally, I’m particularly interested in the diseases of civilization that affect the nervous system, which include (but are likely not limited to) Stroke, Dementia (Alzheimer’s included), Multiple Sclerosis, Parkinson’s and Migraine. I find it both maddening and exhilarating to think that all the suffering wrought by these illnesses is largely optional. This will be the primary focus of this blog:  employing an ancestral health perspective to understand the ways in which we can preserve and protect our trillions of neuronal connections from disease, and maintain optimal brain function.  In other words, how to save our synapses.

14 thoughts on “How I Ended Up Here

  1. Josh, I found your site through MDA and love it! I was just diagnosed with MS this week and am looking for a Neurologist that is open to this kind of approach in the Northern Virginia / Washington D.C. metro area. Do you know anyone you can recommend? Sadly, the Neurologist the hospital connected me with just laughed…

  2. It’s gratifying to discover your site. As someone who was epiphanized by Good Calories, Bad Calories four years ago, then diagnosed with a rare neurodegenerative disease (MMN or multifocal motor neuropathy) two years ago, I’ve been seeing if diet can influence the course of this disease. My focus is on a ketogenic diet. I can’t tell you how exciting it is to find an actual neurologist with an interest in this type of diet, outside of the pediatric-epilepsy crowd, anyway.

    • Thanks. There’s certainly evidence to support an autoimmune/inflammatory component to MMN, for which a ketogenic or ancestral style diet would be an appropriate intervention. I’m curious to hear how it goes for you. Hopefully really, really well!

  3. Hi Josh, this was a great read, I think you are my kind of neurologist! I have MS and am managing it very well through alternative treatments and diet. Have a look at my blog if you’re interested, I look forward to reading more of your posts.

  4. So I found this site by accident, and I love the cartoons…which I’m guessing were your handiwork. I notice that you like the paleo way of eating. I have Loren Cordain’s book, but I’ve got to say…offal = awful. Also, “might as well face it, I’m addicted to cheese.” But I do keep coming back to looking at ancestral eating as a way of life. If I could just kick my sweet tea addiction.

    • Welcome – glad you enjoy my feeble artwork!

      And yes, I definitely favor an ancestral/paleo approach to eating. I also think that, unless you’re lactose intolerant or casein allergic, there’s room for dairy within a paleo framework – especially cheese! So that just leaves the sweet tea… :)

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