1. Lindeberg, S. Modern human phsyiology with respect to evolutionary adaptations that relate to diet in the past, in The Evolution of Hominid Diets: integrating approaches to the study of Palaeolithic subsistence, M.P. Richards and J.J. Hublin, Editors. in press, Elsevier.

This paper reviews evidence from human physiology as to which foods may have been typically consumed by the hominin ancestral lineage up to the advent of anatomically modern humans. Considerable evidence suggests that many common diseases can be prevented by hunter-gatherer diets. Apparently, human nutritional metabolism is not perfectly fine-tuned for recently introduced staple foods, such as cereals, dairy products, added salt and refined fats and sugar. It is much more uncertain if human physiology can provide direct evidence of which animal and plant foods were regularly consumed during human evolution, and in what proportions. The requirements of ascorbic acid can easily be met by organ meats from large animals as well as plant foods. Vitamin B12 is absent in plant foods and must be supplied from meat, fish, shellfish or insects, but the required amounts are apparently small.

Since iodized salt and dairy products were not available before the advent of agriculture, only those ancestors with high regular access to fish or shellfish would be expected to have reached the currently recommended intake of iodine. However, there is insufficient data to suggest that humans, by way of natural selection, would have become completely dependent on marine food sources. Therefore, it is highly possible that human requirements for iodine are currently increased by some dietary factors. These theoretically include goitrogens in certain roots, vegetables, beans and seeds. The notion that humans are strictly dependent on marine foods to meet requirements of long-chain omega-3 fatty acids still awaits solid evidence.
Shifting the focus from general human characteristics to ethnic differences, persistent lactase activity in adulthood is obviously not the only characteristic to have emerged under nutritional selection pressure. Other examples are a relative resistance against diseases of affluence in northern Europeans and a relatively low prevalence of gluten intolerance in populations with a long history of wheat consumption.

In conclusion, humans are well adapted for lean meat, fish, insects and highly diverse plant foods without being clearly dependent on any particular proportions of plants versus meat.

2. Jönsson, T, Olsson, S, Ahrén, B, Bøg-Hansen, TC, Dole, A, and Lindeberg, S. Agrarian diet and dieases of affluence – Do evolutionary novel dietary lectins cause leptin resistance? BMC Endocrine Dis, 2005; 5: doi:10.1186/1472-6823-5-10 >>Free full text>>

BACKGROUND : The global pattern of varying prevalence of diseases of affluence, such as obesity, cardiovascular disease and diabetes, suggests that some environmental factor specific to agrarian societies could initiate these diseases. PRESENTATION OF THE HYPOTHESIS : We propose that a cereal-based diet could be such an environmental factor. Through previous studies in archaeology and molecular evolution we conclude that humans and the human leptin system are not specifically adapted to a cereal-based diet, and that leptin resistance associated with diseases of affluence could be a sign of insufficient adaptation to such a diet. We further propose lectins as a cereal constituent with sufficient properties to cause leptin resistance, either through effects on metabolism central to the proper functions of the leptin system, and/or directly through binding to human leptin or human leptin receptor, thereby affecting the function. TESTING THE HYPOTHESIS : Dietary interventions should compare effects of agrarian and non-agrarian diets on incidence of diseases of affluence, related risk factors and leptin resistance. A non-significant (p = 0.10) increase of cardiovascular mortality was noted in patients advised to eat more whole-grain cereals. Our lab conducted a study on 24 domestic pigs in which a cereal-free hunter-gatherer diet promoted significantly higher insulin sensitivity, lower diastolic blood pressure and lower C-reactive protein as compared to a cereal-based swine feed. Testing should also evaluate the effects of grass lectins on the leptin system in vivo by diet interventions, and in vitro in various leptin and leptin receptor models. Our group currently conducts such studies.

IMPLICATIONS OF THE HYPOTHESIS : If an agrarian diet initiates diseases of affluence it should be possible to identify the responsible constituents and modify or remove them so as to make an agrarian diet healthier.

3. Cordain, L, Eaton, SB, Sebastian, A, Mann, N, Lindeberg, S, Watkins, BA, O’Keefe, JH, and Brand-Miller, J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr, 2005; 81: 341-54 >>Free full text>>

There is growing awareness that the profound changes in the environment (eg, in diet and other lifestyle conditions) that began with the introduction of agriculture and animal husbandry approximately 10000 y ago occurred too recently on an evolutionary time scale for the human genome to adjust. In conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural, and activity patterns of contemporary Western populations, many of the so-called diseases of civilization have emerged. In particular, food staples and food-processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered 7 crucial nutritional characteristics of ancestral hominin diets: 1) glycemic load, 2) fatty acid composition, 3) macronutrient composition, 4) micronutrient density, 5) acid-base balance, 6) sodium-potassium ratio, and 7) fiber content. The evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization.

4. Lindeberg, S, Cordain, L, and Eaton, SB. Biological and clinical potential of a palaeolithic diet. J Nutr Environ Med, 2003; 13: 1-12

Purpose. To explore the possibility that a paleolithic diet, i.e. one that corresponds to what was available in any of the ecological niches of pre-agricultural humans (1.5 million-10,000 years B.P.), is optimal in the prevention of age-related degenerative disease.

Design. Literature review.

Materials and Methods. Between 1985 and December 2002, more than 200 scientific journals in medicine, nutrition, biology and anthropology were systematically screened for relevant papers. Computer-based searches and studies of reference lists in journals and books provided a vast number of additional papers.
Results. Increasing evidence suggests that a paleolithic diet based on lean meat, fish, vegetables and fruit may be effective in the prevention and treatment of common western diseases. Avoiding dairy products, margarine, oils, refined sugar and cereals, which provide 70 % or more of the dietary intake in northern European populations, may be advisable. Atherosclerosis is highly dependent on dietary manipulation in animal experiments. Atherogenic dietary factors include fat (any type) and casein, and hypothetically cereals. Stroke, ischaemic heart disease and type 2 diabetes seem largely preventable by way of dietary changes in a paleolithic direction. And insulin resistance, that may have far-reaching clinical implications as a cause of unregulated tissue growth, may also respond to an ancestral diet.

Conclusions. Lean meat, fish, vegetables and fruit may be optimal, rather than a strictly vegetarian diet, in the prevention of cardiovascular disease, diabetes and insulin resistance.

5. Eaton, SB, Cordain, L, and Lindeberg, S. Evolutionary health promotion: a consideration of common counterarguments. Prev Med, 2002; 34: 119-123

The proposal that Late Paleolithic (50,000-10,000 BP) ancestral experience might serve as a model for prevention research and even, if justified by experiment, as a paradigm for health promotion recommendations is sometimes discounted, before critical assessment, because of reservations based on unjustified preconceptions. Most often such biases involve comparative life expectancy, potential genetic change since agriculture, the heterogeneity of ancestral environments, and/or innate human adaptability. This paper examines these topics and attempts to show that none of them justifies a priori dismissal of the evolutionary approach to preventive medicine. Evolutionary health promotion may ultimately be invalidated because of its falsification by experiment or because another theory accords better with known facts, but these commonly held prejudices should not forestall its thoughtful consideration and investigative evaluation.

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