Paleo Diet Q & A: Blood Type and Diet

Q: Professor, I pulled my information from thepaleodiet.com and attributed the statement, "Paleo is truly is the world’s healthiest diet," to you, which I doubt is a stretch.

Have you gotten into any of the information about the blood-type-related nutrition info? I've only heard snippets, but I'm curious what an expert thinks of it.

Seth

A: Hi Seth,

Thanks for your support. I am currently completing a paper on nightshades, and when it is done the very next topic in the queue is my critique of the Blood Type Diet, which I have been researching and reading about for the past couple of weeks. Although I don’t want to give away the story line, I can say that the concept of four specific types of diet for the four ABO blood groups (A, B, O & AB) is not supported by the available data. However, having said that, susceptibility to disease, and the robustness of the immune response to pathogens throughout the entire GI tract, is very much related to ABO blood groups. Our group has published at least one paper on the dietary lectin/disease concept and we believe that common dietary lectins may promote certain diseases (allergies, autoimmune disease) while simultaneously promoting chronic low level inflammation. However, little evidence in either humans, animals or tissues point in the direction that dietary lectins elicit disease symptoms exclusively via interaction with ABO antigens. Additionally, of the hundreds of plant lectins that have been identified, only a very select few have been demonstrated to bind gut tissue. Hence, most dietary lectins are benign, simply because they cannot penetrate the gut barrier.

Cordially,
Loren Cordain, Ph.D., Professor

Sample Menus for Endurance Athletes

Dear Readers,

Nell Stephenson, Fitness & Nutritional Professional, Ironman Triathlete, and contributor to our newsletter was recently contacted by Details magazine to write up sample menus for endurance athletes: one for a workout day, the other for an off-day from training.

You will find other paleo-friendly menu ideas on Nell's blog.

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Endurance Athlete Sample Menu for Two-a-Day Workout

5:30 AM
Pre-workout Breakfast Smoothie- 8oz brewed, chilled, natural decaf green tea with a banana, egg white protein powder, almond butter whizzed in the blender with some baked yam on the side.

6:30 AM
3-hour bike ride on the trainer-carbohydrate gel taken every 25 minutes.

9:30 AM
Immediate Post-workout recovery drink- HOME BREW (recipe in The Paleo Diet for Athletes) – cantaloupe, egg white protein powder and glucose. Drink plenty of water- keep hydrating.

10:00 AM
Raisins (to restore body alkalinity, continue to help the body recover post workout, and prepare for the session later in the day).

11:30 or 12:00 PM
Grilled Chicken breast, flash-sautéed asparagus, drizzled with flax seed oil and an apple

3:00 PM
Natural unsweetened applesauce with chopped egg whites (to prepare for 2nd workout of the day-shift from the usual Paleolithic macronutrient ratio to the pre-workout focus on carbohydrates).

4:30 PM
Sixty-minute track workout-hard, fast intervals; carbohydrate gel taken immediately post as recovery.

5:45 PM
Banana (high glycemic fruit choice to, again, aid in recovery)

6:30 PM
Poached wild salmon on a bed of steamed kale, mixed green salad, avocado & sliced strawberries, a squeeze of fresh lime juice and a splash of cold-pressed extra virgin oil; sliced oranges on top.

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Endurance Athlete Sample Menu for Off-Day from Training

6:00 AM Breakfast
Poached Cod (or Barramundi) on bed of sautéed spinach (with garlic & olive oil), fresh blueberries and strawberries.

9:00 AM
Steamed broccoli, drizzled with cold pressed flax seed oil, sliced orange and chopped egg whites.

Lunch
Mixed green organic salad, with olive oil and lime wedge, served with grilled chicken, avocado and grapes.

Afternoon Meal
Sliced lean turkey breast used as a wrap, with Mache lettuce, raw almond butter and sliced pear inside.

Dinner
Kangaroo Kebabs-lean meat, skewered with red onion & yellow bell peppers, marinated over night in olive oil, lemon juice & your favorite herbs, then grilled or broiled. Serve with grilled green onion and a fresh spinach salad with tomato, walnut oil & a lime wedge.

Snack
Cinnamon dusted sliced apples-slice an apple, toss in lemon juice to prevent browning/oxidation, then sprinkle cinnamon on top. Enjoy with a cup of herbal or green decaf tea!

Chia Seeds Follow-up

Dear Readers,

This Q & A is in response to Dr. Cordain's special report on Chia Seeds, which appeared in a recent issue of our newsletter, The Paleo Diet Update. The full report is available in The Paleo Diet Update, Volume 6 Issue 7.

Q: Loren,

Hope all is well with you and your work!

After reading your article on chia seeds, I forwarded the article to Dr. Vlad Vuksan in Canada, one of the leading researchers/promoters of Salba Seeds. After he got your article, he seemed to object that your conclusions apply uniquely to chia seeds generically, but not to Salba Seeds (single variety).

Is such a distinction valid? Wouldn't your conclusions regarding chia seeds apply as well to Salba, a variety of chia?

Thanks for your insights,
Frank

A: Hi Frank,

I stand by my conclusions in the newsletter. Until further human trials are completed employing a sample size with sufficient statistical power to resolve these immune system issues, then the potential adverse effects of long term, chronic chia seed consumption may outweigh the potential benefits. I respect Dr. Vukan’s long time collaborative work with David Jenkins at the University of Toronto, particularly in regard to their pioneering work on the glycemic index. I have read both of Dr. Vukan’s recent chia seed papers^{1, 2}, and in neither one do the authors make any distinction between generic Salvia hispanica L. and the trade name (Salba) version of the seed they employed in their two studies. Hence, unless Dr. Vukan and colleagues can show otherwise, the literature results I have uncovered remain unchanged and apply to both Salba and Salvia hispanica L. It should be noted that at least two of the subjects in Dr. Vukan’s first study² refused to continue because of gastrointestinal side effects.

In regard to Dr. Vukan’s first chia study, Table 1 shows a non-significant decrease (7.0 %) in the treatment group’s CRP and a 32.9 % increase in the control group value. The authors interpret this bi-directional group change in the abstract and elsewhere as a significant reduction (40 + 1.6% p less than 0.04) in CRP. This kind of data reporting is misleading when the treatment group mean change was actually non-significant. Despite ANCOVA adjustment for age, gender and sequence in their repeated measures model, their interpretation of the CRP data is at best misleading but likely incorrect. An additional shortcoming in this study involves the reporting of ALA and EPA data (results p. 2806). Why weren’t the actual plasma concentrations (mean + SD) of both of these fatty acids reported in both the experimental and control group? Given that 2% or less of ALA is chain elongated and desaturated into DHA, the EPA data need further scrutiny. Did the reported % differences for ALA and EPA represent within group differences or factorial differences? These shortcomings potentially invalidate the conclusions of the paper that CRP was reduced. In contrast, Nieman and colleagues³ were unable to replicate Dr. Vukan and colleague’s results in a similar study with a much larger sample size and hence greater statistical power.

Cordially,
Loren Cordain, Ph.D., Professor

References:

1. Vuksan V, Jenkins AL, Dias AG, Lee AS, Jovanovski E, Rogovik AL, Hanna A. Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.). Eur J Clin Nutr. 2010 Apr;64(4):436-8.


2. Vuksan V, Whitham D, Sievenpiper JL, Jenkins AL, Rogovik AL, Bazinet RP, Vidgen E, Hanna A. Supplementation of conventional therapy with the novel grain Salba (Salvia hispanica L.) improves major and emerging cardiovascular risk factors in type 2 diabetes: results of a randomized controlled trial. Diabetes Care. 2007 Nov;30(11):2804-10


3. Nieman, D., C., E. J. Cayea, M. D. Austin, D. A. Henson, S. R. McAnulty, F. Jin. 2009. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutrition Research, 29(2009):414-418.

Paleo Diet Special Report: Chia Seeds

Dear Readers,

The following is an excerpt from a special report authored by Dr. Cordain on Chia seeds. The full report is available in our newsletter, The Paleo Diet Update, Volume 6 Issue 7.

Q: Are there any negative effects associated with chia seeds which would make them inappropriate in The Paleo Diet?

Thank you.

A: Good question. I would imagine that many of our readers have never even heard of chia seeds much less eaten them. Chia seeds (Salvia hispanica L.) are a member of the Labiatae plant family and are native to southern Mexico and northern Guatemala. The seeds are small, oval shaped; either black or white colored and resemble sesame seeds. These seeds were cultivated as a food crop for thousands of years in this region by the Aztecs and other native cultures. Chia seeds can be consumed in a variety of ways including roasting and grinding the seeds into a flour known as Chianpinolli which can then become incorporated into tortillas, tamales, and various beverages. The roasted ground seeds were traditionally consumed as a semi-fluid mucilaginous gruel (Pinole) when water is added to the flour. In post-Columbian times the most popular use of chia flour was to make a refreshing beverage in which the ratio of seeds to water is decreased, thereby resulting in a less gelatinous consistency to which lemon, sugar or fruit juice are added. The sticky consistency of chia seed Pinole or chia beverages comes from a clear mucilaginous, polysaccharide gel that remains tightly bound to the seeds. This sticky gel forms a physical barrier which may impair digestion and absorption of fat from the seed⁴ while also causing a low protein digestibility.

In the past 20 years a revival of interest in chia seeds has occurred primarily because of their high fat content of about 25-39% by weight, of which 50-57% is the therapeutic omega 3 fatty acid and alpha linolenic acid (ALA). In the past 10 years chia seeds have been used as a foodstuff for animals to enrich their eggs and meat with omega 3 fatty acids. So I wholeheartedly approve of feeding chia seeds to animals and then eating the omega 3 fatty acid enriched meat or eggs of these animals.

How about feeding chia seeds to humans – should we consume chia seeds because of their high omega 3 fatty acid (ALA) content? The Table below shows the entire nutrient profile of chia seeds. At least on paper, it would appear that chia seeds are a nutritious food that is not only high in ALA, but also is a good source of protein, fiber, certain B vitamins, calcium, iron and manganese.

Unfortunately, the devil is always in the details...

Tofu Revisited

I  realized last week that I had not eaten tofu for at least a month. I wasn't avoiding it, I just didn't think to buy it. Time to correct that as it is a wonderful food for Vegans due to it containing all nine essential amino acids the body needs to build protein. In other words tofu a complete protein. It might not be as high quality protein as soy beans themselves but as part of a balanced Vegan diet it  will give us a good and inexpensive portion of our required daily protein (RDA +/- 50 grams).

Tofu, or bean curd as it is known in the East, originated in China over 2000 years ago. It only became popular in Japan around the 1600's and in the West as late as the 1960's. It is made from dried soybeans and comes two main styles, silken and firm. It is nutritious as it is an excellent source of tryptophan, a very good source of manganese, iron and protein, and a good source of calcium, omega_3, selenium, copper, phosphorus, and magnesium. A cup of tofu will give you approximately 20 grams of protein.

Healthwise tofu is low in saturated fat and studies indicate that regular intake of tofu and other soy products lowers LDL (bad cholesterol) levels. Tofu also contains isoflavones which act like a mild form of HRT and so help to relieve menopausal symptoms and assist with maintaining healthy bones. The iron in tofu with the assistance of the copper it contains aids oxygenation of the blood which in turn lifts energy levels. Tofu's selenium content helps reduce levels of  free radicals and also DNA repair.

Warning: Anyone allergic to soy beans will also be allergic tofu. Tofu also contains oxalates so those with existing and untreated kidney or gallbladder problems may want to avoid eating tofu regularly.

Storage of tofu depends on it's packaging. Long-life boxed silken tofu can be kept without refrigeration until expiry date or opening. Once opened should be refrigerated and used within a couple of days.  Refrigerated tofu can be kept in the fridge for a few weeks but once opened should be in a container filled with water and used within a few days. Change the water daily. Tofu can be frozen as well. Drain the water, wrap in freezer wrap or foil, and freeze for up to 3 months. The texture changes once frozen, it becomes spongy and chewy.

Tofu has very little flavour, so is easy to add to almost any dish whether sweet or savoury. One last point, make sure your tofu is made from organic soy beans and not GMO soy beans.  Enjoy!

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Tofu and Wild Mushrooms

From Weekday Vegetarian by Kelly Rossiter at Treehugger

Taken from the book Ancient Wisdom, Modern Kitchen by Yuan Wang, Warren Sheir and Mika Ono

8 dried shiitake mushrooms

2 tbsp sesame oil

1" / 2cm piece of fresh ginger, peeled and minced

2 cloves of garlic, peeled and minced

2 green onions, cut into 1/4" / 1/2cm pieces, roots and tough tips discarded

1 package firm tofu, cut into 1 inch cubes

2 tbsp cold water

1 tbsp powdered kudzu, arrowroot, cornstarch of other thickener

1 tbsp soy sauce, or to taste

1 tsp lemon juice, or to taste

Soak the shiitake mushrooms in 1 1/2 - 2 cups of water for 20 minutes, or until soft. Drain, reserving the liquid for later use. Cut off and discard the stem, if desired, and slice the remainder in 1/4 inch pieces. Heat the oil in a wok or skillet over medium-high heat. Add the ginger and garlic and cook for 30 to 60 seconds, until fragrant. Add the shiitakes, green onions, and tofu. Add 1 cup of the mushroom liquid, cover and cook over medium-high heat for 5 to 7 minutes, turning the tofu once, until the tofu is cooked through. In a small bowl, stir together the water and the kudzu until no lumps remain. Add the kudzu mixture and soy sauce to the tofu mixture and stir. Cook for another minute. Lemon juice to taste.

Scrambled Tofu

From FatFree.com   By Kate L Pugh

I think it's the dill and nutritional yeast that make this taste like eggs. I'm in the UK as well - I use Engevita nutritional yeast distributed by Marigold, from my local health food shop. I use Sainsbury's own-brand plain tofu - it's best if the tofu hasn't been frozen. ~ Kate

2 tbsp finely-chopped onion

vegetable stock to saute

1/2 pack / 150gms / 5oz plain tofu (not silken), grated

2 tbsp nutritional yeast flakes

1/8 tsp garlic granules

1/4 tsp dried dill

salt and freshly-ground black pepper to taste

Using a non-stick pan, gently saute the onion in a little vegetable stock until softened but not browned. Add the tofu and stirfry for about another 10 minutes. Meanwhile, mix the nutritional yeast, garlic granules and dill with    a few tbsp water to form a thinnish sauce. Season with plenty of salt and pepper. Add the sauce to the pan and stir and cook until the liquid is gone and the scrambled tofu is fairly dry. Serve on toast. Serves 1-2

Mini Coconut Cream Pies

From the Vegetarian Times    These little coconut pies are sturdy enough to travel in a lunch box or picnic basket.

1/3 cup sweet flake coconut

6 oz / 180gms soft silken tofu, drained

1/3 cup raw sugar

5 tbsps cornstarch

1 14oz / 390ml can light coconut milk

1 tsp vanilla extract

1/8 tsp coconut extract

6 mini Vegan graham cracker pie crusts

Preheat oven to 350°F / 175°C.  Spread coconut on baking sheet, and toast 5 minutes, shaking pan occasionally, or until golden. Blend tofu in blender or food processor 2 to 3 minutes, or until smooth. Set aside. Whisk together sugar and cornstarch in saucepan. Whisk in coconut milk, and cook over medium-high heat 8 minutes, or until thickened, whisking constantly. Remove pan from heat. Fold in tofu, vanilla and coconut extracts, and coconut. Divide among mini pie crusts, and chill.  Makes 6 pies.

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Related articles by Zemanta

Tofu, more tofu, test recipes at Seitan Is My Motor blog.

Potted Tofu at Notes from the Vegan Feast Kitchen blog.

Tofu Feta from My Veggie Kitchen blog.

Homemade Tofu Recipe at Vegan Food at Suite 101

Tofu 101: Kicking Off the T&T Challenge (trueslant.com)

Radio Interview with Dr. Cordain

Dear Readers,

Dr. Cordain was a guest on the The Soul's Edge radio program on KKNW Alternative Talk Radio, 1150 AM, in Seattle on March 30. You may listen to an MP3 recording of the interview from our web site. The segment with Dr. Cordain begins at time index 15:23 in the MP3 recording.

Paleo Diet Q & A - Lichen Sclerosis, Stevia

Lichen Sclerosis

Q: Hi there - I have been following a Paleo Diet for a few weeks now and there is no doubt that I feel much better for it. I did not need to lose weight and I always regarded myself as pretty fit and healthy. However, a little while back I developed a troublesome skin condition called Lichen Sclerosis. Have you ever been asked about this condition and suggested dietary changes? I think part of the problem is that the etiology is not fully understood but many doctors seem to think it has an autoimmune component though I have read recent research that suggests oxidative damage plays a part and that antioxidant therapy may be useful in treatment. This condition is supposedly incurable (though manageable with potent steroids) but I'm sure it would give a great many people some comfort if simple dietary changes could help. Would be really great to hear your thoughts.

Simon

A: Dear Simon,

The available evidence indicates that an autoimmune component likely occurs with Lichen Sclerosis (LS). With all autoimmune diseases, an autoantigen (self protein) exists and represents the target protein being attacked by the immune system. About 75 % of LS patients maintain an IgG autoantibody to Extra Cellular Matrix Protein 1 (ECM1)¹. Acceleration of ECM1 deposition in dermal (skin) blood vessels may underlie the disease symptoms ^{2, 3}. So the question now arises, what causes an accelerated deposition of ECMI in dermal blood vessels in LS patients? The available evidence indicates that increased concentrations of a ubiquitous enzyme in the body called tissue transglutaminase (TG2) is primarily responsible for excessive ECM1 accumulation³. In medical terms, an increase in a concentration of a substance in the bloodstream by another substance is called "upregulation".

So, in LS patients, an upregulation of TG2 causes an upregulation and increased deposition of ECMI in the skin blood vessels in the affected area of the body. The next question to be posed is, what event or events trigger an upregulation of TG2? When we answer this question, then dietary recommendations advocated by the Paleo Diet will make sense. A storage protein called gliadin which is fournd in wheat, rye, barley and oats is known to upregulate TG2 ^4-7. Hence grain free diets may prove to be therapeutic for LS patients, although no current randomized controlled trials of this intervention strategy have yet been conducted.

Cordially,
Loren Cordain, Ph.D., Professor

References:

1. Chan I, Oyama N, Neill SM, Wojnarowska F, Black MM, McGrath JA. Characterization of IgG autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Clin Exp Dermatol. 2004 Sep;29(5):499-504.
2. Kowalewski C, Kozłowska A, Chan I, Górska M, Woźniak K, Jabłońska S, McGrath JA.Three-dimensional imaging reveals major changes in skin microvasculature in lipoid proteinosis and lichen sclerosus. J Dermatol Sci. 2005 Jun;38(3):215-24. Epub 2005 Mar 3.
3. Fisher M, Jones RA, Huang L, Haylor JL, El Nahas M, Griffin M, Johnson TS. Modulation of tissue transglutaminase in tubular epithelial cells alters extracellular matrix levels: a potential mechanism of tissue scarring. Matrix Biol. 2009 Jan;28(1):20-31. Epub 2008 Nov 5.
4. Michaelsson, G., Ahs, S., Hammarstrom, I., Lundin, I. P., & Hagforsen, E. Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer ki67+ cells in the dermis. Acta Dermato-Venereologica, 2003; 83(6):425-429.
5. Biagi F, Campanella J, Laforenza U, Gastaldi G, Tritto S, Grazioli M, Villanacci V, Corazza GR. Transglutaminase 2 in the enterocytes is celiac specific and gluten dependent. Dig Liver Dis. 2006 Sep;38(9):652-8.
6. Gorgun J, Portyanko A, Marakhouski Y, Cherstvoy E. Tissue transglutaminase expression in celiac mucosa: an immunohistochemical study. Virchows Arch. 2009 Oct;455(4):363-73.
7. Villanacci V, Not T, Sblattero D, Gaiotto T, Chirdo F, Galletti A, Bassotti G. Mucosal tissue transglutaminase expression in celiac disease. J Cell Mol Med. 2009 Feb;13(2):334-40.

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Stevia

Q: Is Stevia Paleo? I have attempted to find an answer for this and the information I've found is conflicting at best. Please advise!!
Jeff

A: Dear Jeff,

There's some scientific evidence to support the notion that Stevia is safe, even in type 2 diabetes patients^{1, 2}. Furthermore, it has been demonstrated to have antihypertensive properties, as shown by Chan et al.³ and a long-term study⁴. Having said this, I am not aware of any study examining the potential antinutrient (lectins or saponins) content of the plant, hence we do not know the possible adverse effect of consuming this plant on a daily basis. Hunterh-gatherers used to consume a wide range of plants, thereby minimizing the amount of a single bioactive compound ingested and its toxicity. It is known that rotating the kind of plants is a good strategy in order to decrease food allergy and intolerance.

From an evolutionary standpoint we should look at nutrition as "whole food" rather than nutrients per se. The bottom line is that Stevia seems to be safe, but we need more research to rule out possible side effects.

I hope this is helpful,
Maelán

References

1. Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism. 2004 Jan;53(1):73-6.
2. Barriocanal LA, Palacios M, Benitez G, Benitez S, Jimenez JT, Jimenez N, Rojas V. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul Toxicol Pharmacol. 2008 Jun;51(1):37-41. Epub 2008 Mar 5.
3. Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20.
4. Hsieh MH, Chan P, Sue YM, Liu JC, Liang TH, Huang TY, Tomlinson B, Chow MS, Kao PF, Chen YJ. Clin Ther. 2003 Nov;25(11):2797-808. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study.