Meal Frequency

Eat every 3 hours, fast regularly, eat for what you are going to do, eat for what you have done, eat for the season, change your diet for type of activity, eat in specific combinations, eat cooked, eat raw; well that is a partial list of your touted options.

How to decide?

Here are some techniques or approaches that various experts, committees and health book authors have used to generate their advice;

  • Cultural tradition; e.g. all primitive cultures eat a flat bread of one kind or another and either rice, corn or wheat as dietary staples so we should too
  • Epidemiology; which cultures eat what and live long, disease free lives; e.g. “The China Study” or other related recommendations or, Asian cultures eat soy so we should too: many versions of this type.
  • “Science”‘; perfect example is the McGovern commission’s ‘science’ derived recommendation that we all eat a low fat diet. Please, here at least, spare me from having to rehearse how poorly ‘science’ was either served or employed in these recommendations but simply be warned that there are problems with this model
  • Genetics; e.g. those with the Apo E 4 variant are more likely to have blood cholesterol levels influenced by dietary cholesterol whereas other Apo E variants show little or no such relationship so be guided by genetic information shown through testing or family history

Now the most recent trend or fad has been to develop dietary guidelines based on speculative anthropology; current examples are the various evolutionary diet types like Paleo diets, Caveman diets and so on. One notorious problem with this approach is that, as a species, we don’t really know how our dietary history has evolved and is thus reflected in our true healthy dietary needs. One famous example of the limits of speculating about our dietary history is the fat issue. In the past those who used the speculative anthropology method thought primitive man ate a very low fat diet; after all, after the kill primitive man was faced with the opportunity to eat all of that nice low fat muscle/meat in wild living, wild feeding animals- a known to be low fat meat. Problem was that when we finally got the opportunity to observe nearly pristine primitive cultures the first thing they were found to eat of  killed animals was as much of the fat and organs as could be gleaned, only later getting to the part we thought they ate first. So ‘speculative anthropology’ went from recommending low fat to high fat diets with little pause between.

One of the longest speculative anthropological arguments has been how omnivorous man is. Evidence from teeth, type and number, to the role of the appendix have all been martialed to make the argument that man was really either an omnivore, herbivore or carnivore. I assume everyone engaged in that debate were honest seekers after truth; though that seems hard to believe when coming from those on the herbivore side of the discussion. Well you can guess which side I came down on. In any case the amount of inference possible from the occlusion pattern of molars has been vastly over sold; follow the deep literature and you will see this phenomenon of speculation taken to the point of near fantasy.

The point of these stories, all of which could be enormously multiplied, is to show you how vexed each approach has been as a unitary source of dietary guidelines. They each, science, tradition, genetics, speculative anthropology, make contributions to the loosely bound science of nutrition.

I don’t like any of them very much so let me tell you my version and why I think it not only makes the most sense but provides a testable hypothesis for each of us.

A few anecdotes to set some boundaries: if you have read many of my posts you will have run into my maxim ‘starvation cures disease’ and why I hold this to be true and the limits of its use. Well, when my patients use a modified form of starvation, diplomatically called ‘fasts’, I find that some notice real and meaningful benefits but that most, after a few weeks or months of benefit, begin engaging in compensatory eating behavior and wind up right where they started or, often, worse. This is human behavior whether you want to attribute it to the metabolic set point reasserting itself or just to the very human need to seek comfort in food denied during fasting; either way my experience of fasting is that it is much better as an idea than as a fact. If you do not take this ‘anthropological’ fact into account then whatever theory you come up with will be speculative fiction and not reality based advice.

OK, I like fasting but have found very poor results employing them. Not ‘no results’ just very limited ones.

How about ‘genetics?’ Well, the flaw here can be seen in the early history of the genetics of disease. I remember early in the course of the human genome project that each new site described that could possibly be found to have some statistical link to any disease was, on an almost daily basis, trumpeted in the press as the new ‘genetic cause’ of the disease in question. After awhile, if you looked online at the emerging map, you could find dozens of these associations; associations to the point that even if there were some link there was an unknowable, actually uncalculatable, number of potential interactions such that knowing any particular association added nothing to what you either knew or could do anything about. If that last sentence was confusing the problem stems not just from my limited skills as a writer, it was a tough concept. Simply put ‘genetic’ information was so interactively complex that complexity itself limited the use of genetic information. And that is for known diseases which draw on fewer genetic points or sites than our evolutionary, dietary, genetic diet needs and types. So genetics becomes not useless but hobbled. Are you genetically prone to high C-RP, the Apo E 4 variant, and so on? If so, this is useful but even then of limited value and in any case such variables in themselves do little to describe ones diet.

So genetics is helpful but only just.

Well, surely cultural histories tell us much about human dietary needs; after all such diets are living witnesses to being able to sustain survival. Here is the rub: every primitive diet type, based on flat breads, grains and the like as subsistence calories has proven to be all but poison as soon as near starvation was taken out of the culture. Rice: the Chinese are becoming diabetic at an alarming rate not because they are switching to a Western diet but because they can now get enough rice to satisfy their craving. Sub-continental Indians are becoming diabetic at an alarming rate, again, not because of the Western diet but because they can get all of the Gulab Jamon, roti, rice and nan that they want. Once calorie restriction, see ‘starvation cures disease’ above, is gone, degenerative diseases set in. By the way, I’ve got lots of ammunition on this one.

Nope, score almost zero for ‘traditional’ diets; unless you want to practice caloric restriction and I don’t.

Oops! I see by the word counter that I am already going long. Well, as you will have guessed I’ve got much to say about almost all published approaches so let me give you the short course:

  • whatever our genetic, cultural, anthropological history it is mixed up; we are all ‘mutts’ of one kind or another
  • set up stable benchmarks to assess the diet type you choose to adopt; like your 100 meter time, mile time, 3 rep max on bench, dead and squat, know your heart rate response to exercise, including resting, peak, and recovery, know your fasting glucose and insulin, A1c, triglycerides, C-RP, circumference at the waist, at the umbilicus and the boney hips, the quality of your sleep, nighttime awakening pattern and then try your diet. If the entire list isn’t getting better and you are not able to recover, train and be injury free you are eating something wrong; doing something wrong. If you are making gains, sleeping well, having great bowel movements, holding strength, clear eyed and bushy tailed you are on to something. Simply faster, stronger, bigger or lighter are very inadequate benchmarks, which is why I recommend a broad array of markers; only such a list plumbs the metabolic depths that proper diet can probe.
  • I’ve done this kind of data driven dietary design and it works. You will find the diet outline that most commonly works for most people in several of my other posts. That said, I’ve also found that the general guidelines do not work for everyone.
  • I realize that my more controlling readers will be aggravated that I have not rehearsed the whole story here; please forgive me, know that I am working on the book, and let this be a jumping off point for your own experiments. Believe me, your guess, guided by such a methodology, could not be worse than most of the recommendations of the American Diabetic Association or the American Heart Association.

As always: “Eat, Whole, Real, Micronutrient Dense Food”

Smile, Have Fun and God Speed,

Dr. Mike

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