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Urology pearls – classic

My neighbor the caveman seems to be on a diet

Shahar Madjar, MD, Journal columnist

EDITOR’S NOTE: This column originally appeared in The Mining Journal on Feb. 25, 2000.

At one point in my life, when I lived on Mount Carmel, Israel, it would have taken me about 15 minutes to drive to his home. He would have to take a two hour walk to reach my place. I guess it would have made us neighbors if it weren’t for the 185,000 years that separated us. He was a much earlier version of the same species to which I belong, Homo sapiens, Latin for wise man. He lived in a cave during the Stone Age. I lived with my parents in an apartment at the top of Mount Carmel.

I was reminded of his remote existence several weeks ago when I began to write a series of articles about diets. My goal wasn’t to describe the many different diets, or to bring about more biased advice about one fad diet or another. Instead, I wanted to search for scientific evidence that would help me categorize the different diets, and find patterns that would inform me and my readers as to what constitutes a healthy diet. It was then that I read, in depth, about the Paleolithic diet (Paleo diet, caveman diet, or stone-age diet).

The Paleo diet attempts to mimic the diet of our ancestors. The premise of the Paleo diet goes something like this: For 2.4 million years, our ancestors relied on hunting and gathering. Agriculture is a recent development (12,000-23,000 years according to different estimates). Animal husbandry is even more recent (about 10,000 years). There hasn’t been enough time for our bodies to genetically adapt to these rapid changes. This attack of modern food on our genetically unprepared body resulted in a variety of diseases, many of them related to obesity.

Evolutionary biologist Marlene Zuhair claims that the premise behind the Paleo diet is false and that 10,000 years is plenty of time for our digestive system to adapt.

The Paleo diet is limited to meat, nuts, eggs, healthy oils and fresh fruit, roots, and vegetables. Cereal grains, sugar, legumes, milk and dairy products and other processed or refined food items are forbidden. Salt, alcohol and coffee should also be avoided.

Scientific research indicates that, in terms of weight loss, the Paleo diet works. It leads to consistent decrease in body fat and in body weight. It works both in the short and long term. For example, a study on 70 postmenopausal women-comparing the effect of Paleo diet to that of a diet that follows the Nordic nutrition recommendations-found that after two years of attempting the two diets, the Paleo group had a higher rate of adherence to their diet (77% compared to 63%); they also lost more fat mass (11.1 kilograms vs 5.5 kg). Other studies showed that the Paleo diet had beneficial effects on waist circumference, blood pressure, glucose and lipid profile.

The Paleo diet remains controversial despite and perhaps because of the exaggerated claims made for it by wellness bloggers, celebrity chefs, and the doubtful hypothesis on which it is based. Opponents of the Paleo diet claim that it’s hard for people to adhere to it because of low palatability and high costs. Also, the Paleo diet isn’t without risks. It could result in deficiencies in vitamin D, Calcium, and iodine.

I remember our elementary school field trip to the one of the caves on Mount Carmel. I didn’t meet any caveman at the cave, but I could imagine his life. My neighbor, the caveman, lived in small groups in damp, cold caves. Keeping the fire going was a challenge. He ventured outside of the cave and wandered for hours in search of food. Before agriculture was invented, before fruits and vegetables were cultivated, a tomato was the size of berries, a potato was as big as a modern peanut, lettuce was bitter and prickly and fruits were tart and small.

With his primitive tools (a sharp stone at the tip of a spear was a relatively modern invention), a successful hunting session must have been a cause for celebration. Food supply was scarce and inconsistent. The caveman was lean, his stature short, not just because of his diet, but because getting food was hard work that took tremendous amount of energy expenditure. His life and his diet weren’t the results of romantic idealization of what it meant to be a caveman, nor was it an attempt to stay fit or handsome. If he were to stay alive, he just had no other choice. And after all of this, he was lucky to live beyond his twenties.

I respect my neighbor, the caveman. And I am willing to do a lot to rid myself of a few pounds of fat. But should I, should you, men and women of modern time, adopt the Stone Age diet even if we have other options?

Editor’s note: Dr. Shahar Madjar is a urologist at Aspirus and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.

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