Ancestral Health Symposium 2021: WHY DID WE ALL GET SICK? Tucker Goodrich

Presentation given at the Ancestral Health Symposium 2021

1. WHY DID WE ALL GET SICK? The Nutritional Transition & How Seed Oils Drove It. Prairie, Idaho 1 Tucker D. Goodrich

2. A Brief History of Nutritional Transitions Oolite Interpretive Site, Grandview, Idaho Leaves, fruit, insects ∼65 Mya Tubers, scavenged meat, and hunted small game 6.5 Mya More meat & nutrient extraction: Stone tools 2.6 Mya More meat & endurance running 1.8 Mya More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER ! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya 2

3. A Brief History of Nutritional Transitions Oolite Interpretive Site, Grandview, Idaho Leaves, fruit, insects ∼65 Mya Tubers, scavenged meat, and hunted small game 6.5 Mya More meat & nutrient extraction: Stone tools 2.6 Mya More meat & endurance running 1.8 Mya More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER ! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya 3

4. A Brief History of Nutritional Transitions Oolite Interpretive Site, Grandview, Idaho Leaves, fruit, insects ∼65 Mya Tubers, scavenged meat, and hunted small game 6.5 Mya More meat & nutrient extraction: Stone tools 2.6 Mya More meat & endurance running 1.8 Mya More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya 4

5. Sweet Connie Trail, Boise, Idaho Leaves, fruit, insects ∼65 Mya Tubers, scavenged meat, and hunted small game 6.5 Mya More meat & nutrient extraction: Stone tools 2.6 Mya More meat & endurance running 1.8 Mya More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya 5 A Brief History of Chronic Disease

6. Sweet Connie Trail, Boise, Idaho More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya A Brief History of Chronic Disease Near-vegetarian diets: India, Egypt 5 Kya Less meat: Seed crops and oils 5 Kya Industrial processing of starches: roller mills 300 ya Industrial production of seed oils: Detoxification of cottonseed 150 ya 6

7. Sweet Connie Trail, Boise, Idaho More efficient nutrient extraction:Fire for cooking 1 Mya Less meat: Out of Africa 600 Kya Less meat: Weapon throwing tools 50 Kya Less meat: Seafood (shell middens) 140 Kya BEER! Collection of wild grains 11 Kya Less meat: Plant agriculture 10 Kya More meat: Pastoral agriculture 9 Kya Less meat: Fat/oil for lighting 17 Kya A Brief History of Chronic Disease Near-vegetarian diets: India, Egypt 5 Kya Less meat: Seed crops and oils 5 Kya Industrial processing of starches: roller mills 300 ya Industrial production of seed oils: Detoxification of cottonseed 150 ya Malocclusion 300 ya Diabetes (common) 120 ya Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Dental Caries 14 Kya Heart disease (common) 120 ya Cancer 120 ya Stunting 5 Kya 7

8. Sweet Connie Trail, Boise, Idaho A Brief History of Chronic Disease Malocclusion 300 ya Diabetes (common) 120 ya Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Dental Caries 14 Kya Heart disease (common) 120 ya Cancer 120 ya Stunting 5 Kya 8 And too many more… 120 ya

9. Sweet Connie Trail, Boise, Idaho Malocclusion 300 ya Diabetes (common) 120 ya Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Dental Caries 14 Kya Heart disease (common) 120 ya Cancer 120 ya Stunting 5 Kya Chronic diseases with known causation 9 A Brief History of Chronic Disease And too many more… 120 ya

10. Sweet Connie Trail, Boise, Idaho Malocclusion 300 ya Dental Caries 14 Kya Stunting 5 Kya Clear, well-recognized causation Increased carbohydrate, decreased meat RCTs confirming causation In humans were possible—animal model for malocclusion Stunting and caries partially reversible Only common diseases shown to be caused by carbohydrate/malnutrition Chronic diseases with known causation 10 A Brief History of Chronic Disease

11. Sweet Connie Trail, Boise, Idaho Malocclusion 300 ya Dental Caries 14 Kya Stunting 5 Kya Clear, well-recognized causation Increased carbohydrate, decreased meat RCTs confirming causation In humans were possible—animal model for malocclusion Stunting and caries partially reversible Only common diseases shown to be caused by carbohydrate/malnutrition Chronic diseases with known causation 11 A Brief History of Chronic Disease “Thus, as modern food preparation techniques spread throughout the world during the 19th century, so did dental crowding [malocclusion].” (Rose & Roblee , 2009)

12. Sweet Connie Trail, Boise, Idaho Diabetes (common) 120 ya Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Heart disease (common) 120 ya Chronic diseases with disputed causation 12 A Brief History of Chronic Disease

13. Sweet Connie Trail, Boise, Idaho Diabetes (common) 120 ya Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Heart disease (common) 120 ya Chronic diseases with disputed causation 13 Less meat: Seed crops and oils 5 Kya Industrial production of seed oils: Detoxification of cottonseed 150 ya A Brief History of Chronic Disease

14. Sweet Connie Trail, Boise, Idaho Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Chronic diseases with disputed causation 14 Less meat: Seed crops and oils 5 Kya A Brief History of Chronic Disease Evidence largely circumstantial Archeological evidence thin T2DM depends on written accounts, CVD has been identified in mummies Impossible to know prevalence Mostly extrapolation back from modern hunter-gatherer or agricultural societies So we’ll focus on modern evidence

15. Sweet Connie Trail, Boise, Idaho Diabetes (rare) 2.5 Kya Heart disease (rare) 2.5 Kya Chronic diseases with disputed causation 15 Less meat: Seed crops and oils 5 Kya A Brief History of Chronic Disease Evidence largely circumstantial Archeological evidence thin T2DM depends on written accounts, CVD has been identified in mummies Impossible to know prevalence Mostly extrapolation back from modern hunter-gatherer or agricultural societies So we’ll focus on modern evidence

16. Sweet Connie Trail, Boise, Idaho Chronic diseases with disputed causation 16 A Brief History of Chronic Disease Diabetes (common) 120 ya Heart disease (common) 120 ya Industrial production of seed oils: Detoxification of cottonseed 150 ya

17. Sweet Connie Trail, Boise, Idaho Chronic diseases with disputed causation 17 A Brief History of Chronic Disease Diabetes Heart disease Seed Oils Highly correlated with each other This suggests a common mechanism At current prevalence, all are new diseases Within living memory there were industrial populations with low rates of CVD and T2DM Every population that has transitioned to a “Modern, American-style Diet” has high rates of chronic diseases.

18. Sweet Connie Trail, Boise, Idaho Chronic diseases with disputed causation 18 A Brief History of Chronic Disease Diabetes Heart disease Seed Oils Highly correlated with each other This suggests a common mechanism At current prevalence, all are new diseases Within living memory there were populations with low rates of CVD and T2DM Every population that has transitioned to a “Modern, American-style Diet” has high rates of chronic diseases. “Between 1900 and 1920… the death rate from diabetes, despite improved treatment of the disease, had increased by as much as 400 percent... It had increased fifteen-fold since the end of the Civil War.” (Taubes 2008)

19. Hell’s Canyon, Oxbow, Oregon 19 Oils that are produced from seeds, not fruit Seeds such as: cotton, sunflower, sesame, soybean, peanut, etc. + Fruits such as olive, avocado, palm, or coconut* *Coconut is a fruit and/or nut Seeds generally have high polyunsaturated fat content, especially omega-6 (n-6). + Macadamia is an exception Fruits have more monounsaturated or saturated fats, less n-6 What are Seed Oils and What Do They Do?

20. Hell’s Canyon, Oxbow, Oregon 20 What are Seed Oils and What Do They Do? Sesame seed first cultivated ~5 Kya, in India, oil extracted by crushing (Fuller 2003) Sesame seed oil spread into Egypt, the Mediterranean, and Africa Safflower was cultivated in Egypt, use was common in Ptolemaic period, but references begin 3.5 Kya Used as food and for lamps Animal fat illegal in Ptolemaic Egypt (!) (Sandy 1989)

21. Hell’s Canyon, Oxbow, Oregon 21 What are Seed Oils and What Do They Do? Modern mass-production of seed oils started in 19 th century, 200 ya “By the early 19th century, Russian farmers were growing over 2 million acres of sunflower” (The National Sunflower Association) American production was mostly cottonseed oil, first a toxic waste product “Generally the manufacturers in the United States make no pretence [sic] of exporting pure lard…. “The chief adulterant found is cotton seed oil” (Dominion of Canada, 1890) Hydrogenated cottonseed oil (Crisco) introduced in 1911, taking vegetable fats mainstream

22. Hell’s Canyon, Oxbow, Oregon 22 Cottonseed ruled until soybean oil introduced Biggest change in diet in modern era is increase in seed oils ( Blasbalg et al. 2011) What are Seed Oils and What Do They Do?

23. Hell’s Canyon, Oxbow, Oregon 23 What are Seed Oils and What Do They Do? “By the 1990s,soybean oil accounted for about 70% of… edible oils and fats in the [US]… soybeans now account for the bulk of vegetable oil consumption worldwide “This dramatic difference was largely accounted for by a major increase in the consumption of vegetable fats by poor and rich nations alike “Although meat consumption declined in high-income countries (by 6-9%), there was little overall reduction in fat intakes, as animal fats were replaced by a greater proportion of vegetable oils and products” ( Drewnowski & Popkin, 1997) “The Nutrition Transition: New Trends in the Global Diet”

24. Hell’s Canyon, Oxbow, Oregon 24 What are Seed Oils and What Do They Do? By the 1990s,soybean oil accounted for about 70% of the production and consumption of edible oils and fats in the [US] and soybeans now account for the bulk of vegetable oil consumption worldwide “This dramatic difference was largely accounted for by a major increase in the consumption of vegetable fats by poor and rich nations alike.” Although meat consumption declined in high-income countries (by 6-9%), there was little overall reduction in fat intakes, as animal fats were replaced by a greater proportion of vegetable oils and products. ( Drewnowski & Popkin, 1997) “Fifty years later, I still cannot cite a definite mechanism or mediator by which saturated fat is shown to kill people.” (Lands 2008)

25. Hell’s Canyon, Oxbow, Oregon 25 What are Seed Oils and What Do They Do? Linoleic acid (LA) is the primary n-6 fat in seed oils Unlike saturated fats, LA is very susceptible to oxidative damage This is due to missing hydrogen atoms. Hydrogenation (adding hydrogen) makes fats more stable, changes LA to stearic acid. Stearic acid ( C 18 H 36 O 2 ) Linoleic acid (C 18 H 32 O 2 ) + H 4

26. Hell’s Canyon, Oxbow, Oregon 26 What are Seed Oils and What Do They Do? Linoleic acid (LA) is part of the problem Since it’s unstable, it can oxidize into other compounds, like 4-hydroxynonenal ( HNE ), an aldehyde Like HNE , many of these compounds are highly toxic HNE is a mutagen, and toxic to cells. In evolutionarily-appropriate amounts, it’s a signalling molecule Linoleic acid (C 18 H 32 O 2 ) HNE (C 9 H 16 O 2 )

27. Hell’s Canyon, Oxbow, Oregon 27 What are Seed Oils and What Do They Do? HNE is involved in every aspect of Chronic Disease Marker/mediator of Oxidative Stress ( Žarković et al., 1999; Tsimikas , 2006)) Induces Atherosclerosis (Steinberg & Witztum, 1991; Willeit et al 2021) Insulin resistance (Ingram et al., 2017; Pilon et al., 2012) DNA damage (Hu et al., 2002; Chung et al., 2003) Inflammation (Trevisani et al., 2017; Poli & Shauer , 2007) Mitochondrial Dysfunction (Gomes, 2014) Fibrosis (Gomes, 2014; Chiarpotto , 2005) Pain (Trevisani et al., 2017; Chen et al., 2018) Etc ( Shoeb et al., 2014; Sottero et al., 2019; Poli & Schaur , 2000) HNE is derived exclusively from n-6 fats (Ayala et al., 2014) HNE

28. Lava Mountain, Boise National Forest, Idaho 28 “So few subjects in the present survey were found to have any of the conventional signs of coronary disease that it would be futile to analyze the data with any hope of defining the existence of risk factors for this disease within this population. ” ( Sinnett & Whyte, 1973)

29. Lava Mountain, Boise National Forest, Idaho 29 CVD and Seed Oils Cardiovascular Disease (CVD) is a modern disease While it existed in Ancient Egypt… (Finch, 2011) “ Heart disease was an uncommon cause of death… at the beginning of the 20th century. By midcentury it had become the commonest cause” (Dalen, et al., 2014) And when heart attack was unknown, some ate lots of animal fat (Michaels, 1966) CVD is still unknown in populations eating ancestrally—no industrially-produced food (Kaplan et al., 2017) Heart disease

30. Lava Mountain, Boise National Forest, Idaho 30 In the 1960s, researchers looked at CVD in different countries. (Lee at al., 1964) They used heart attack determined by autopsy, an extremely reliable method Was CVD genetic, or environmental? They used thousands of autopsies, even bringing some hearts back to the US to confirm diagnosis What they found confirms the earlier studies… CVD and Seed Oils Heart disease

31. Lava Mountain, Boise National Forest, Idaho 31 In the 1960s, researchers looked at CVD in different countries. They used heart attack determined by autopsy, an extremely reliable method Was CVD genetic, or environmental? They used thousands of autopsies, even bringing some hearts back to the US to confirm diagnosis What they found confirms the earlier studies… CVD and Seed Oils Heart disease

32. Lava Mountain, Boise National Forest, Idaho 32 So what could the environmental factor be? In the 1970s, Brown and Goldstein attempted to induce the first step of atherosclerosis (Goldstein et al., 1979) It failed LDL would not convert macrophages to foam cells They discovered the LDL must be modified CVD and Seed Oils Heart disease

33. Lava Mountain, Boise National Forest, Idaho 33 Steinberg and Witztum demonstrated the nature of the modification (Steinberg & Witztum, 1991) Fats in the LDL must be oxidized, when they are sufficently oxidized, foam cells (poisoned macrophages) will form OxLDL is cytotoxic: toxic to cells. The toxins in oxLDL are oxidized n-6 fats, such as HNE CVD and Seed Oils Heart disease

34. Lava Mountain, Boise National Forest, Idaho 34 Human studies show that dietary seed oils lead to LDL oxidation (Steinberg & Witztum, 1991; Reaven et al., 1993) Several human RCTs demonstrate higher CVD events with seed oil feeding (Ramsden et al., 2016) One RCT reduced n-6 intake to an evolutionarily-appropriate level, saw a 70% decline in CVD events (de Lorgeril et al., 1994) “…if you… remove [oxLDL] from "LDL-C" to derive a corrected LDL-C, corrected LDL-C is NO LONGER predictive of events.” ( Willeit et al., 2020) CVD and Seed Oils Heart disease

35. Lava Mountain, Boise National Forest, Idaho 35 CVD is not a normal human disease, it’s recent, depends on environment Only populations eating excess seed oils get CVD at modern levels Important confounders include: omega-3 fats and smoking CVD and Seed Oils Heart disease

36. Lava Mountain, Boise National Forest, Idaho 36 CVD is not a normal human disease, it’s recent, depends on environment Only populations eating excess seed oils get CVD at modern levels Important confounders include: omega-3 fats and smoking CVD and Seed Oils Heart disease

37. Shafer Butte, Boise National Forest, Idaho 37 Type 2 Diabetes and Seed Oils Diabetes We have to get something out of the way

38. Shafer Butte, Boise National Forest, Idaho 38 “The diet consisted almost entirely of sweet potato, carbohydrate providing over 90% of the calories.” “No clinical evidence of diabetes mellitus was found in this survey.” (Sennett & Whyte, 1973a, 1973b) Type 2 Diabetes and Seed Oils Diabetes We have to get something out of the way

39. Shafer Butte, Boise National Forest, Idaho 39 And since you’re wondering… (Lai et al., 2013) They do eat less sucrose, but compare to Chinese children ( Afeiche et al., 2018) Type 2 Diabetes and Seed Oils Diabetes

40. Shafer Butte, Boise National Forest, Idaho 40 Lots of populations ate/eat traditional diets w/out T2DM Type 2 Diabetes and Seed Oils Diabetes Traditional Japanese Kitavans Okinawans Inuit Aborigines Pima Indians Hadza Tsimane !Kung san (Bushmen)

41. Shafer Butte, Boise National Forest, Idaho 41 Lots of populations ate/eat traditional diets w/out T2DM “…their mean two-hour post-glucose level of 121 mg/ 100 ml could be regarded as falling within the "diabetic" range.” “…the relative carbohydrate intolerance of our primitive Bushmen subjects is at first glance rather surprising.” (Joffe et al., 1971) “…the prolonged increase after two hours in both San series certainly suggested a diabetes-like condition in the San…” (Jenkins et al., 1974) Type 2 Diabetes and Seed Oils Diabetes !Kung san (Bushmen)

42. Shafer Butte, Boise National Forest, Idaho 42 !Kung eat lots of mongongo fruit and nuts As much as 1/3 of their calories. ( Bindon , 2009) Mongongo nut season is when the diabetic OGTT was taken (Joffe et al., 1971; Guyenet, 2010; Bindon , 2009) One other non-diabetic OGTT was taken of HG !Kung, not stated when. ( Wilmsen , 1982) !Kung eating non-HG diet did not test diabetic. (Jenkins et al., 2010) Mongongo nuts are high in n-6 ( Gwatidzo et al., 2017) Type 2 Diabetes and Seed Oils Diabetes

43. Shafer Butte, Boise National Forest, Idaho 43 1961: soybean oil introduced as an IV food supplement— Intralipid ( Gura , 2020) 1964: Noted that Intralipid induces insulin resistance and hyperglycemia ( Felber & Vannotti , 1964) 2014: “Infusion of Intralipid , comprised predominantly of polyunsaturated fatty acids [ linoleic (44–62%)…]… is an established model for producing lipid-induced insulin resistance.” In humans (Chow et al. 2014; Jensen et al., 2003) Type 2 Diabetes and Seed Oils Diabetes

44. Shafer Butte, Boise National Forest, Idaho 44 “The lack of… gluconeogenesis in the Clinoleic vs. the Intralipid group suggests that different classes of fatty acids exert different effects on glucose kinetics in preterm infants.” Proposed mechanism is IR (van Kempen et al., 2006 Clinoleic is an olive-oil infusion, low in n-6 Of course eating something is vastly different from injecting something Type 2 Diabetes and Seed Oils Diabetes

45. Shafer Butte, Boise National Forest, Idaho 45 In humans, IR precedes T2DM by years (Martin et al., 1992) OxLDL is associated with IR, and precedes it by years ( Carantoni , et al., 1998; Park et al., 2009) As discussed, seed oils lead to LDL oxidation Other sources of oxLDL (smoking, sepsis) also induce IR ( Lymperaki et al., 2015; Carlson, 2003; Attval et al., 1993; Behnes et al., 2008) “Unexpectedly,… targeting oxidized LDL [via antibodies] improves insulin sensitivity…” in monkeys (Li et al., 2013) Type 2 Diabetes and Seed Oils Diabetes

46. Shafer Butte, Boise National Forest, Idaho 46 Switching from high to low n-6 oils lowers insulin resistance (Nigam et al., 2014) Dose-dependent relationship to n-6 content of seed oils Liver fat also improved—NAFLD patients “… 15–21% protein… 55–70% carbohydrates, and 20% fats.” Type 2 Diabetes and Seed Oils Diabetes

47. Shafer Butte, Boise National Forest, Idaho 47 Switching from high to low n-6 oils lowers insulin resistance (Nigam et al., 2014, including chart data) Dose-dependent relationship to n-6 content of seed oils Liver fat also improved—NAFLD patients “… 15–21% protein… 55–70% carbohydrates, and 20% fats.” Type 2 Diabetes and Seed Oils Diabetes

48. Shafer Butte, Boise National Forest, Idaho 48 Lowering n-6:n-3 ratio lowers insulin resistance (Van Name et al., 2020) “The intervention diet consisted of a low n–6 to n–3 PUFA ratio of 4:1…” “…macronutrient content was 50%–55%... carb., 20% from protein, and 25%–30% from fat…” Diet monitored by blood biomarkers, including oxLAMs No control, performed at Yale Type 2 Diabetes and Seed Oils Diabetes

49. Shafer Butte, Boise National Forest, Idaho 49 Lowering n-6:n-3 ratio lowers insulin resistance (Van Name et al., 2020, including chart) “The intervention diet consisted of a low n–6 to n–3 PUFA ratio of 4:1…” “…macronutrient content was 50%–55%... carb., 20% from protein, and 25%–30% from fat…” Diet monitored by blood biomarkers, including oxLAMs No control, performed at Yale Type 2 Diabetes and Seed Oils Diabetes

50. Shafer Butte, Boise National Forest, Idaho 50 People on a low n-6, ancestral diet don’t get T2DM. Carbs don’t matter N-6 fats induce insulin resistance in humans IR and hyperglycemia are mediated in part by immune system, through LDL Reducing n-6 intake ameliorates IR and related symptoms Nevertheless, T2DM is a condition of carbohydrate intolerance, so diet for T2DM is best to be low-carb! Type 2 Diabetes and Seed Oils Diabetes

51. Toxaway Lake, Sawtooth Wilderness, Idaho 51 TK “In 1616, Ieyasu Tokugawa, the founder of the Edo government died. It is said he had been overeating fish fried in sesame oil.” From “Tempura... Another Usage of Lamp Oil” (Walker, 2003 quoting Ishige , 1980)

52. Toxaway Lake, Sawtooth Wilderness, Idaho 52 Conclusion Humans can be healthy eating a wide variety of diets Chronic disease is clearly linked to diet Most date from introduction of seed oils Epidemiology and mechanistic studies confirm Reduction/elimination of seed oils and animals concentrating seed crops should be first step in fixing diet

53. Thank you City of Rocks National Reserve, Idaho 53 References available at my blog, Yelling Stop https://yelling-stop.blogspot.com/p/ahs21_14.html