women

06/12/2013 - 20:41

 I'm thrilled that Grub Street shut down its entire Chicago department so that instead of writing about Chicago’s vibrant food scene, they can publish garbage like this: The Rise of the Lady Paleos: How a Dubious Diet Aimed at Men Appeals to Women, Too.

What really struck me is how they linked to the New York Times article from 2010: 

The Paleo diet has always been difficult to take very seriously. The program aims to mimic what our hunter-gatherer ancestors ate during the Paleolithic era and is most often associated with city-dwelling males who go around pretending they're cavemen. But the new shepherds of the Paleo diet aren't hypermasculine men who install meat lockers in their apartments and gnaw on turkey legs; they're friendly, perky women who wear polka dots and create Paleo-approved recipes for banana porridge. Including women has made the Paleo diet more popular than ever — even as the science it's supposedly based on looks more and more dubious.

Since that article first was published in 2010, it has been linked that way many many times in the context of suggesting paleo is a diet for faux-manly men, not women. Back in 2010, women were simply not allowed to eat such a meaty diet. We had to survive on cupcakes.

Oh, but right there on the top of the article is a picture, and in that picture guess who is there? Me. And I'm 100% sure I'm a woman. Maybe I'm just not "perky" looking enough?

Interestingly there were a large number of photos of me taken for the article. One of the nicer photographers, a woman, sent me hers. I can’t post them here for legal reasons (they still belong to the Times), but I look much like myself in them. The New York Times chose a picture where the lighting and angle seems designed unflatter everyone in the picture (a great illustration of how powerful this can be in this great video), and for me it makes me look somewhat less "perky" than I usually do to say the least. I felt like the editors who chose that particular picture had an agenda, which was to portray the paleo diet as conforming to outdated stereotypes about “cavemen.” 

The NYtimes photo they chose, where half my face is in shadows vs. a much more flattering professional photo by Pro Creation of Bacon.

 Despite my criticism of the paleo diet, to reduce these women– best-selling authors who run their own successful businesses, to being defined by stereotypically girlish personalities, food and clothing, is disgusting. “Meat lockers” (what some of these reporters call chest freezers) are for men...and porridge is for women? I have little interest in porridge, but I’ve had a so-called “meat locker” for several years now and I love it.

Notice they did not choose to interview women who do not fit stereotypes as easily, women who have had paleo books on the market for quite a long time. One of the co-authors of one of the FIRST paleo diet books was Marjorie Shostak, a prominent feminist anthropologist. It was published in 1989 when I was just toddling around. I sometimes wonder what influence she might have had if she were still around. Sadly she passed away in 1996. The Vegetarian Myth and Primal Body, Primal Mind (I’m not particularly fans of the accuracy of those books these days, but they had an influence on MANY people) were published in 2009. I guess since these women don’t fit girly GOOP-like diet empire guru stereotypes, it’s OK to overlook them.

Marjorie Shostak, who lived with !Kung hunter-gatherers

The 1989 book

The really stupid thing is that they chose authors that are actually moderate and flexible in their approach (esp compared to other authors) and then criticized the paleo diet for not reflecting the flexibility and variation of the past. They say they are excluding things like dairy and grains, while several of the authors consume dairy and in that very article they say one of them feeds her son grains (albeit sprouted, but still grains)! If this article gets anything right, it’s that a lot of them seem to call their junk food -free whole foods diets “paleo” just to call it that. I have to say, that while they didn't dig their own graves, they did hand the reporter a shovel. After the New York Times article and several other horribly biased articles, I learned how to figure out what reporters to avoid and what not to say to them. And most importantly, what editors hold their reporters to a higher standard. I learned that the number of these people was vanishingly small.   

Recently I wrote an article about Malort, a bitter spirit, for NPR's The Salt and I was really impressed by how their editors encouraged me to write in a balanced and fair fashion. It also forced me to confront my own biases. Because of an article I had read before, I honestly thought when I started out that the people working for Jeppson's didn't really know how it connected to Sweden. Because the editor questioned this, I tracked down Peter Strom, who ended up completely changing my mind. I ended up re-writing a lot of the article. 

But the thing is that "paleo" has grown increasingly scientifically and rationally vapid in the past few years. Most of these approaches aren't based on "dubious" science, a lot of them don't even bother for science. They are like Gwenyth Paltrow's GOOP inc. for people who like bacon.

There are issues with the paleo approach, but the author of this article is clearly not qualified to address them, instead resorting to Gawker-like sensationalist bullshit. I like how they cited Paleofantasy as being a book about debunking the diet, when not even half the book is about the paleo diet.

The sad thing is that Grub Street had a host of great reporters on restaurants, booze, and that sort of thing that they cut very recently in my home city of Chicago as well as other cities. They should have stuck to writing about bacon burgers and local pubs.

10/04/2012 - 23:23

Fasting, particularly the type known as intermittent fasting, has been popular in many health communities for awhile. Many people learn about it through Mark Sisson, Leangains, or Eat Stop Eat. Some people do it for weight loss, other people do it for its other potential benefits such as boosting cellular cleanup known as autophagy.

But it has been getting some negative press. The latest I saw was this horror story: How Intermittent Fasting Saved Me…while Slowly Killing Me:

By week 8, my chin was breaking out more. By week 9, more, by week 10, I had legitimate acne; large cist-like monsters just hanging out under my skin. A bumpy, unhealthy face, tired eyes, no energy, what my mom called a “depressed” state of mind. My hormones were ALL out of whack.

 

Yikes! But many people report that fasting has great benefits. That was my own experience. At first at least. I liked the idea of IF because I've always hated breakfast and it jived with my natural tendency to want to work without thinking about food. And often it was pretty awesome for me. I felt energetic and focused.

But sometimes I just felt terrible. Fatigued, lacking focus, light-headed, distracted by gnawing hunger. Was it time to ditch the IF habit?

No, because this was only happening sometimes. Clearly there were times my body was not up for fasting. And others when it provided a boost.

So over time I've figured out a few rules that keep me from fasting when it's going to back-fire. Of course this requires you not follow a strict regimen, that you be willing to skip fasting when it's not the right time. Don't worry you can always go back to Leangains or whatever later. And you'll be better prepared to do it if your body isn't a mess. Because fasting in the wrong context can stress your body, telling your biological systems that you are in a very bad place. And when that happens, it can respond dysfunctionally.

When to consider skipping fasting rather than skipping meals

 

  1. When your sleep is disrupted: Oh, you accidentally stayed up all night because you were watching a movie? Or your sleep was bad because a dog was barking outside your window all night? This might not be the best time to fast. Wait until you get a good night's sleep before you fast.
  2. When you are psychologically stressed: Have a huge project due at work? Just broke up with your boyfriend or girlfriend? Have an important speaking engagement? This not be the best time to skip meals.
  3. When you are not getting good nutrition: if the meals you are eating when you aren't fasting aren't nutritionally dense and nourishing, you aren't in much of a good state for fasting.
  4. When you are using it to reach unrealistic or unhealthy goals: Are you a woman trying to get six-pack abs? Maybe you should consider that at the body fat percentage required to have those, many women experience amenorrhea. My own opinion is…well, why bother risking it? Do you want to trigger the dreaded female athlete triad? I don't know, I've always been perfectly happy with a normal flat stomach with vague muscles though. I guess if you are trying for the bodybuilder look, go slow and be careful. You might want to try many small meals instead of IF because it might be less likely to trigger starvation adaptations.
  5. On that note, IF might not be for you at all if you have serious hormonal dysfunction: I'd recommend not trying IF if you have amenorrhea, because the last thing you want to do is trigger more stress in those hormonal systems. Also, if you start to experience menstrual irregularities, maybe it's time to reconsider your fasting habits. I've only experienced this once in my fasting and it was when I did my vegan paleo experiment. And I discontinued it immediately because I've encountered so many women in this community who lost their periods on IF…and never got them back. I'm not going to say that IF is dangerous for women, but be aware that when done dysfunctionally it absolutely has the potential to make you a hormonal wreck.
  6. When you have issues that can be exacerbated by caloric disturbances like hypothyroidism, low blood pressure, and feeling cold all the time. I've had issues with low blood in the past and I suspect that IF led to an episode in which I fainted. Over time I was able to recover by eating a higher carb diet, but until my blood pressure was up, I fasted from fasting.
  7. When you are suffering from certain digestive issues is another bad time to do it. Fasting might help bloating/gas, but if you are constipated, it's probably going to make it worse by decreasing motility and moisture.
  8. When you are suffering from constant hunger pangs. Some people are going to disagree with me, but my own experience and the experience of many others I know is that if your body is in an appropriate state for fasting, you will not experience hunger during your fasts. That is one of the reasons I do not ever time my fasts. I eat when I am hungry. For me, to constantly have to obsess about food and suffer from hunger pangs totally defeats the purpose of fasting. I don't know if it's a sign of physiological stress,but it's definitely a source of psychological stress.
  9. When you are trying to adapt to a new diet. Whether it be a paleo diet, a ketogenic diet, a gluten-free diet, an elimination diet… or any other major change in dietary habits, let your body adapt to your new diet, which often is a source of stress, without adding fuel to the stress fire by not actually eating your diet.
  10. When you are trying to adapt to a new exercise regimen. Another dumb thing I did…keeping up my fasting at the same time I was taking an Olympic lifting class. Yeah, and then I wondered why I felt crappy. Changes are hard and especially when you are ramping up your activity level it can take your body time to adjust. It's probably a good idea to provide consistent nourishment at the beginning of this change.

 

A borderline case is when you feel like you are getting sick. Often I will fast in this case and end up not getting sick. But the research on this matter is mixed, with few studies in humans. One study showed that it might be a good idea to feed a cold and starve a fever. Instead of fasting, it might be a good idea to stick with gentle easy to digest immune nourishing foods like soup or stews. There is even some scientific evidence that chicken soup might help fight colds

edit: and as someone pointed out in the comments on Facebook, it's probably not the greatest idea to fast when you are pregnant or nursing. I'd hope that would be obvious...but you never know. And it seems to be a problem in some cultures.

I'll fully admit that sometimes this is hard to follow. When I'm stressed and have a big project due, the last thing I want to think about is breakfast. But to be honest, I've found it's better to eat something "bad" in this kind of situation than to fast. I wish I could just skip a meal if there are no good choices, but sometimes I have to bite the bullet and know that while what I'm eating isn't optimal, at least I am not pushing my body into a bad place.

And as always: if something makes you feel bad and isn't working for you, it's probably a good idea to stop doing it. 

02/07/2012 - 00:25

I read an advanced copy of Why Women Need Fat when I was moving and because things were so hectic, I didn't have time to review it before it was released. I haven't heard that much about it though, except for this interesting interview with one of the authors in Salon. It's co-authored by Dr. William D. Lassek and anthropologist Steven Gaulin. 

It's an interesting book, but it's slightly hampered by the fact that their theories and prescriptions are both quite complicated and controversial. Unlike most other diet books, the authors are not claiming that their diet will make you thin. In fact, they emphasize the importance of body fat to women and the unique factors that influence women's health risks. 

So the book opens up a can of worms because it addresses fat in women, as well as evolutionary psychology. Talk about hot-button topics! But they are indeed strange bedfellows and it's interesting to see the synergy between them both. 

The first chapter of the book addresses similar territory as Good Calories, Bad Calories with a history of how dietary fat, particularly saturated fat, became unfairly demonized by Ancel Keys and friends. But there is more discussion regarding the rise of polyunsaturated fats, which were erroneously believed to be a healthy alternative to the naughty animal fats.

Ironically, the next chapter starts with a discussion of Denmark, where women eat more saturated fat than Americans, yet they have lower rates of obesity and heart disease. It's ironic because last year Denmark stupidly started taxing saturated fat to discourage consumption. But here the book diverges a bit from Taubes because they note that actually sugar is a smaller share of calorie consumption in the US than it was in 1961 and overall we eat about the same amount of sugar as the Danes. They also note that the idea that carbohydrates are the culprit also doesn't make sense if you compare countries like Japan to the US. 

Instead the authors look towards what they call the single biggest change in the American diet in the past forty years:the enormous increase in vegetable oils high in polyunsaturated fat, particularly the omega-6 variety. We consume more soybean oil than any other country in the world. That's been great for industrial monoculture farmers and food corporations, but hasn't seem to have done much good for our health. To add insult to injury, many of the oils introduced into the diet were not only mostly omega-6 fat, but also were partially hydrogenated, which created trans fats. Trans fats are pretty much unanimous considered extremely detrimental to health even in small amounts (as an aside, on the issue of women and fat, I think it's criminal that the Girl Scouts teach our young women to sell cookies that still contain trans-fats.

Most food corporations have switched away from trans fats, but polyunsaturated oils are still considered healthy by many, including the USDA. Even people who aren't cooking with the oils are getting generous servings in nearly everything, from salad dressings to baked goods. 

But here is where I get skeptical- the authors say that omega-6 could be a cause of weight increases in the population because it's converted into arachidonic acid. But if arachidonic acid is the issue, it makes the later dietary recommendations in the book seem suspicious, because most animal products are rich in arachidonic acid. And many of the studies they cite simply show that people who are overweight have higher blood levels of omega-6, but that doesn't tell us that the omega-6 was the cause. Considering that omega-6 fats are added to almost every processed food, you could blame it on an assortment of things from the palatability of the food (The End of Overeating) to wheat (Wheat Belly). However, it is interesting that it seems that some studies show that the weight gain from those eating diets very high in omega-6 is disproportionately distributed in the waist. 

So how do they think this all works? They say that omega-6 makes us heavier by producing certain types of signaling molecules called eicosanoids, which promote the growth and development of fatty tissue and fat storage. Another factor is that such eicosanoids make white blood cells more active, which increases inflammation. 

Much like Wheat Belly did with wheat, they also frame their villain as an addictive drug, since the body can make marijuana-like molecules out of arachidonic acid called endocannabinoids. Yes, cannabinoids, like marijuana, and the authors claim that it can stimulate the appetite similarly. But then it goes back to the fact that if this were true, wouldn't other foods rich in arachidonic acid cause similar problems? And those foods include things like meat and eggs.

I think they erroneously dismiss Kressler's book by focusing on sugar, when in reality Kressler also pegged processed fat as a villain as well, just one that works in synergy with other components of processed foods, which seems more likely to be the issue with these omega-6 rich vegetable oils than arachidonic acid. 

Either way, through the studies that show omega-6 can cause weight gain disproportionately in the waist seem quite tentative, it is an interesting thing to think about, especially since several chapters focus on the importance of fat distribution. 

These are the chapters bring in evolutionary psychology, which discuss controversial theories on the functional attractiveness of the waist-hip-ratio. Anthropologists have surveyed hundreds of cultures across the world and one of the few measures of attractiveness that seems fairly constant is that men seem to prefer a waist to hip ratio between .68 and .72 (even blind men). Does this actually mean anything evolutionarily? Is there an adaptive reason men find this attractive? 

Human women are unusual in the first place by how fatty we are. A slim woman can have a body fat percentage of 30%. A chimpanzee female has a body fat percentage around 5%. In this metric, we are closer to whales or polar bears than other primates. The fat is usually concentrated in the buttocks, breasts, thighs, and hips. Studies have shown that the average man finds fat in these areas particularly attractive. 

What is this fat for? Interestingly, women tend to lose the fat in these areas as they have children even if they gain weight overall and have plenty to eat. The lose correlates to the number of children a woman has. Lassek and Gaulin found that most of this fat seemed to be lost during nursing. During this period, an average woman eats less than she needs and instead seems to use up this lower body fat. 

Why is this happening? It doesn't make sense that women would be just using this fat to give the baby extra calories, because otherwise they would eat more.

Turns out that there is something in this fat tissue that the developing infant brain really needs. The human infant brain is unusually large and it's not just hungry for calories, it's hungry for fat. In particular it's hungry for DHA, the immediately usable form of omega-3 fatty acids that has been found to be crucial for optimal infant brain development. 

Unfortunately, the diets of most American women only provide half of the DHA that a pregnant woman and her infant need. Another type of omega-3 fatty acid, Alpha Linoleic Acid (ALA) can be converted to DHA, but this conversion varies (though interestingly pregnant women have upregulated conversion and the placenta also has the ability to push DHA "uphill" creating a higher level of DHA in the infant's blood than in the mother's) and can be down-regulated by excessive omega-6 in the diet.

The authors theorize that towards the end of the pregnancy, a woman eats less in order to foster utilization of her own fat tissues that are rich in DHA. The fat in the hips, buttocks, and thighs has more DHA than the fat in other parts of the body. This DHA has been accumulated over many years, starting in infancy.

I read a frightening Facebook conversation I witnessed in which a girl was bragging about how her thighs didn't touch, another girl mentioned that she was so mad that her thighs kept touching even though she had gotten "thin.". Like this question on Paleohacks, many women find that weight seems to come off everywhere but the thigh/buttock/hip region where the gluteofemoral fat lies. This can be frustrating in a culture where slimness everywhere but the breasts is desired. But seen in the light of the importance of this fat, it makes sense why the body resists mobilizing this fat when weight is lost and many women can't achieve the thinness they want in this region without getting so thin everywhere else that they are dangerously overweight or their ribs are showing. These women don't have "lipodystrophy," they are normal women whose bodies are trying to remain functional in a world where our body ideals have become dysfunctional.

The authors own research that suggests that women with more of this important fat have smarter children.

They also attempt to find a reason why men seem to like small waists, despite the fact that they are associated with low BMI, which is associated with poor fertility. Women aren't just fatter than other apes, we have the riskiest childbirth, a consequences of our infant's oversize brains. The first birth is always the most risky because the birth canal is un-stretched. The authors present data that shows that smaller-waisted women have smaller babies (even though they eat more during pregnancy) and thus easier first-time childbirth. So for most of evolutionary history, it would seem more beneficial for a woman to be neither too heavy, nor too thin, with the fat concentrated in the buttocks, hips, and thighs.

But once the first baby expands the birth canal, a woman can afford to have a bigger baby. And biologically, bigger babies might not be good for a first-time mother, but if they make it out of the birth canal they are more likely to survive and thrive. So the authors theorize that the reason many women find that they are starting to get bigger around the waist after they have their first child is that the extra weight will benefit the next child.

The mechanism they use to explain this is leptin, which plays many important roles in fertility. It also tells a woman's hypothalamus how much body fat she has and then uses this as a guide to tell the body how much of the nutrients that come from meals that she should store and how much should circulate in the blood. When a woman has higher body fat, her hypothalamus "tells her cells to pay less attention to her insulin's request to save." Higher fat stores mean more fat, sugar, and amino acids in the blood. Nutrients are more available to the placenta in the first place and the brain is more amenable to requests for more. But too much fat can be a bad thing at a certain point. Heavier mothers are more likely to suffer from preeclampsia, which could be because the placental hormones that "request" more nutrients are overactive and then the cells of the placenta burrow deeper into the wall of the womb to access the biggest arteries, causing an immune-system reaction. Interestingly, it's more likely if it's the first time a mother is carrying a particular man's child and becomes less likely as she bears more children by the same man.

So Lassek and Gaulin theorize that a larger waist signals to a man that a woman might already have a child to take care of and has also already used up some of her valuable DHA-rich fat. Another controversial idea they introduce is that even a child-less woman will gain weight as she ages because she is likely to have fewer children, so in order to increase the likelihood of genes being passed on, it's more important for any children she has to survive because she might not get another chance. So her waist accumulates fat in order to have a bigger baby, even if that means increasing the risk of the childbirth. 

But even if some weight-gain is desirable, things seem to have gone haywire recently. Women gain this weight much earlier and are overall much heavier than their foremothers. They also suggest it's possible that the low amount of DHA in our diets might be responsible for higher overall fat accumulation, reasoning that if a woman gets half as much DHA from her diet as another woman, she will have half as much DHA in each pound of fat. So in order for her body to accumulate an optimum total amount of DHA, she will need to store more fat. I didn't feel the evidence was very strong for this theory, mostly the observation that  women are thinner in countries with high-DHA diets, but it is very interesting.

The next part of the book is devoted to the idea of achieving "a natural healthy weight." It examines several studies that show that being slightly overweight (BMI of 25-29) seems to actually be healthy for women (but not for men). A lot of this stuff is similar to what was in the Healthy At Every Size book I read.

Another reason why older women might tend to be overweight, was that in the past this represented a protection against infections like tuberculosis, which killed many thin women. This may be because fat confers more active white blood cells. Luckily, estrogen protects women from some of the downsides of having more fat. Higher estrogen means higher HDL, which is good cholesterol. In general, women are seven times less likely than men to die of coronary disease before age sixty-five (I suspect personally that iron levels play a role here too). There is a downside, in that higher levels of estrogen seem to be related to higher risk of breast cancer, but that seems to mainly hold true for obese, not overweight, women. Overweight women are also more likely to develop type 2 diabetes. The authors recommend that women can follow a high omega-3, low omega-6 diet to help mitigate this risk regardless of a woman's weight.

Some other interesting facts are mentioned, such as the fact that heavier women are less likely to break their hips. Hip breakage is a common cause of death in the elderly. However, heavier women are more likely to have arthritis. 

But overall, they say that the focus on heaviness itself is probably misguided, because it's where the fat is distributed that matters. Large waist size in particular seems to be associated with health risks. Interestingly, in the 1990s, about half of women in the overweight group had waist sizes in the unhealthy over-35-inch range. Today roughly three out of four do and 1/7 "normal" weight women also have this problem. 

Unfortunately, dieting just doesn't work for most people and in fact people are often worse off after they try diets. Lassek and Gaulin say that calorie restriction makes women miserable and often ends up raising their set points. Instead, they say women should try to return to more human-appropriate diet, with special attention to consuming more omega-3 and less omega-6. 

They have a section on reducing omega-6, which mainly focus on fried and processed foods that contain soybean or corn oil. They also recommend being careful about poultry, though weirdly they don't mention pork. They also have a whole section on potatoes as hidden sources of omega-6, but all the potato-foods with high-omega-6 levels are fried or cooked with high omega-6 oils, so it's not actually the potatoes that are the problem. 

In order to boost omega-3, they recommend grass-fed meat, wild fish, and/or fish oil/algal DHA supplements. Annoyingly, they don't mention some potential caveats to supplementing such as "fishy burps" and general gastrointestinal upset. It's also definitely not a paleo diet, because they recommend you eat wheat, since it doesn't have much omega-6. They also recommend canola oil, which I personally view with skepticism, particularly if the goal is to return to the diet and thus the weights of our foremothers. I wasn't such a fan of this section of the book. It's clear the authors know much about anthropology and medicine, but not that much about food. I'm glad they are promoting grass-fed meat, but it honestly doesn't have that much DHA. You would have to eat 4.6 lbs of grass-fed beef to get the recommended 1.6 grams of DHA.

And then the rest of the book is about finding your realistic "natural weight," which is the weight your body will gradually shift to once you adjust your diet. This takes into account age and bone structure. Unfortunately, it also involves four steps of calculation. And there are also some eating tips, which are kind of easier said than done:

  1. Eat until you are satisfied and then stop
  2. Eat breakfast and avoid snacks after dinner
  3. Try to have smaller portions
  4. Chose nuts and fruit for snacks
  5. Limit commercial beverages
  6. Get regular exercise
  7. Reduce the amount of processed food in your diet

The interesting thing is that nuts have tons of omega-6. Shouldn't they be bad then? In the end I applaudan approach that recognizes that body fat plays a unique role in women and discourages the eating-disorder-like behavior and unrealism of traditional dieting. Unfortunately, while I think most bloggers I read have a healthy attitude, I see ridiculous bro-science about women's weight like this post on "Top 10 ways to get Skinny Fat." Besides the obvious fact that there are plenty of women who do those things who have ideal or very low body fat, I thought the choice of "scare" picture was telling:

Seriously? That is not a picture of an unhealthy "skinny fat" woman. In fact, there are plenty of women who eat the "magic" paleo diet that many of these sites tout and have much more body fat than that. Not that I think that's a bad thing. Those women are probably much healthier than some of the health bloggers I've seen who are so thin that it really worries me.

That's one limitation to the book. Despite having a more realistic attitude about weight than most books, it still seems to be primarily targeted towards people who want to lose. But the theory the book contains implies that not having DHA-rich fat stores would be bad as well. I personally believe it's possible even for women who are skinny to rebuild healthy curves. I was very very thin when I was raw vegan and over the years of eating fertility-supporting foods like butter and fish roe and improving my digestion I have laid down more fat tissue (and quite a bit of muscle) on my chest, thighs, and buttocks without increasing my waist size very much. I've received similar comments from other women. Is it any surprise that Marilyn Monroe ate a similar diet?

Also, let's get real here. Just like it's absolutely hilarious that writers can quote studies that show foragers are healthy in one breath, and demonize foods that make up most of their diet in another, I think it's weird to tout a very modernized female ideal as part of a "paleo" approach considering that forager women simply don't look like that and that art from the actual Paleolithic seems to portray a culture in which fertility-related fat was venerated.

I also enjoyed the evolutionary theory for the role of body fat in women. But I think their practical advice seems awkward and limited by lack of food expertise. I also think the evidence that omega-6 is responsible for obesity is somewhat limited, as laid out by a recent post by Stephen Guyenet, though I definitely agree that it can cause other problems. And maybe the association only holds up for women?

08/09/2011 - 18:47

 I saw this on one of Razib Khan's latest posts:

It reminded me of the time when I stupidly told a college career counselor that I wanted to have kids in my twenties. She was aghast...what a waste of a promising young woman! Looking back, perhaps they should have named her title "Capitalist Life-Extraction Encourager." Graduating in a recession, I wasn't exposed to the glamor that masked the true nature of careerism in the past. I never had an expense account or nice business trips. Co-workers have told me of a golden age where we had expensive parties with ice sculptures and wine. Since I've started working all we've had are potlucks. There is no veneer of self development, there is "do this and do it as fast as you can." I do want I do because I want to make ends meet. Though I admit there are benefits to my job, it is not a source of fulfillment for me. I know that for me and many others "career" is just a company trying to extract labor from me as efficiently as possible and that an employer is no more reliable than the old structures it replaced. Falter or just be at the wrong place at the wrong time and they will discard you. I am leaving this cycle in the autumn, something I am lucky to do. My father did the same several decades ago, becoming self-employed. 

Sometimes I read feminist writers in magazines like The New Yorker with resentment. They talk about women's careers from a position of privilege, the vaunted (and highly protected) few who make ends meet by speaking their mind with considerable personal and professional freedom. The latest irking was from Elisabeth Badinter, a French feminist writer (who also happens to be a heiress worth millions), who is aghast at the growing obsession of women with "naturalism". Maybe something was lost in translation, but it seemed like she was painting a straw man in order to dismiss very real considerations about reproductive biology. 

I read the excellent mini-book Razib referenced, The Baby Chase: An Adventure in Fertility. Holly Finn is an accomplished woman who is trying to have a baby in her forties. She goes through expensive IVF and gets nothing in return. She tries to date men who are wanting to start a family, but they are interested in younger fertile women. She seems a little bitter:

Any credible conversation about female aspirations today, especially one that urges women to lean way into their careers, should also talk about children—and not just as an aside. Otherwise, we are doing to the next generation what was done to many of us: robbing them of a possibility.

But I get the feeling women in their twenties aren't forgoing childbearing because of careers anyway, particularly those of us who graduated in the Great Stagnation. I get the feeling it's more about not having any money or support. I've also been reading The Coming Population Crash, which discusses the fact that fertility is declining almost everywhere, but most dramatically in wealthy developed nations. He has a few case studies in the book of first-world women and their child-baring decisions. Most of the women, particularly those in stagnant developed countries such as Italy, say they simply do not have enough money for children.

I also think reforms to the work system have been fairly shallow. Holly mentions this

One of the primary culprits cited by Drago and Varner is what they call “the Ideal Worker norm.” “In general,” they write, “the ideal worker is someone who enters a profession immediately upon receiving the relevant academic credential, works his or her way up the career ladder by putting in long hours without interruptions beyond short vacations, and continues in this fashion until retirement age. The ideal worker can contribute financially to the family, but cannot make substantial time commitments to children or other family members without endangering his or her career.” The result? Working women stop having children.

When I'm looking at foraging societies, I'm noticing that women DO work. They contribute so much to their communities all while carrying their babies around and breastfeeding them. I would like to see work options for women that acknowledge that many women want to provide a level of biological fulfillment (breastfeeding, physical closeness) and be the primary caregivers to their own children. I would like to see similar work options for men. I was in a wealthy neighborhood recently for an appointment on Wednesday at around noon. It was creepy how empty the nicely-groomed yards and million-dollar houses looked. People are just getting their energy extracted in their prime to pay for stuff they rarely get to use. They aren't going to look back when they are 80 and think of those expenses spreadsheets they used to make or the code they used to debug. I'm sure there are people who are out there who are doing awesome stuff that they love, but I guess I am skeptical that this is more than a tiny minority. 

And a dysfunctional bizarro-world dating culture. I must admit a spent some time on OKCupid and I was amused that interest dropped from several messages a day to none when I indicated I was interested in having children in the near future. To be fair, OKCupid seems to be a site for people interested in casual things, but that brings up the question of where people interested in serious things are supposed to go? 

Biology carries on, but I certainly didn't know how rapidly fertility drops in the thirties until I saw this chart. Sex ed is so focused on NOT having children, that it was just not in my mind. I did know about infertility though, I suppose if you are my age the odds that your parents or their friends struggled to have children is pretty high. I knew before I saw this chart that I didn't want to be 40 on my first try like so many of them. 

Notice that as you age the gap between "pregnancy regardless of outcome" and "pregnancy resulting in a healthy child" widens. Age and the nature of IVF later on conspire to increase the risks of health problems and birth defects. 

Holly warns: "The first thing I tell women ages 26 to 34 is: Start having babies. I know it’s not polite or funny. But I don’t want others to go through what I’m going through now." Yikes. But this is real. Take a look at that chart and start thinking of how you want to gamble. Maybe you don't want to have children at all, but if you have even an inking, it's important information. Men, if you are interested in having babies, you need to look at this too, though you guys seem to have more leeway than us.  

I didn’t want to settle at 25. I wanted adventures. I just didn’t imagine their cost, and how I would struggle to keep paying it.
 

05/05/2011 - 20:58

 These is some interesting discussion on Primal Wisdom on the Venus of Willendorf, a figurine from the Upper Paleolithic. 

As this paper describes, the figurine is an uncannily accurate anatomically correct depiction of adiposity.

Don asserts that such figures are found throughout paleolithic sites in Europe, but I would view these in a different light

The Venus of Willendorf, a depiction of what modern scientists refer to as "obesity" is in the middle. The other two are less clear cut. They look like they have steatopygia, a genetic condition that has died out in modern humans but which may have once been more common.

Either way, there haven't been many dietary studies done on the skeletons found nearby, so while it may seem logical to assume they were eating mostly meat and fat that far north, who really knows? That's the reason the aforementioned paper is really one of the few reputable ones I could find on the subject, since such a figurine doesn't really tell us all that much.

However, I don't find it as surprising as others do. There is evidence from that period and region for material inequality and sedentism- for example, textiles that would have taken many people years to produce and would have been only worn by one person. Such a person may also have had a sedentary life with much food simply given to them. 

It might also shock you to learn there are paleolithic skeletons with evidence of cavities, cancer, and other pathologies. The more I actually study bones, the less I am able to hew to the idea that the paleolithic was some kind of health utopia where everyone looked like the hot folks at your local gym. 

Either way, we have a lot to learn about the paleolithic. I'd love to see isotope or starch grain analysis done on those bones if possible. 

02/05/2011 - 18:38

 I was going to just do one big post on this subject, but the amount of information out there is so extravagant that perhaps I'll do several. I suspect this topic doesn't get much air because well, most bloggers don't want to relate personal anecdotes. And really, there are no really good solutions to this issue. 

If you are anything like me, in high school health class you were taught that things were pretty bad for women and then suddenly they invented The Pill and it freed us to enjoy sex without worry.

Like many women I was given the pill before birth control was even on my mind. Doctors routinely give it out to make menstrual cycles "more regular," fix PMS, cure acne, and for other non-birth control reasons. 

This troubles me and now that I know better I would make sure that any daughter I have isn't handed the pill so casually. There are so many types of hormonal contraceptives and so many conflicting studies that it's hard to say that the pill is a bad thing. But given how little we still know about human reproduction, I'd rather not take it unless I have to. When I stopped taking it many frustratingly persistent health problems I struggled with went away. 

I think because there aren't very many good alternatives for birth control, some of the problems with the pill are swept under the rug. Women deserve to know about them. 

So here are some good sources I've been reading: 

Some letters from a study on long-term mortality. Here are some good quotes (nulliparous means women who have never had children)

"Deaths increased three times more in “ever” takers under age 30 than in young “never” takers. GP observed “ever” takers had significant increased mortality rates compared with “never” takers for all circulatory diseases, cerebrovascular disease, other circulatory diseases (thrombosis), and violence (perhaps reflecting previously increases in mental illness and marital break ups in “ever” takers). A much vaunted ovarian cancer reduction depended on 14 deaths in “ever” takers and 29 deaths in “never” takers and 75 deaths in each group in the full data set. Whether these women were taking fertility drugs or HRT, which can increase the risk of ovarian cancer, is unknown.2,3"- Dr. Ellen Grant

"Troubling trends of increased morbidity and mortality among OC users v. non-users are also apparent when considering the subset of women who constituted a small minority of users in this study cohort, but who predominate among current users, namely, young nulliparous women."- Dr. Joel Brind

"The results of this large study are really welcome and promising to highlight long term safety of oral pills which are the most effective method of contraception and save many women's lives from complications of unwanted pregnancies-" Dr. Sharma

"It is surprising why the authors did not give greater importance to the fact that such a huge proportion of participants (one third) were lost to follow-up. Usually, a great restrain is needed when interpreting a cohort study attaining a retention rate lower than 80%."- Dr. Miguel A. Martinez-Gonzalez

"It is now surely inconceivable that any medical scientist who has some understanding of basic mechanisms could believe that widespread hormone use, especially of progesterones, is not a major health problem."- Dr. Ellen Grant

Here is among the most interesting letters:

Hannahford et al. (2010)[1] report convincing evidence for reduction in mortality from several forms of cancer and other disease in women who have used oral contraception compared to never users. However, they also find a higher rate of violent death among ever users, and that the rate of violent death increases with longer duration of oral contraceptive use, but they are unable to explain these intriguing results. I suggest that recent evolutionary insights into human partner choice may provide a clue.

There is evidence that use of oral contraception alters women’s baseline preferences for men[2,3] such that pill users prefer men who are relatively similar to themselves at loci in the major histocompatibility complex (MHC). One consequence of being partnered with relatively MHC-similar men is that such women express lower sexual responsivity toward their long-term partner compared with women in relatively MHC-dissimilar couples, reject sexual advances from their partner more frequently, and report having had more extra-pair partners[4]. Other evidence points to MHC- similar couples being more likely to experience problems conceiving children, and having less healthy children due to lower MHC-heterozygosity[5]. Cumulatively, these effects could have real impact on the quality of spousal relationships[3,5].

It is not unreasonable to suspect that such effects could also influence rates of intimate partner violence. This is the most common cause of nonfatal injury among women[6] and accounts for more than a third of women murdered in the US[7]. Furthermore, ex-partners are a key risk factor[6], which could further emphasise the risk for pill users if the behavioural effects of pill use ultimately influence rates of marital breakdown[3,5].- Dr. S. Craig Roberts

As you can see there is still a bit of a debate on how exactly hormonal contraceptives impact women's long-term health. A debate I was totally unaware of when I was on them...

And more and more stuff still comes out every year showing unintended effects. An interesting, but inconclusive study last year found that hormonal contraception can change a woman's brain structure. I could definitely write separate posts on how the pill effects nutrition, future fertility, bone density, inflammation, heart disease risk, hypertension, libido, mood, and that's the tip of the iceberg. I can't promise a series, but this is a topic that definitely interests me. 

Context and Variation has a good post about The Pill from an anthropological perspective

The second health issue I want to mention is the potential increase in systemic inflammation with the use of hormonal contraceptives (one of my other undergraduates, Katherine Tribble, found this article for our lab's weekly journal club). Morin-Papunen et al (2008) looked at women at thirty one years of age in the Northern Finland Birth Cohort, born in 1966. They grouped these women into levonorgestrel-releasing intrauterine device (IUD) users, oral contraceptive users, and no hormonal contraception use. Morin-Papunen et al (2008) found oral contraceptive usage was correlated with increased C-reactive protein concentrations -- this is a biomarker for inflammation that is associated with cardiovascular disease. Compared to IUD users, oral contraceptive users also had more insulin resistance, higher blood pressure, raised lipids and insulin levels, despite having a smaller waist and lower waist-hip ratio (a larger waist or higher waist-hip ratio is often associated with these results). Further, most of these results actually strengthened when factors like BMI, household income, and alcohol consumption were controlled for. Another interesting point, third generation hormonal contraceptives, which are lower concentrations of synthetic hormones than the second generation, actually had higher serum levels of insulin, CRP, total cholesterol and other lipids, compared to users of second generation contraceptives.

Based on my own research, I think it's not a good idea to use The Pill for anything other than birth control unless all other options have been explored. As birth control it is the most effective, which leaves women who don't do well on it or who would prefer to take a precautionary approach with some tough choices. There is some evidence that non-oral methods like the Nuvaring are better, though actually there are some disturbing studies on the patch and Depo. Women in marriages/long-term relationships for whom a pregnancy wouldn't be the worst thing might want to explore fertility charting (this isn't your mom's method, significant research and improvement has been done on this method in the last decade) or withdrawal (possibly just as effective as condoms). 

I think an issue is that it's considered silly to think about children in your twenties. But just because you'll change in the future doesn't mean you shouldn't think about it at all. If you are trying to live close to the species optimum as possible in the modern world, you will probably make different choices. 

02/05/2011 - 15:58

 A few interesting things:

 

Really great conversation between John Hawks and Kathryn Clancy, both physical anthropologists. Apparently Clancy is gluten intolerant. She also studies fertility. I suggest reading her blog. Also tantalizing is that Hawks has a grad student studying autoimmune differences between farmers and foragers.

Some great posts by Dr. Clancy:

Iron-deficiency is not something you get just for being a lady: EXACTLY why doctors need to start reading about evolutionary medicine. Almost all doctors seem to think that iron-deficiency is part of being a woman, but that doesn't make sense evolutionarily. Turns out, it's no normal and doctors who think it is often miss the true cause, which is internal bleeding. 

When I was a freshman college I had iron issues. Just like in the post my doctor gave me iron pills, which absolutely destroyed my stomach. Finally a better doctor found out I had a GI bleed. Now why do so many people get GI bleeds? In my case it was from taking NSAIDs, which is a fairly common cause. 

-I don't have a 28-day menstrual cycle, and neither should you 

 

Great new post at Evolutionary Psychiatry about ADHD and diet. I need to post about "food allergy tests" some time, since I get so many questions about them. The unfortunate thing is that most are very inaccurate. Unethical doctors (usually naturopaths, which doesn't help their reputation) market them as accurate and I've gotten emails from people saying they are allergic to absurd combinations of food like kangaroo, banana, and cinaamon buns (just kidding). This causes people to avoid perfectly good foods. Dr. Deans mentions these tests in her post

There were a couple of interesting wrinkles. The kids were all tested for IgG antibodies to food, supposedly helping one sort out food intolerances. These tests are widely used by doctors and para-professionals alike to diagnose food allergies, but when you get down to it, there is not a lot of evidence these tests tell you much about what you might actually be allergic to. IgG antibodies simply mean that somewhere along the way your bloodstream was exposed to food allergens. To be honest, I think people with tons of positive IgG food allergies have leaky guts, that wheat and poor gut biome are reasonably likely culprits, and the foods that show up in the IgG test are a random sampling of what happened to make it through the leaky gut. In the INCA study, the kids were carefully rechallenged with their IgG + foods, and their symptoms of ADHD seemed to have nothing to do with the IgG test. So I'm right ;-) (maybe).
 

Facinating post on using infant closeness as an incubator. The fact that this had to be re-thought of speaks to the medical profession's disconnection with our evolutionary heritage. In foragers, a baby away from a female relative's body is a dead baby.

Reminds me of something I've been musing on for awhile. Evolutionary applications to modern social life sometime seem like they were invented by bros. Lots of papers on how promiscuous humans are, men are different from women, why men like attractive women blah blah blah. But what about the stuff that doesn't jive so easily with modern life? Like the importance of breastfeeding, the fact that optimal fertility occurs when a woman is relatively young, that that non-relatives don't do as good as job taking care of children as kin do? These are not ideas people want to accept because they are so against modern cultural norms. 

01/15/2011 - 00:56

I said I'd go to bed, but then I read something interesting. Lately there has been some discussion in the comments here about what level of body fat is healthy for women. Is it healthy for women to be as lean as men should be (below 18% body fat)? Some authors say yes. After all, don't women in third world refugee camps have babies all the time?

Turns out it's more complex than that. Ancient Bodies, Modern Lives is my go-to reference on this sort of thing and lo and behold it had some answers on this matter.

To a great extent, reproductive hormone levels are set during development and reflect resource availability while a girl is growing.As we will see with regard to fetal development, a maturing system (the reproductive system in this case) reads cues about the environment to assess future conditions and adjusts levels of hormones and other components of the system to match the expected conditions. If a girl develops in a health-rich environment, her system "expects" that environment to be stable, but if she experiences short-term deprivation fo food, for example, her reproductive system may down regulate to wait for the expected better times.

Wenda mentions some rare examples of famines in first world countries, like the Dutch famine in WWII, where fertility levels completely crashed. So it's theorized that each woman has a "set point" established while growing up that determines her body's response to food intake.

Ammenorhea is a complex condition. Lots of long-distance runners suffer from it(which makes me doubt that women participating in persistence hunts was ever part of our evolutionary history)...but others don't. It sounds like a cliche, but everyone is different. For exercise-induced ammenorhea, it's not just body fat that's a factor, but cortisol and probably quite a few other hormones.

I would note that many advocates of low body fat for women are men. My own opinion is that this is foolish and will lead women to disordered eating. The only body fat that you want to avoid is visceral fat. I guess if you don't want to have children and care mostly about being super lean you can do that...but don't pretend it's healthy or natural.

Lassek and Gaulin also argue that hip and buttocks fat are the primary sources of fatty acids that are passed from the mother to the fetus during gestation and the infant during lactation. These long-chain polyunsaturated fatty acids play a major role in brain development. Thus, they argue, hip and buttocks body fat does not just signal overall energy availability for pregnancy, but also signals that the essential fatty acids for brain development are in sufficient supply. Does hip and buttock fat correlate with cognitive abilities? IN an examination of the third NHANES study database, Lassak and Gaulin found that high amounts of hip and buttocks fat relative to waist size (a low waist-hip ratio) was predictive of women's own and their offspring's cognitive performance. They refer to this fat as "a privileged store of neurodevelopmental resources.

I think other people refer to it as "my humps"

Edit: some commenters got the idea that this is about being "fat", which is it not. I mention that visceral fat is a highly unhealthy possession, and it is. Ideally a woman should have a relatively flat belly (unless she is pregnant), but not worry about ample hips, buttocks, or breasts.

12/15/2010 - 23:04

So far the best book about how evolution has shaped women's bodies. Chock full of interesting info.

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