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Eat for your health, the planet, and your values.

Unicorns & Rainbows: The Myth of the Paleo Panacea

This is a joint post with myself and my very good friend Dr. Emily Deans

I recently had a nutrition client who, during her initial consult, was super nervous to tell me that she had recently been diagnosed with cyclothymia, a mild version of bipolar disorder. She had an appointment coming up with a psychiatrist and was concerned that I might tell her that she would be just fine with diet alone. 

My answer to her was this, “I think that there are meds out there that can be really helpful in situations like this. Why live your life in pain when there are tools out there to help you? If you had a heart condition, would you try to just ‘stick it out’ with diet alone? No! So, if you have a mental illness, why do you feel like a failure if you try medication?”

PC http://www.worldatwarmagazine.com/waw/germs-in-war/
This is a self portrait of when I was an art student at age 20, living in New Mexico, and incredibly sick (and depressed) from undiagnosed Celiac Disease.

[Tweet “Paleo is no panacea”]

I think people sometimes have a false perception that the paleo diet is magic. Like mythical unicorns and rainbows, people sometimes think eating real food can solve everything, and make you live forever.  I do believe that getting optimal sleep, a paleo-type diet, time outdoors, and having a supportive social network are key to good health. However, I also believe that there are times when all of these things are simply not enough. Modern medicine, with all its criticisms, can also be a true blessing. Many people would not be here today without it. Me included. If it wasn’t for antibiotics, I may have died as a child from infection. There are tons of people today who owe their lives to advances in the medical world like vaccines, emergency surgeries, medical testing and prescription drugs.

Long ago, it was quite common for women and infants to die during childbirth. Longevity for men in Paleolithic times exceeded women for this reason. The countries (worldwide) with lowest infant mortality in the world have a C-section rate of about 20%. Although almost no one “chooses” a C-section, having the option of a C-section improves infant outcomes, and along with antibiotics to treat the formerly deadly pupuerial fever, modern medicine has led to the lengthening of the average woman’s life to exceed that of men.

Some folks feel that if one has a maximized immune system for their children via respecting the gut flora and breastfeeding, vaccines aren’t necessary. Well, Native Americans on the East Coast of the US and Canada had been fighting off incursions by the Vikings and everyone else for hundreds of years. Then, in 1620, a very few Pilgrims followed by a few more Puritans managed to successfully permanently settle a hostile coastline. There is no way Pilgrims were more militaristic or aggressive than the Vikings…but the Pilgrims landed right after infectious disease decimated the native population (with estimates of up to 95% of the population perishing), leaving the land nearly empty. These peoples didn’t have c-sections, or antibiotics, or formula. They ate plenty of mineral rich organ meats and collagen for their guts and bones…and they died, as most humans in history have, from infectious disease. Hygiene, antibiotics,  and vaccines have been some of the most important advances for modern humans when it comes to fighting off this ancient scourge.

smallpox
When the Europeans began their settlement in America, blankets carrying the smallpox virus devastated the Native Americans. Credit: http://www.worldatwarmagazine.com/waw/germs-in-war/

Now before you get all cranky with me about the vaccine debate, I want to make it clear that I think that the science is still out on  the efficacy of certain ones, and a healthy debate to question the research is necessary. However, chances are you don’t know anyone who has died from measles, smallpox, polio, syphilis, diphtheria, or scarlet fever, and antibiotics and vaccines are the reason why.

Let’s also look at pain. I personally had a natural childbirth with baby #1. I did it. Nobody gave me a medal. It hurt. A lot. With #2, I had an epidural, then watched “Goonies”, had a baby, then ate a cheeseburger (gluten free bun). I have to say that my experience with #2 was much more pleasant. I’m NOT saying that it’s crazy to want to have a natural childbirth, or that I discount the “cascade of events” that can happen when women are forced into medical situations that end up in unnecessary C-sections. However, I do think that it’s TOTALLY OK to accept an epidural if you want one. I also think that if men actually had to give birth, the rate of epidurals would be much higher. I felt tons of pressure to have a “natural” childbirth, and felt guilty having the epidural. Guess what? That’s silly! I pass no judgment on any woman who chooses to relieve the pain of childbirth with an epidural.

Now let’s look at mental illness. According to the CDC, suicide is the #10 leading cause of death. The most common underlying disorder is depression, 30% to 70% of suicide victims suffer from major depression or bipolar (manic-depressive) disorder, which is often undiagnosed. Approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year.

Screen Shot 2016-06-04 at 9.32.28 PM

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source: https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf

During my nutrition consult, I did a quick google search of “Wellbutrin and Cyclothymia”, and guess what? Wellbutrin (bupropion) seems to be quite effective in treating the depression associated with bipolar disorder and contrary to other antidepressants, does not cause weight gain. In fact, weight loss is quite common with patients taking Wellbutrin. I showed her my computer screen. She told me that the fact that I “approved” of her taking an antidepressant was a huge relief.  

Life is short. Everyone’s goal is to have a happy life. Why go through it in pain when there are some very effective tools out there that could help you be happier?

My client has significant weight to lose. She is 100% willing to do whatever it takes, via food and lifestyle changes, to lose the weight. I believe she will be quite successful. However, I also think that removing the stigma of mental illness, accepting help, and trying a pharmaceutical intervention will give her that extra edge she needs in order to have live a happier life.

Let’s look to diet and lifestyle as a starting point to a better life. When these things aren’t enough, let’s consider what modern medicine has to offer, weigh the benefits and consequences, and make a good decision.


IMG_7590
Emily Deans, MD

As the “evolutionary psychiatrist” I get a lot of consults from people who want to minimize or come off of medications. Sometimes optimizing lifestyle interventions can really help…getting the nutrition, sleep, exercise, and microbiome dialed in can be miraculous for many chronic modern health conditions. However, I’ve also seen people come to me obsessed with health, with lab values, with clean diets, whose obsessions have significantly impaired their quality of life. I’ve also seen folks who have done their best with therapy and lifestyle interventions whose symptoms and functioning  improve immeasurably by adding a few medications. Intervention with medications can be enormously helpful with mental illness, despite some known limitations. I know many cases where folks have literally been given their lives back from devastating suicidal depression or incapacitating psychosis with medications…and sometimes people are in no condition to take on rigorous food and lifestyle change until they are feeling better.

In the more general paleo community, I feel there is sometimes an unstated wish for immortality, that if you just eat the right omega 3 supplement and use the best blue-blockers and combine hiking and HIIT and organ meats, you will live happily and healthy forever more.

In my medical training, I’ve had many occasions to sit with the dying of all ages. In the emergency room, in the cancer ward, in the pediatric trauma wing, after 2 futile months in the ICU after a stroke, even a sudden and devastating heart attack induced by the deadly heart attack of a spouse. In fact the majority of our medical dollars in the US are spent during the last 6 months of life.

I can tell you that the dying regret working too much. They regret worrying too much.  They do regret those many years of cigarettes. They wish they had learned a musical instrument, spent more time with family, and read more books, and visited more places. They don’t think about how much omega 3 they consumed…they think about taking in that last sunrise and getting out of the hospital and into some place more comfortable with their loved ones. Even the young ones whose losses are the most heartbreaking want to have lived well if they don’t have the choice to live for very long.

I’m all for spending a judicious amount of time and money maximizing lifestyle interventions and providing societal incentives to promote breastfeeding, home cooking of whole foods, reduce unnecessary C-sections, reduce antibiotics (particularly as a regular component of animal feeds) and for appropriate nuanced study of vaccine safety. But I also think we should accept our mortality and be well-informed of the realities of heroic interventions to keep life extended unnaturally, with resultant suffering. We should also understand that in many cultures in written human history, young children weren’t even named before the age of two because we were so likely to lose them as infants or to infectious disease. Let’s not throw out the baby with the bathwater of modern hygiene and medicine and instead use our science to maximize evolutionary science and modern medicine to create the happiest, healthiest human bodies we can, and accept our limitations and eventual deaths with dignity. We have the technology…and sometimes that includes modern medicine (even statins! sometimes!).

[Tweet “Accept mortality: be well-informed of the realities of interventions to keep life extended unnaturally, with resultant suffering.”]

The good news is there’s almost no chronic health condition a healthy whole foods diet, appropriate sleep, and proper physical activity won’t improve. And for those of you with chronic kidney disease who need to avoid potassium or too much protein (so your standard paleo diet would be horrible), or unusual fat metabolism genetic disorders who need to eat super high carb…well, you have medical science to help guide the way.


Diana

For those of you who are suffering from depression, please know that there are diet and lifestyle changes you can make to improve your life, but that taking a prescription drug doesn’t mean you’ve failed. There’s no shame in reaching out for help.

 [Tweet “In the end, we’re all going to die anyway. Why not live the healthiest, happiest life we can?”]

Screen Shot 2016-06-05 at 8.29.49 AM

And in closing, I’ll leave you with the song below, recommended during a twitter exchange with “Doc Parsley” and written by one of my favorite childhood authors, Shel Silverstein. 

 

 

 

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36 thoughts on “Unicorns & Rainbows: The Myth of the Paleo Panacea”

  1. Loves this article but not so crazy about the ending quote and song. So… smoke, drink, do coke etc because we will die anyway…hmmmm

    1. Welp, that’s too bad. It was intended to lighten things up – CLEARLY I’m not advocating that, if you had read the ENTIRE REST OF THE POST. If you have followed anything I said, then you’d understand that I think we all need to take everything with a grain of salt, that none of us are making it out alive, and that paleo is not an infinity pill. Enjoy your life. Also, that was a reference to a twitter thread from yesterday from Kirk Parsley. I’m sure he also doesn’t honestly believe this.

      1. wow..you took my comment so the wrong way….I did read your whole article. I do SUBSCRIBE to functional and conventional medicine (been an RN for 20+ years. I am celiac with multiple food ALLERGIES etc….with help from all avenues I lead a wonderful –mostly healthy life ….enjoying the variety in life always.
        I have been thankful for all of your knowledge and your book.
        I simply think a lot of the public will read the end and say see it’s ok to do the other things with no hurt.
        We simply only have one life and we should try our best to give it the best we have got.

        1. Yes, so the point of lightening it up at at the end, is that even with all of our best efforts, we are not immortal. I was trying to illustrate that, at the end of the day, our death is out of our control. So, yes – I’m on board with your comment that we only have one life and to give it the best, but don’t become overly obsessed because you also need to live and not let your quest for immortality ruin life. 🙂

          1. I think your reply to Christine’s comment was a bit too aggressive. I was already feeling a bit uncomfortable with the tone of the article in general, and, hopefully you won’t bite *my* head off for saying this, but combined with your replies it feels a bit preachy rather than sympathetic in tone.

          2. It’s definitely uncomfortable for people to face their own mortality. I’m definitely not a preachy person but also tend to be a complete realist and do not dance around things at all. I’m super direct, which sometimes gets me in trouble with folks who don’t like that. The post is about real life, and the fact that no matter what we do, death is going to happen, so if you’re unhappy, PLEASE take some steps to change that, even if it’s with pharmaceuticals. It’s absolutely critical that people take care of themselves and this whole notion that everything needs to be all natural, all the time is complete garbage.

  2. Great article. As i have ENTERED my 50s I have realized a lot of the things I have obsessed over, during the previous years, ate just that, an obsession.

  3. Thanks for this! There is so much readily-available INFORMATION out there that can confuse us and make us wOrse for The stress it causeS! This is a very balanced way to approach health and a refreshing, Freeing read!

  4. I absolutely loved this article! Thank you so much! I Was diagnosed with hashimotos a few years back and Was one of those people who was obsessed with labwork, a clEan diet takIng the right supplements. My life was consumed by it. Life gave me a curve ball for a solid year i tried hard To keep up the lifestyle but couldnt. Was still AIP bUt not as obsessive. I got through just fine and then bam i got pregnant was not planned but happy anywAys. I had an epidural and My Birth could not have gone better. I agree like i would tell people wHen they asked me if i was having an Epidural (they would assume i woUldnt since i was into all the nAture organic lifestyle) i would say yes and they would be shocked. I would say hey you wouldnt get a cavity fixed without something to numb the whole experIence! Anyways life is so much better now. I have laxed a bit hEre and there and i feel great! I Am still a bit weary of vaccinations but i planned on a delayed schedule and of Certain ones because of my autoimmune historY

  5. when emily made mention of supporting statins (albeit i’m sure in a very specific circumstance) it made me think more of what it means to be a “proper citizen” that supports modern medicine and their guidelines (which are the opposite of specific –as in the case of statins). The whole post deals with supporting treatments that people see as a resignation from fighting the “good fight” with lifestyle modification, even though the treatments are riddled with many side effects and in many cases just transiently manage symptoms. I think your support for this, aside from your genuine beliefs that they may help (really talking about things like psychiatric meds here, not vaccines or antibiotics), are an addition to these lifestyle modifications (nutrition, sleep,etc.,) that involve supporting the mainstream. it’s obviously very stressful to constantly be at odds with what everyone around us is thinking and doing, so why not indulge everyone else, medications and all, and be in sync with the rest of society. i’m not in any way taking away from your honest intentions to help, but just offering a different view of the situation.

    1. Actually, if you read the literature, statins are an effective treatment in men who have already had a heart attack. It’s crucial that people learn how to read scientific papers with a critical eye and make good decisions based on their own situations. That’s what this whole post is about – be your own advocate, look at ALL the options, don’t rely on health gurus to tell you what’s the right choice, and modern medicine is not to be discounted.

        1. thanks for the blog recommendation! I’ve known about thennt for a while but have never checked out their blog-looks interesting. And I understand what you mean about being your own advocate, I just wish that we had better modern medicines for things like depression,etc,. instead of being stuck between consistent healthy, and many times difficult, life choices or medications that are not treating the root causes of disease (e.g. serotonin for depression, cholesterol for statins, etc.,) and leave us with many unpleasant side effects. For whatever it’s worth I’m one of those who consistently suffer with depression and wish i could just go to the doctor, take the pills, and feel better, but it never works out (due to those pesky side effects) that way so i keep chasing unicorns and rainbows =P

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  7. Such a great article! The polarization of the holistic and allopathic communities can really limit the things that people are willing to do in order to improve their quality of life, regardless of what side they subscribe to. We can be dogmatic in our belief system that we fail to see the bigger picture or acknowledge that perhaps we don’t have ALL the answers. As a practitioner, I am really trying to hold myself accountable that my words and actions focus on more uniting and less dividing. Imagine how much we could accomplish if mainstream healthcare integrated with holistic healthcare to create an accessible, affordable, and effective treatment model? That’s my idea of a panacea. : )

  8. i couldn’t agree more. in the paleo autoimmune community, this rings true as well. some people are able to achieve a medication-free remission, but for the ones who can’t, there’s a feeling of shame for taking the meds and getting the help they need. we need to stop seeing paleo and conventional medicine as either/or, and instead see them as complementary practices that can work together when necessary. it’s all about living the best life possible, with all the tools at our disposal.

  9. That quote at the end truly killed the entire post which is sad because there was a time I enjoyed the information and even podcast. Not saying it’s your responsibility to please all readers, but I think most of us who try and go the extra step past western medicine deal enough with the “do whatever and you’re going to die anyway”. I would hate to send one of my friends to this blog and encounter such a discouraging post.

    1. It can be incredibly upsetting to face the fact that we are not immortal. Emily warned me that some people experience unconscious rage at the fact of inevitable death. So, please allow me to remind you of the big picture take aways from this post: Food and lifestyle are incredibly helpful in every situation, but don’t feel like you’ve failed if you you also need to pull in some modern interventions, final thought: lighten up because none of us are getting out of here alive. Yes, I know it’s harsh, and people don’t like to hear it, but honestly, I’ve seen so much death in the last year that it’s important to know that sometimes no matter what you do, you die. Yes, be happy and try to be healthy, but you just never know what’s going to happen. Sorry this was discouraging to you.

  10. you are so right! There’s no one cure for everything. My husband had been struggling with high blood pressure For 4 years. we tried everything “natural.” from diet (sometimes Paleo) to exercise to you name it. His bp kept getting higher. after years of disappointment and trying everyone’s tried and true remedies we resorted to medicine. going from as high as 185/95 to 124/71 we are both relieved. sometimes MEDICINE CAN BE YOUR BEST FRIEND.

  11. Wonderful article, but i have to say my experience is the reverse or inverse. I was doped up on a combination of wellbutrin, ativan, ambien, & codeine when i had depression, codeine because i was experiencing chronic pain. no doctor told me to address my nutrition, or to begin exercising, and in fact many medical professionals i encountered didn’t think all of the above would help.

    it was through friends that i was introduced to crossfit, yoga & meditation. So i think that the closed-mindedness exists at both ends of the spectrum. My belief now? can anti-depressants help? yes. but they ought (IMHO) to be taken only when absolutely necessary, and combined with addressing things from other angles, including nutrition & exercise.

    1. Yes, I completely agree. I guess I was already assuming that people are aware that the standard is drugs “first”, and diet and lifestyle has “nothing to do with it”. I do believe Emily and I mentioned several times that changing your diet and lifestyle is critical, but my point was that if you need meds, that’s ok too (meaning, in addition to diet and lifestyle). Emily also pointed out that if someone is really sick, dramatic lifestyle changes may be unrealistic until they’re feeling better.

  12. hI dIANA,

    tHANKS FOR THIS ARTICLE, JUST WHAT I neEDED! i’VE BEEN STRUGGLING FOR YEARS NOW WITH SO MANY DIFFERENT DIETS, INCLUDING PALEO AND KETO, TRYING TO SOLVE MY CHRONIC FATIGUE, GUT ISSUES, ANXIETY, BRAIN FOG AND BAD MEMORY. nOTHING HAS REALLY HELPED, i FEEL THE SAME NOW AS WHEN i WAS EATING THE STANDARD WESTERN DIET. mAYBE i’M JUST UNLUCKY OR THERE IS SOMETHING ELSE GOING ON WITH ME WHICH CAN’T BE CURED WITH DIET ALONE (i AM HAVING APPOINTMENTS NOW WITH A GASTROENTEROLOGIST). eVERY DIET i HAVE TRIED PROMISES THE SAME- INCREASED ENERGY, A SHARPER MIND, REDUCED ANXIETY AND DEPRESSION ETC. bUT FOR ME, NONE OF THEM DELIVERED. sO MANY SUPPLEMENTS, BOOKS, PROGRAMS ETC. i HAVE TRIED AS WELL AND i AM TIRED OF IT ALL. i REALLY LIKE YOUR HONESTY IN THIS POST, SO MUCH OF WHAT YOU READ ON THE INTERNET IS SUCH BULL AND JUST DESIGNED TO SELL SOMETHING……

    i’M NOW LEARNING HOW TO LISTEN TO MY BODY AND USING MY OWN BRAIN AND COMMON SENSE TO THINK ABOUT WHAT MIGHT WORK FOR ME INSTEAD OF LOOKING EVERYTHING UP AND PINNING ALL MY HOPES ON THE LATEST GURU i’VE FANCIED.

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  14. Thank you for this post… I have been struggling with severe, suicidal depression for many years… Along with This comes chroNic pain, chronic migraines, fatigue, etc. about a year ago, i finally found a drug combo that atleast help take the edge off so that I could function and i finally had some motivation to make healthy lifestyle changes… The first time i met with a naturopath they told me i needed to stop all medications to detox my body and Eliminate the gamot of food immediately… I was turned off completely by this experience… However, mOre recently have decided to stand up for myself and because “cold-turkey” changes were too overwhelming for me, i met with a new practioner who is helping me make smaller changes, one at a time toward the large goal of weightloss and health, and she (much like you in this article) doesnt make me feel ashamed of my illness, nor that, atleast for now, i choose to stay on my medication. Thank you for being open to everyone’s differing situations – you are a better practioner for it

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  17. Yikes! This is terrible advice. Please read Robert Whitaker’s “Anatomy of an Epidemic” and Kelly Broagn’s “A Mind of Your Own” before consuming psychiatric medications. They are extremely dangerous drugs, cause many more health issues than a poor diet ever could (INCLUDING brain, nerve, metabolic and hormonal damage, as well as EXACERBATING MENTAL HEALTH PROBLEMS OVER TIME), and can take years to recover from. While some are helped from these drugs, others are gravely harmed and even disabled by them. Please do more research. Wellbutrin is not a safe drug.

    1. Sorry for the all-caps in places… it wasn’t my intention to have them in there at all. your comment reply box does not allow me to type in lower case letters.

    2. Kelly’s book is on it’s way to me, actually. She just emailed me. I’m not sure you really got the point of this article – I’m saying that diet and lifestyle are very important, but that drugs should not be overlooked and that paleo is not a panacea. I am fully aware that pharma can harm, but it can also help. The point is that it can help and should be considered if you need it.

      1. I got your point, but I think you have missed mine. If someone understands the TRUE risks involved in taking these drugs and still consents to taking them, that’s perfectly fine, but most are never made aware. Your google search with your client that revealed Wellbutrin’s “effectiveness” is but one side to a very dark and largely untold tale. The “other side” must be presented as well for a truly informed decision to be made.

        All of these drugs cause some degree of brain and bodily changes for everyone, and can cause drastically more pain and suffering than they were originally intended to resolve. We currently have no way of knowing who the unlucky percentages will be who find themselves facing years of disability, brain damage, and extreme, inhumane suffering due to taking these drugs. This can happen to anyone over time, and occurs at much higher percentages than most people realize. Usually the damage is slow and insidious, and therefore the connection between newly emerging medical and emotional issues and the drug they were prescribed years ago is never made. It is very important to be aware of this.

        I look forward to reading what you think about this matter after reading Kelly’s book, and urge you to pick up Whitaker’s as well. Best wishes.

        1. Again, I think we’re on the same general page here. I just don’t want people AVOIDING prescription drugs just because they feel that diet is a “cure”. I wrote this with my colleague, a psychiatrist, who deals with this on a daily basis.

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