TPNS 55-57: Stephen Phinney, Native Americans, and Low Carb Fitness

Primitive Nutrition 55:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part I

In my short time studying the low carb view of nutrition, the most interesting person I learned about is Stephen Phinney.

He has extensive experience and great professional credentials so he should know what he's talking about, and if you read his journal articles you'll see he is no lightweight.

He has a longstanding professional and personal investment in the low carb idea, as you'll see.  If you've built your career as a low-carb scholar and researcher, it might be difficult to eventually realize that low carb never was a very good idea.  I see no indication he has reached that point yet, so I’ll try to help him come around in these videos.

For now, he is still putting into writing wacky beliefs such as implying that a minority of people can tolerate beans, whole grains, or vegetables without packing on the pounds.  Perhaps he’s thinking of magic beans with more calories per gram than fat.

I'll only be examining two articles of his.  This is one.  It’s an interview in which he extols the virtues of pemmican, a dense mixture of meat and fat eaten by the Plains Indians.

We’ll start with this paper though.  This is a scholarly article he wrote to present ketogenic diets as compatible with athletic fitness. This is the paper most often referenced online to prove that you can be an athlete and perform well on an extreme low carb diet.  There is practically nothing in the medical literature that makes this argument beside this paper, so it’s become somewhat of a stand-by for the low-carbers.  To create some context, let's first consider the concept of low-carb athletic performance.

Realize the basic objective of low carb dieting is to control insulin.  Low-carbers are forever at war with their body fat.  They think that since insulin promotes fat storage, if you keep your insulin down, you won't store fat.  I've already talked about why in real life it doesn't quite play out this way over time in my Low Carb, High Fad section.  Low carb and high saturated fat diets cause a multifaceted dysregulation of metabolism, which might even cause epigenetic defects in later generations.  But for the moment, the point is their own stated objective is to suppress insulin.

From an athlete's perspective, I don't see why this would be desirable.  The athletes I know don't struggle with weight loss.  They are usually more interested in becoming stronger.  Suppressing your insulin won't help with that.  I trust the friendly folks at Steroid.com know what they are talking about when they say insulin is one of the most powerful anabolic, or muscle-building, agents.

It is because of carbohydrate's effect on insulin that carbs are considered essential to increase strength.  Low carb diets have been shown to reduce one's capacity for muscle building, and this is probably why.

Even the promoters of low carb say it is not good for building muscle.

Insulin is not the only hormone we should consider.  This study looked at the free testosterone to cortisol ratio, a possible biomarker of overtraining, in two diets, one in a normal carbohydrate range and another in the low carbohydrate range.  The free testosterone to cortisol ratio plunged in the low carb group, likely indicating an impaired capacity for recovery from training.

Why take an unhelpful approach even further until you’re in ketosis?  Ketone body production was found to directly relate to perceived exhaustion in this study.

This study found the same thing.

The carbs in recovery drinks have been shown to reduce the inflammation response after a workout and to prevent damage to your DNA.

Food and Agriculture Organization of the United Nations

These are some of the reasons major health organizations say when you're an athlete, you need more carbs than ordinary people, not less.

Athletes looking at low carb research need to keep in mind a strikingly consistent fact.  Those low-carb-friendly studies were generally carried out on individuals with impaired glucose regulation, excess body fat, or other metabolic problems.  Low carb is all about easy fat loss for the sedentary.  This is why I think it is such a slouching, gloomy approach to health.

Should easy fat loss appeal to an athlete?  Should an athlete desire inefficiency in the function of his or her body?  Wouldn't you rather consider your body to be an amazingly efficient machine that deserves only the best and cleanest-burning fuel?

Against this backdrop, Phinney has a big challenge if he wants to convince the typical athlete that he or she should give up carbs. In his attempt to persuade you, Phinney gets off to a terrible start.  His first argument, unreferenced, is that our ancestors had limited access to carbs.  Somehow the isolated population dispersals into the arctic dictated how all humans on the planet developed.  I have shown you at length that this revision of history doesn't make any sense.  Dr Phinney needs to brush up on his evolutionary history and population genetics.  That this Paleo-truthiness made it in to their scholarly journal should be an embarrassment for Nutrition & Metabolism.

Look at the editorial board of this online journal and you will see it includes Phinney along with the usual cast of low-carb apologists.

Nutrition & Metabolism has a neutral sounding name but don't be fooled.  It is a product of the Nutrition and Metabolism Society, a low-carb advocacy organization.   When you visit their site to learn more about saturated fats, they will offer you an article by none other than conspiracy-minded cardiac surgeon Donald Miller.  The low-carb echo chamber now has a scholarly journal to give it an imprimatur of academic gravitas.  I doubt a top-tier mainstream scholarly journal would have published Phinney's article.

I won't go through the research he presents as the foundation of what he oddly calls carbohydrate supremacy, which is I guess his way of saying modern sports nutrition.  Unlike the cholesterol confusionists, he doesn't even try to discredit any of this science. 

I will note that in his review of history, Phinney predictably relies on the Stefansson meat-diet study.  I've already shown you why that study is nothing to crow over. 

After this section Phinney's primary material is drawn from two studies he conducted, one published in 1980 and the other in 1983. 

It's a little odd that he would write an article in 2004 that relies on these old papers so heavily.

In the first one, he subjected obese volunteers to prolonged ketosis in order to see if they were capable of moderate physical exertion in that condition.  He found they performed their best after a period of adaptation.  This is his main point regarding low carb fitness.  All other research into low-carb and ketogenic diets and exercise did not allow for a sufficient period of adaptation.

You can see even way back in 1980 he was relying on good old Stefansson and his meat-diet study.  His focus was different back then, though.  I think this is really interesting.  He was not interested then in ketogenic diets as a way of providing sufficient calories for long-term sustainability.  He said they had little clinical relevance to the treatment of obesity.  Back then he called the diet in his study a protein-supplemented fast, or PSF.

And that was certainly more accurate than calling it a diet.  These people only consumed 500 to 750 calories a day with supplements. As you know, supplements are necessary for low carbers to avoid serious deficiencies and are therefore used in all their studies.

Sometime since that study, Phinney decided those protein supplemented fasts should instead be called ketogenic diets.  Fast forward to 2011 and he doesn't tell you some were eating as little as 500 calories a day when he says, "In case you're wondering, while on the ketogenic diet, they had lost, on average 25 pounds."  Now that you've seen what they really ate, do you think he is reporting honestly here?

Here are their weight loss statistics.

In that rock-bottom range of calorie restriction, his participants were able to drop their cholesterol.  There is no mention of LDL, but give him a break, this was 1980.

Athletes, take note.  Ketosis absolutely cratered their insulin production.

At the end of their six weeks, with the doldrums of keto-adaptation well behind them, the people in the study did improve their performance, but Phinney doesn't make too much of this.  Dropping that much weight will certainly make an obese person perform better.

In that 2004 article, Phinney goes on to recount another study.  That one used subjects who were not only not obese, they were athletes.  This is interesting, and it's next in Part II.

Primitive Nutrition 56:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part II

After his study on severely calorie-restricted overweight people, Phinney then conducted another study, here recounted 21 years later.  This one was more interesting.  He took well-trained cyclists and fed them enough to maintain their weight.  Once again, serious supplementation was deemed necessary.

Two papers came out of this study.  One result stood out for Loren Cordain here, and I agree with him completely.  After only four weeks on a ketogenic, extremely high-fat diet, these athletes saw their cholesterol rise from 159 to 208.  Imagine that.  In less than a month they went from having excellent cholesterol levels on what were likely very healthy high-carb diets all the way into what we conservatively would call a borderline high level today.  Imagine if they stayed with that diet how high their numbers might have gone.  Again, these were athletes, and this happened in only four weeks.  This is why every other low carb, meat based study conducted by low carb promoters creates a serious energy deficit.  At maintenance levels of calories, low carb diets are flat out dangerous.  Phinney amazingly says in the abstract that serum lipids were not pathologically elevated.  This is charitable of him to say the least.

The diet fed the cyclists was based on Phinney's recreation of an Eskimo diet.  To simulate the consumption of brackish water and caribou blood, they received the usually battery of low-carb supplements.  This is just the use of Paleologic to rationalize and repackage a nutritionally deficient diet.  Bear in mind his choice of an Eskimo model for later.

Also note that a diet free of carbohydrate is not historically accurate if you are reproducing an Eskimo diet.  Not only did they eat berries for carbs, but their practice of eating meat in its raw form gave them the glycogen stored in the muscles of the animals they ate.  Glycogen is a carbohydrate.

This is the second paper this study produced.  Glycogen in their muscles dropped like a stone.  Nevertheless, the cyclists did adapt to ketosis to the point that they performed almost as well as they did at the beginning of the study.  It's a very interesting result.  The human body really is amazing. 

So what are the lessons Phinney would like us to take from this study?  First, there is adaptation after that difficult induction period into a ketogenic diet.  For me, this raises a question.  Did the cyclists need a similar period of adaptation when they went back to eating carbs?   I think I'm safe in assuming they didn't, and this should tell you which diet is healthier for humans.  One observation in this study, often glossed over by low carbers, is that while in ketosis they did not match their sprinting performance on normal diets.

Because of this, Phinney is conservative in his written conclusions.  He says if you are using a ketogenic diet therapeutically, and I would question whether it's therapeutic for most uses, you don't need to stop exercising.  But athletes, understand this next point.  Your explosive strength will be handicapped on this diet.  This is probably a serious drawback for most sports.  Phinney says this factor would strongly discourage its use in competition.  So why do it at all?

One last note about this paper.  Cholesterol is not mentioned in his recounting of the 1983 study.  Do you think this was an innocent oversight?

Here is the other article I'd like to comment upon.  This one is an interview with Phinney.  He has a particular interest in the Plains Indians and their use of pemmican.

If you don't know what pemmican is you can pause the video and read how it was made. Basically it is dried meat and hot fat mixed together in a bag to provide a transportable source of calories in nutrient-poor environments.  Pemmican literally means "he makes grease."  Low carbers like Phinney evidently think grease is health food.

Because pemmican was a potential calorie-dense food source, the US military attempted to use it as a ration for troops.  It might have made sense to use it for personnel in the Arctic but it was abandoned because it was known that men did not thrive on it.  Put this in historical context and it is quite damning. The military had unsophisticated food preservation methods by our standards back then along with a great need for foods that could be easily and safely shipped, stored, and carried.  I doubt they gave up on this effort easily.  It must have been found seriously lacking as a source of nutrition.  This is the food Phinney finds so intriguing.

Here are some excerpts from this interview.  He is caught up in the reputed height of the Plains Indians and he thinks their diets were responsible for them being tall.  It is clearly assumed by him that being tall is healthy, and is a good measure of overall health.

I'm not sure why he believes this.  Greater height tends to associate with shorter life span.

Here is a graph from a study of height and longevity using data from baseball players.  Age is along the vertical-axis and height runs along the bottom.  There is a clear trend toward shorter lifespan with increasing height.

It's also an odd choice for someone who believes so much in the Eskimo diet, which is nutritionally quite similar to pemmican.  You'll recall from my Eskimo videos that they were notably short people.  They did not benefit from longer life as a result, though.

If you need the reminder, you can see they were considered short and fat, to put it bluntly.  As I have said previously, these are good traits if you live in extreme cold.

Here is another reference to their short height and short lives if you need it.

And another.

In the first paragraph here Phinney is interested in the Cheyenne tribe for their height.

He thinks they were eating practically no carbs and up to 80% fat.  Why he thinks this I have no idea.  As this author points out, those who think the Cheyenne ate only flesh are wrong.  They ate plenty of healthy carbs.  He points out that their diet was like those of the other Plains Indians, with a wide variety of plant foods to go with their meat.

For what it's worth, there are differing accounts of which tribes were tallest.  Here the Sioux are said to be taller than the Blackfeet.

This author extols the Sioux for their great height and fine appearance.

This author says the Blackfeet were among the tallest, though.

What did the Blackfoot Indians eat?  Here is an old text from 1905 which tells us the Plains Indians ate a lot of underground storage organs like potatoes.  Vegetables were so important to the Blackfoot they chose their routes of travel based on their availability.

They did eat a lot of meat, but also a lot of vegetables and berries.

What about the Sioux?  Rocky Mountain tribes ate a very large proportion of their food from root vegetables, according to this old source.  The Sioux are mentioned as particularly big consumers of a type of turnip, along with corn and meat.

Yet Phinney inexplicably believes they ate no dietary fiber.  He doesn't seem to have done enough research on this.  He says the same about the Inuit.  Is he right?

The Inuit did eat some fiber.  They just got it from a far less appetizing source, the contents of animals' digestive tracts.

Here is a magazine article from 1919 that gives you further evidence of Eskimos eating half-digested moss.  It was understood at the time this practice was employed to relieve constipation.

It doesn't look like Phinney was so concerned with duplicating the Inuit diet that he fed his cyclists reindeer intestinal contents like moss.

I invite Phinney to have a look at this book.  Eskimos did eat plant foods when they could get them.  Not included here are some less-than-ideal plant foods they ate in times of desperation.  Berries were highly prized, however.

Some Eskimos would go to considerable effort to ensure a year-round supply of them.

Writers in 1922 were trying to correct the perception that the Eskimos did not consume plant foods.  The message still hasn't reached Dr Phinney.

If you think this talk of fiber is leading to a slightly awkward subject for me to discuss, you are right.  I will discuss bowel health in Part III.

Primitive Nutrition 57:
Stephen Phinney, Native Americans, and Low Carb Fitness, Part III

I left you with Dr Phinney making some dubious historical claims about how much fiber was in Eskimo and Plains Indian diets.

In that interview, Phinney explained why you don't need fiber to have healthy bowel movements.  I have to say, it is pretty crazy to read comments like this coming from a doctor.  Anyway, this argument is based on Eskimos and Sioux being in ketosis.  I will show you in my Ketosis is Natural section next that this is absolutely not true.  Phinney has made the mistake of assuming here without actually researching this.  The Sioux would not have been ketotic, either, with their consumption of turnips and corn.  Phinney then walks straight into trouble saying that the Eskimos must have had easy bowel movements because they would have needed to be quick about their business out in the cold.

Once again, it seems he didn't research this.  Here is an often referenced article by low carbers written by a doctor who cared for the Inuit early in the twentieth century.  He said constipation was in fact common.  He said the cold weather added to the problem for them.

There don't seem to be many old references to constipation among the Eskimo beyond this one so I must conclude that their practice of eating partially pre-digested caribou food worked adequately if not well.  I can nevertheless show you how a relatively comparable culture with high meat consumption fared with respect to bowel health.

This paper is an examination of the Innu culture by Peter Armitage.  I have seen this document used to describe the Inuit online but this is a mistake.

The Innu and the Inuit are distinct cultures.  Some Inuit do, however, live near the Innu.  In these cold conditions they are obligated to subsist on animal-based foods due to the lack of vegetation around them...

Meaning their diet was and is high in meat and very low in carbohydrates.  Like the Inuit these are hunter gatherers who have a created a culture over the generations which has allowed them to maintain a stable population despite extreme cold.

This paper is well-known because of this section, in which Armitage tells us about a mythical spirit among the Innu called the Fart Man.  You might think the fact that they have such a legend is merely an odd quirk of their culture, but actually the Fart Man is very important in their belief system.  He is able to punish people for misdeeds with constipation so severe as to be fatal.  To the right you can see a mythic legend retold that makes clear the Fart Man was considered the most powerful of Innu spirits because of his power to constipate.  I think it is safe to say from this that constipation was a serious concern for these people, and I also think it is safe to say this was a result of their diet.

Phinney says he is going back to basic principles when he suggests we only need fiber so we have proper bowel movements.  He also says low carb diets provide adequate short chain fatty acids for intestinal health.  Neither of these beliefs are true.  Fiber promotes bowel health, which in turn promotes overall health in ways that are only recently coming into focus.

Moreover, low carb diets have been specifically criticized for not providing adequate short chain fatty acids to avoid bowel disorders.

In this interview Phinney is asked about the incidence of stroke among the Eskimos.  His response is to question if the Eskimos being referenced were truly pure low carb.  This is a common tactic for the low carbers.  Any historically documented health problems with extreme low-carb cultures were caused because they were not extreme enough in their diets.  You know you are dealing with a radical when he immediately suspects phantom carbs and overlooks the obvious. 

The extremely high levels of omega-3 fatty acids they consumed made the Eskimos very susceptible to blood loss.  Here is your explanation for their strokes, Dr Phinney.  No phantom carbs necessary.

To close out, let's circle back to the Plains Indians.

I am fortunate enough to own this old book featuring the photography of Edward Curtis.

Curtis set out over a hundred years ago to document the indigenous cultures and people he feared would soon disappear.  His pictures are mesmerizing.

One cannot look at them without pondering how much different their lives must have been from ours today.

Life in a challenging environment...

meant a life filled with hardship.

The people in the photos are fascinating...

and I would say beautiful.

But looking at these photos does not suggest to me their lifestyle would match our values today.

Although I respect these people, I would not trade places with them.

I'm sure this guy could hold his own living that life. 

I am not like this guy.

One of the photos stood out to me.  This lovely young mother and her child look especially healthy.  She is a Hopi Indian.  What did they eat?

The Hopi were practically vegetarian. 
This young woman came from an agricultural society that relied heavily on healthy carbs.  They let hardly a plant go to waste.

Curtis's photos suggest these were very healthy people for their day.

They seemed to have done a little better than merely survive.

Here they are preparing their grains.

When the Spanish encountered the Hopi, they were amazed at their physical fitness.

The Hopi even produce an Olympic medal winner for the United States in 1908, Lewis Tewanima.

And he was a true Hopi starch-eater.

Maybe Dr Phinney could take some inspiration from these people for his future work.

Phinney and the other low-carbers want you to believe you should be in an extreme metabolic state called ketosis.  I'll take that on directly in the next section.