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Nutrition Past and Future

The Tokelauans, the Samburu, and the Masai Again

Running a Cholesterol Confusionist Gauntlet, Part 5 – The Tokelauans, the Samburu, and the Masai Again

Our attention now turns to the Tokelauans and the Pukapukans.

Anthony Colpo says I don’t want you to know about them, presumably because he thinks something about their health and lifestyle calls into question the lipid hypothesis. Let’s see if that is the case.

This is the study about them to which Colpo apparently refers. Back in 1981, it was concluded that vascular diseases were uncommon among both populations, and their high saturated fat intake did not seem to cause them any problems. Now let me ask you, honestly, have you ever heard of the Tokelauans or the Pukapukans? Don’t you suspect Coplo is mentioning them here because they are somehow unusual? Do you think this paper about these few island natives in the South Pacific will cause the world to toss out the lipid hypothesis? If you’ve watched my videos, you might be able to guess where I’m going first in my look at these people.

If you guessed I’d be looking for evidence of parasites among these primitive people that might have kept their cholesterol concentrations in check, you are right. Do you think I was able to find a good reference for this? Of course I was.

But it was not easy. There is a lack of material on this subject because these people just have not been studied very much, as far as I can tell. It’s a safe bet that they would have had some parasites, but there seems to be a lack of data on this.

This site says there are 183 infectious diseases that are endemic or potentially endemic to Tokelau. This reference is not good enough.

But here’s a pretty good reference. Filiarial fever was called the principle cause of ill health there. That condition is the result of a tropical parasitic infection by worms.

It’s always a good bet that parasites are present in primitive cultures lacking adequate sanitation. Most parasitic infections are maintained in their human hosts at a low level over long periods of time. Remember, our immune systems were likely strongly affected by the parasites living in our ancestors.

Let’s take a look at that paper on these Pacific Islanders and see if there is not more to consider than just one reference about their parasites. Gary Taubes has mentioned them. In typical fashion for him, he filters out any information that might not align with his single-minded fixation on carbs as a cause of excess body fat. On the right, you can see that he gives the impression these folks consumed no starches at all. If you only went by his book, you would think they traditionally only ate coconuts and fish. I covered the healthy starches consumed by other Pacific Islanders in my video number 69. The Tokelauans ate healthy starches, too, as reported in this very paper, including pandanus, breadfruit, and starchy aroids. For what it’s worth, the Pukapukans ate taro and pulaka. These are starchy carbs that Taubes forgot to mention.

You can see here just how much starch they ate. The Tokelauans ate a lot more saturated fat than the Pukapukans, and the Pukapukans ate more carbs, including cereals.

Taubes also forgot to mention that these people were not exactly slim. Despite a subsistence economy, the Tokelauans were overweight on their high-saturated-fat diet.  The Pukapukans were overweight, too, despite the fact that the authors said they sometimes ate little or nothing for a whole day or more. The Pukapukans were lighter even though they ate more carbs. This should be a another warning for anyone hoping to lose weight on a high-saturated fat diet.  The Tokelauans had saturated fat from coconut at every meal yet they were still overweight. I wonder how the Weston Price people would explain this. Don’t they say you should eat fat to lose fat?

Here’s the cholesterol data on these people. The Tokelauans had much higher cholesterol than the Pukapukans.

The Tokelauans also ate much more saturated fat and less carbs than the Pukapukans. Can we agree that this is yet more evidence that saturated fat raises cholesterol? This is another score for Ancel Keys, right?

The authors of this study say themselves, “These results suggest that the serum cholesterol differences between the two atoll groups may be ascribed largely to differences in saturated fat intake.”

So what about their rates of heart disease? The authors state that the numbers of people available for their study were too small to allow for definitive conclusions about their rates of heart disease. This is the paper that is the basis for claims that they did not have heart disease? This is so weak. Yet Anthony Colpo brings up these people as if they offer compelling evidence against the lipid hypothesis. Once again, his pretense of certainty is a mere fig leaf to conceal his vanishingly small case.

The only diagnostic tool used to evaluate the cardiovascular health of these people was electrocardiography.

Here is a prior study looking at their rates of heart disease. Electrocardiography was the means of testing. An ECG only measures the electrical activity of the heart. From this we can see that those tested had not experienced a prior heart attack, and that their heart function was normal. Modern methods of assessing their degree of atherosclerosis were not used. Assessments of their rates of heart disease were not based on mortality data. Again, this is really weak evidence. Moreover, cross-sectional assessments of their serum cholesterol levels showed patterns similar to those of high-cholesterol, high-heart disease cultures like those measured in the US. Do you see how their cholesterol kept increasing as they got older, and then fell sharply at the end of life?

Do you remember this slide? Do you see how similar these patterns are? Minnesotans and New Zealanders with high saturated fat diets and high rates of heart disease had shown a big upside-down U-shaped pattern, too, as their cholesterol went far higher than necessary only to later come plummeting back down at the end of life as their health gradually fell apart, consistent with Western patterns of chronic disease. This is in contrast to the Asians represented below, who maintained much lower cholesterol levels that only gradually increased throughout life, and did not drop off as decay set in during their later years. Those people were known to remain productive almost all the way through their lifespan.

And here again are the patterns of the Pukapukans and Tokelauans. In the absence of mortality data, I am inclined to think older people in these cultures saw their cholesterol levels plummet due to end-of-life illnesses.

What about the mention by the authors that Tokelauan migrants to New Zealand, who would have left behind their traditional dietary practices, had higher blood cholesterol despite eating less saturated fat? Well, let’s remember that in New Zealand they also ate more dietary cholesterol. That’s an important factor.

They were also in a more sanitary environment. Perhaps their lack of infections in New Zealand meant their cholesterol would tend to be higher. Yes, I’m speculating here, but this is not accounted for in the Tokelauan migrant study, probably because they did not know about the effects of parasites on lipids. Also, you may remember from my other videos that caloric restriction reduces serum cholesterol. The native Tokelauans may have eaten less. But let’s keep our eye on the ball here. If the lesson from the Tokelauan migrant research is that Tokelauans in New Zealand were less healthy, I think that’s a good lesson. One indication of their worse health was their higher cholesterol levels.

They ate more meat. They had higher uric acid concentrations. They were more likely to have gout. Serum cholesterol was one factor that associated with gout among these people. Once again, high cholesterol does not seem very healthy.

Let’s remember here, Colpo wants to debate the lipid hypothesis. He is saying these people were free of heart disease. But look at their cholesterol numbers. They were well below 200. This is considered the desirable range in the US. So we are to conclude that the lipid hypothesis is invalid because people with relatively low cholesterol seemed to have good heart health? Do you see how unhelpful to your case this is, Mr Colpo?

Even a saturated fat apologist like Stephan Guyenet acknowledges that the traditional and historic Tokelauans had high rates of infectious disease. Perhaps their immunity was weakened by all that fish they ate.

It is amazing to see the mind of a saturated fat apologist at work. Here he says we will never know for sure what Tokelauan health was like when it was completely traditional.

But here he says that traditional Tokelauans appeared to have a low incidence of heart attacks, and he thinks this should be common knowledge. Sure, why not? It’s highly speculative, poorly studied, probably has important confounders, and is focused on a genetically isolated population. We all should know about this so we can close our eyes to all that other research, right? These guys seem to have no awareness at all of their own biases.

The paper authors also did not account for the cholesterol lowering foods they might have eaten in Tokelau. I could not find clear references on this, but it is likely that if they were eating high-fiber, high-quality plant foods, they were eating foods that would tend to lower cholesterol. As this paper says, they consumed a diet rich in fiber-containing foods. They were not consuming the typical saturated fat bombs that Americans eat. They rarely ate pork or chicken or eggs. Gary Taubes forgot to mention that, too.

I include this study on the diets of the Maori people, who are in the same relative neck of the woods, which details the cardioprotective plant foods they ate. This effect of plant foods is probably not clearly accounted for because these protective effects may not have been understood by those researchers back then, but that does not mean that today we should pretend that the other components of their diets were not a piece of this puzzle.

The Maori are mentioned here along with other Pacific peoples in a comparison of stroke rates with Europeans. Pacific Islanders would have eaten a lot of fish. They also had a significantly higher relative risk of stroke compared to Europeans. As I said, high fish intake has made some primitive people into potentially serious bleeders.

Here are other Pacific Islanders studied for the relationship between fish consumption and toxin burdens. The French Polynesians in this study had very high blood concentrations of mercury, about as high as those measured in the Inuit. In the absence of similar research on the Tokelauans and the Pukapukans, I think it is fair to say they were consuming a lot of mercury, too.

You don’t have to be a Pacific Islander or an Inuit to be effected by the toxins in fish. Fish-eating women in San Francisco had a mean level of mercury ten times greater than is typical. Some children there were more than forty times the national mean. Their mercury levels declined once they stopped eating fish.

Colpo mentions other exceptional cultures to distract us. As I said, he thinks I am pretending the Masai never existed, when actually he is pretending that my videos about the Masai don’t exist. So what about these other people, the Samburu?

Here is the paper to which he is likely making reference. As you can see, the Samburu are another pastoral, blood-and-milk-consuming culture in Kenya like the Masai. Again, if your big argument requires you to draw conclusions based on a few exceptional cultures, your big argument probably has some weaknesses. To understand the Samburu, I am going to simply refer you to my videos on the Masai since their circumstances were so similar.

Here is a reference to help you see that their dietary practices were very similar, and that they had their own concerns with parasites as well because of these practices.

Something I left out of my Masai videos which I’ll throw in here is this evidence of the unique characteristics of the Masai with regard to their cholesterol metabolism. This paper informs us that the Masai were shown to have a highly efficient negative feedback control that allowed them to modulate their blood cholesterol based on the dietary cholesterol they consumed. Their blood cholesterol would not get very high because of this. This is called a long-term biologic adaptation here, and this is an adaptation that Anthony Colpo lacks.

Here is another reference for this. The Masai are protected by genetic adaptations from high serum cholesterol. So you see, Mr Colpo, there are other important issues to be considered here before jumping to conclusions about the lipid hypothesis.

We’re back to modern epidemiology in the next video.

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