ASK DR. JONNY
What do health professionals truly think of the Paleo diet, and what is homocysteine, exactly?
Jonny Bowden digs into the science behind the Paleo diet and homocysteine.
Q: What is homocysteine? Do I need to worry about it?
Homocysteine is a normal by-product of protein metabolism. It becomes a problem when the body isn’t able to get rid of it, in which case it accumulates in the bloodstream. And that’s decidedly not a good thing. Elevated homocysteine levels are a significant risk factor for heart disease and stroke. Elevated homocysteine is also associated with inflammation, depression and dementia.
High homocysteine is typically treated with a trio of B vitamins, specifically folic acid (in its bioactive form ,5- methyl tetra hydro fol ate, or 5-MTHF), vitamins B6 and B12. These are the nutrients that are needed to metabolize homocysteine and clear it from the bloodstream, and they’re often lacking when your homocysteine is high.
Homocysteine can be measured by a simple and inexpensive blood test that can be ordered by your doctor. Levels above 13 to 15 µmol/L are considered high, and levels below 10 to 12 µmol/L are considered normal. (In functional and integrative medicine and nutrition, we like to see levels under 10 µmol/L.)
The discovery of homocysteine is an interesting story and a lesson in how conservative the conventional medicine establishment can be. Homocysteine was discovered in 1969 by a research scientist at Harvard University, Kilmer McCully, MD. Dr. McCully noticed that young people stricken with heart disease had one thing in common – very high levels of this weird thing in the blood called homocysteine. He thought that homocysteine might
be as good as or better than cholesterol as a predictor of heart disease, a heretical theory that challenged the establishment theory of cholesterol as the main player in heart disease and that literally got McCully driven out of Harvard.
About 25 years later, homocysteine had come to be accepted by that same establishment as the risk factor McCully always knew it was. Dr. McCully was welcomed back to Harvard where he serves part-time as associate clinical professor of pathology at Harvard Medical School in addition to his day job working at the US Department of Veterans Affairs Medical Center.
Q: What do doctors, nutritionists and other health professionals think of the Paleo diet?
The US News and World Report ranked the Paleo diet number 32 out of 40 in their “Best Diets Overall” list. I – and hundreds of my colleagues – think they have their proverbial heads up their proverbial derrieres. If that kind of robust disagreement among health professionals surprises you, read on.
The basic assumption of your question is that doctors, nutritionists and other health professionals are a single, unified, homogeneous group and agree on basic principles of nutrition. That couldn’t be further from the truth. (About the only thing everyone agrees on is that vegetables are good for you.) We disagree as often as the members of congress, and sometimes just as vehemently.
Medicine and nutrition have their “left wing” and “right wing” sides, just as politics does. Conventional medicine and dietetics tends to be “center right.” The conservative faction defends old bromides like that vitamins give you expensive urine, low-fat diets are good for you, saturated fat is bad, and you need carbs for energy.
The “left” side has a much different view. This faction recognizes that the Standard American Diet (SAD) is a complete disaster, believes that sugar – not fat – is the true enemy of health, and that our genes are not suited to a diet high in processed carbohydrates like cereals. This side has a slightly skeptical view of much of conventional wisdom when it comes to diet, citing the awful 1992 USDA Food Pyramid as a case in point. I am very much a member of this “left wing” party.
So from the point of view of the medical and nutrition professionals I know and work with, the Paleo diet ranks very high. It’s not just a fad but a return to a diet in which we ate mainly from what I call “The Jonny Bowden Four Food Groups,” or foods you can hunt, fish, gather or pluck. That’s what kept our human ancestors alive, and it makes a lot more sense to me than a diet based on things like low-fat milk, cereal and processed soy burgers.
JONNY BOWDEN, PhD, CNS Board-certified nutrition specialist, motivational speaker, author and expert in the areas of weight loss and health.