Paleolithic Diet Abstracts 1

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The 'carnivore connection'--evolutionary aspects of insulin resistance
            (Colagiuri and Brand Miller, 2002) Download
Insulin resistance is common and is determined by physiological (aging, physical fitness), pathological (obesity) and genetic factors. The metabolic compensatory response to insulin resistance is hyperinsulinaemia, the primary purpose of which is to maintain normal glucose tolerance. The 'carnivore connection' postulates a critical role for the quantity of dietary protein and carbohydrate and the change in the glycaemic index of dietary carbohydrate in the evolution of insulin resistance and hyperinsulinaemia. Insulin resistance offered survival and reproductive advantages during the Ice Ages which dominated human evolution, during which a high-protein low-carbohydrate diet was consumed. Following the end of the last Ice Age and the advent of agriculture, dietary carbohydrate increased. Although this resulted in a sharp increase in the quantity of carbohydrate consumed, these traditional carbohydrate foods had a low glycaemic index and produced only modest increases in plasma insulin. The industrial revolution changed the quality of dietary carbohydrate. The milling of cereals made starch more digestible and postprandial glycaemic and insulin responses increased 2-3 fold compared with coarsely ground flour or whole grains. This combination of insulin resistance and hyperinsulinaemia is a common feature of many modern day diseases. Over the last 50 y the explosion of convenience and takeaway 'fast foods' has exposed most populations to caloric intakes far in excess of daily energy requirements and the resulting obesity has been a major factor in increasing the prevalence of insulin resistance.

Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets
            (Cordain et al., 2000) Download
Both anthropologists and nutritionists have long recognized that the diets of modern-day hunter-gatherers may represent a reference standard for modern human nutrition and a model for defense against certain diseases of affluence. Because the hunter-gatherer way of life is now probably extinct in its purely un-Westernized form, nutritionists and anthropologists must rely on indirect procedures to reconstruct the traditional diet of preagricultural humans. In this analysis, we incorporate the most recent ethnographic compilation of plant-to-animal economic subsistence patterns of hunter-gatherers to estimate likely dietary macronutrient intakes (% of energy) for environmentally diverse hunter-gatherer populations. Furthermore, we show how differences in the percentage of body fat in prey animals would alter protein intakes in hunter-gatherers and how a maximal protein ceiling influences the selection of other macronutrients. Our analysis showed that whenever and wherever it was ecologically possible, hunter-gatherers consumed high amounts (45-65% of energy) of animal food. Most (73%) of the worldwide hunter-gatherer societies derived >50% (> or =56-65% of energy) of their subsistence from animal foods, whereas only 14% of these societies derived >50% (> or =56-65% of energy) of their subsistence from gathered plant foods. This high reliance on animal-based foods coupled with the relatively low carbohydrate content of wild plant foods produces universally characteristic macronutrient consumption ratios in which protein is elevated (19-35% of energy) at the expense of carbohydrates (22-40% of energy).

Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease
            (Cordain et al., 2002b) Download
HYPOTHESES: Consumption of wild ruminant fat represented the primary lipid source for pre-agricultural humans. Hence, the lipid composition of these animals' tissues may provide insight into dietary requirements that offer protection from chronic disease in modern humans. METHOD: We examined the lipid composition of muscle, brain, marrow and subcutaneous adipose tissue (AT) from 17 elk (Cervus elaphus), 15 mule deer (Odocoileus hemionus), and 17 antelope (Antilicapra americana) and contrasted them to wild African ruminants and pasture and grain-fed cattle. RESULTS: Muscle fatty acid (FA) was similar among North American species with polyunsaturated fatty acids/saturated fatty acids (P/S) values from 0.80 to 1.09 and n-6/n-3 FA from 2.32 to 2.60. Marrow FA was similar among North American species with high levels (59.3-67.0%) of monounsaturated FA; a low P/S (0.24-0.33), and an n-6/n-3 of 2.24-2.88. Brain had the lowest n-6/n-3 (1.20-1.29), the highest concentration of 22:6 n-3 (elk, 8.90%; deer, 9.62%; antelope, 9.25%) and a P/S of 0.69. AT had the lowest P/S (0.05-0.09) and n-6/n-3 (2.25-2.96). Conjugated linoleic acid (CLA) isomers were found in marrow of antelope (1.5%), elk (1.0%) and deer (1.0%), in AT (deer, 0.3%; antelope, 0.3%) in muscle (antelope, 0.4%; elk, trace), but not in brain. CONCLUSIONS: Literature comparisons showed tissue lipids of North American and African ruminants were similar to pasture-fed cattle, but dissimilar to grain-fed cattle. The lipid composition of wild ruminant tissues may serve as a model for dietary lipid recommendations in treating and preventing chronic disease.


The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic
            (Cordain et al., 2002a) Download
OBJECTIVE: Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). Consequently, the characterization of HG diets may have important implications in designing therapeutic diets that reduce the risk for CVD in Westernized societies. Based upon limited ethnographic data (n=58 HG societies) and a single quantitative dietary study, it has been commonly inferred that gathered plant foods provided the dominant energy source in HG diets. METHOD AND RESULTS: In this review we have analyzed the 13 known quantitative dietary studies of HG and demonstrate that animal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). This data is consistent with a more recent, comprehensive review of the entire ethnographic data (n=229 HG societies) that showed the mean subsistence dependence upon gathered plant foods was 32%, whereas it was 68% for animal foods. Other evidence, including isotopic analyses of Paleolithic hominid collagen tissue, reductions in hominid gut size, low activity levels of certain enzymes, and optimal foraging data all point toward a long history of meat-based diets in our species. Because increasing meat consumption in Western diets is frequently associated with increased risk for CVD mortality, it is seemingly paradoxical that HG societies, who consume the majority of their energy from animal food, have been shown to be relatively free of the signs and symptoms of CVD. CONCLUSION: The high reliance upon animal-based foods would not have necessarily elicited unfavorable blood lipid profiles because of the hypolipidemic effects of high dietary protein (19-35% energy) and the relatively low level of dietary carbohydrate (22-40% energy). Although fat intake (28-58% energy) would have been similar to or higher than that found in Western diets, it is likely that important qualitative differences in fat intake, including relatively high levels of MUFA and PUFA and a lower omega-6/omega-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD.


Origins and evolution of the Western diet: health implications for the 21st century
            (Cordain et al., 2005) Download
There is growing awareness that the profound changes in the environment (eg, in diet and other lifestyle conditions) that began with the introduction of agriculture and animal husbandry approximately 10000 y ago occurred too recently on an evolutionary time scale for the human genome to adjust. In conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural, and activity patterns of contemporary Western populations, many of the so-called diseases of civilization have emerged. In particular, food staples and food-processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered 7 crucial nutritional characteristics of ancestral hominin diets: 1) glycemic load, 2) fatty acid composition, 3) macronutrient composition, 4) micronutrient density, 5) acid-base balance, 6) sodium-potassium ratio, and 7) fiber content. The evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization.

Origins and evolution of the Western diet: implications of iodine and seafood intakes for the human brain
            (Cunnane, 2005) Download
Cordain et al (1) are to be congratulated on a succinct and topical overview, recently published in the Journal, of the perils of a West- ernized diet with respect to the risk of chronic degenerative diseases in humans. Indeed, there is widespread support for reinstituting several aspects of the so-called Paleolithic diet, especially higher fiber and lower content of refined, adulterated, or synthetic constit- uents. However, the authors do not seem to have made reference in their article to the effect of diet on a defining feature of modern humans—namely, the brain—whether that effect is related to brain development, advanced brain function, or risk of degenerative brain disease. Several micronutrients are discussed, but iodine seems to have been overlooked, despite the fact that it is 1 of the 2 nutrients (the other is iron) from which humans globally are considered to suffer the most common deficiency (2).

Paleolithic vs. modern diets--selected pathophysiological implications
            (Eaton and Eaton, 2000) Download
The nutritional patterns of Paleolithic humans influenced genetic evolution during the time segment within which defining characteristics of contemporary humans were selected. Our genome can have changed little since the beginnings of agriculture, so, genetically, humans remain Stone Agers--adapted for a Paleolithic dietary regimen. Such diets were based chiefly on wild game, fish and uncultivated plant foods. They provided abundant protein; a fat profile much different from that of affluent Western nations; high fibre; carbohydrate from fruits and vegetables (and some honey) but not from cereals, refined sugars and dairy products; high levels of micronutrients and probably of phytochemicals as well. Differences between contemporary and ancestral diets have many pathophysiological implications. This review addresses phytochemicals and cancer; calcium, physical exertion, bone mineral density and bone structural geometry; dietary protein, potassium, renal acid secretion and urinary calcium loss; and finally sarcopenia, adiposity, insulin receptors and insulin resistance. While not, yet, a basis for formal recommendations, awareness of Paleolithic nutritional patterns should generate novel, testable hypotheses grounded in evolutionary theory and it should dispel complacency regarding currently accepted nutritional tenets.

Diet-dependent acid load, Paleolithic [corrected] nutrition, and evolutionary health promotion
            (Eaton et al., 2010) Download

The article by Stro ̈hle et al (1) in this issue of the Journal significantly furthers appreciation of our remote ancestors’ nu- tritional milieu. Such insight has potential biomedical signifi- cance because nearly all the genes and epigenetic regulatory mechanisms we carry today were originally selected for behav- iorally modern humans who appeared in Africa between 100,000 and 50,000 y ago. Genetic evolution during subsequent millennia has continued, as shown by pigmentation changes (hair, eyes, skin), intestinal lactase retention beyond infancy, and adaptive defenses against microorganisms (eg, hemoglobin- opathies and immune system adaptations). However, core bio- chemical and physiologic processes have been preserved (2). Accordingly, it can be argued that the typical diet, physical activity patterns, and body composition of late Paleolithic hu- mans remain normative for contemporary humans—and models for disease-prevention recommendations.

Effect of intermittent fasting and refeeding on insulin action in healthy men
            (Halberg et al., 2005) Download
Insulin resistance is currently a major health problem. This may be because of a marked decrease in daily physical activity during recent decades combined with constant food abundance. This lifestyle collides with our genome, which was most likely selected in the late Paleolithic era (50,000-10,000 BC) by criteria that favored survival in an environment characterized by fluctuations between periods of feast and famine. The theory of thrifty genes states that these fluctuations are required for optimal metabolic function. We mimicked the fluctuations in eight healthy young men [25.0 +/- 0.1 yr (mean +/- SE); body mass index: 25.7 +/- 0.4 kg/m(2)] by subjecting them to intermittent fasting every second day for 20 h for 15 days. Euglycemic hyperinsulinemic (40 mU.min(-1).m(-2)) clamps were performed before and after the intervention period. Subjects maintained body weight (86.4 +/- 2.3 kg; coefficient of variation: 0.8 +/- 0.1%). Plasma free fatty acid and beta-hydroxybutyrate concentrations were 347 +/- 18 and 0.06 +/- 0.02 mM, respectively, after overnight fast but increased (P < 0.05) to 423 +/- 86 and 0.10 +/- 0.04 mM after 20-h fasting, confirming that the subjects were fasting. Insulin-mediated whole body glucose uptake rates increased from 6.3 +/- 0.6 to 7.3 +/- 0.3 mg.kg(-1).min(-1) (P = 0.03), and insulin-induced inhibition of adipose tissue lipolysis was more prominent after than before the intervention (P = 0.05). After the 20-h fasting periods, plasma adiponectin was increased compared with the basal levels before and after the intervention (5,922 +/- 991 vs. 3,860 +/- 784 ng/ml, P = 0.02). This experiment is the first in humans to show that intermittent fasting increases insulin-mediated glucose uptake rates, and the findings are compatible with the thrifty gene concept.

A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs
            (Jonsson et al., 2006) Download
BACKGROUND: A Paleolithic diet has been suggested to be more in concordance with human evolutionary legacy than a cereal based diet. This might explain the lower incidence among hunter-gatherers of diseases of affluence such as type 2 diabetes, obesity and cardiovascular disease. The aim of this study was to experimentally study the long-term effect of a Paleolithic diet on risk factors for these diseases in domestic pigs. We examined glucose tolerance, post-challenge insulin response, plasma C-reactive protein and blood pressure after 15 months on Paleolithic diet in comparison with a cereal based swine feed. METHODS: Upon weaning twenty-four piglets were randomly allocated either to cereal based swine feed (Cereal group) or cereal free Paleolithic diet consisting of vegetables, fruit, meat and a small amount of tubers (Paleolithic group). At 17 months of age an intravenous glucose tolerance test was performed and pancreas specimens were collected for immunohistochemistry. Group comparisons of continuous variables were made by use of the t-test. P < 0.05 was chosen for statistical significance. Simple and multivariate correlations were evaluated by use of linear regression analysis. RESULTS: At the end of the study the Paleolithic group weighed 22% less and had 43% lower subcutaneous fat thickness at mid sternum. No significant difference was seen in fasting glucose between groups. Dynamic insulin sensitivity was significantly higher (p = 0.004) and the insulin response was significantly lower in the Paleolithic group (p = 0.001). The geometric mean of C-reactive protein was 82% lower (p = 0.0007) and intra-arterial diastolic blood pressure was 13% lower in the Paleolithic group (p = 0.007). In evaluations of multivariate correlations, diet emerged as the strongest explanatory variable for the variations in dynamic insulin sensitivity, insulin response, C-reactive protein and diastolic blood pressure when compared to other relevant variables such as weight and subcutaneous fat thickness at mid sternum. There was no obvious immunohistochemical difference in pancreatic islets between the groups, but leukocytes were clearly more frequent in sampled pancreas from the Cereal group. CONCLUSION: This study in domestic pigs suggests that a Paleolithic diet conferred higher insulin sensitivity, lower C-reactive protein and lower blood pressure when compared to a cereal based diet.

Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study
            (Jonsson et al., 2009) Download
BACKGROUND: Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin. METHODS: In a randomized cross-over study, 13 patients with type 2 diabetes, 3 women and 10 men, were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; and a Diabetes diet designed in accordance with dietary guidelines during two consecutive 3-month periods. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records. RESULTS: Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI = 50) than in the Diabetic diet (GI = 55). CONCLUSION: Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes.


The critical role played by animal source foods in human (Homo) evolution
            (Milton, 2003) Download
Wild primates take most of the daily diet from plant sources, eating moderate to small amounts of animal source foods (ASF). Plant materials make up from 87% to >99% of the annual diet of great apes, the closest living relatives of modern humans (Homo sapiens sapiens). Reflecting their close genetic relationship, gut form and nutrient requirements of apes and humans (Hominoidea) are very similar, as is their pattern of digestive kinetics-one predicated on a relatively slow turnover of ingesta. In plant-eating mammals, in contrast to carnivorous mammals, greater body size is associated with lower dietary quality. Turning to ASF as a routine rather than occasional dietary component would have permitted the evolving human lineage to evade the nutritional constraints placed on body size increases in apes. Without routine access to ASF, it is highly unlikely that evolving humans could have achieved their unusually large and complex brain while simultaneously continuing their evolutionary trajectory as large, active and highly social primates. As human evolution progressed, young children in particular, with their rapidly expanding large brain and high metabolic and nutritional demands relative to adults would have benefited from volumetrically concentrated, high quality foods such as meat. Today, many humans, particularly those in high income nations, have a variety of high quality, non-ASF dietary alternatives, but such foods were not generally available to paleolithic human ancestors nor to many people today in low income nations.

Relationship and interaction between sodium and potassium
            (Morris et al., 2006) Download
Compared with the Stone Age diet, the modern human diet is both excessive in NaCl and deficient in fruits and vegetables which are rich in K+ and HCO3- -yielding organates like citrate. With the modern diet, the K+/Na+ ratio and the HCO3-/Cl- ratio have both become reversed. Yet, the biologic machinery that evolved to process these dietary electrolytes remains largely unchanged, genetically fixed in Paleolithic time. Thus, the electrolytic mix of the modern diet is profoundly mismatched to its processing machinery. Dietary potassium modulates both the pressor and hypercalciuric effects of the modern dietary excess of NaCl. A marginally deficient dietary intake of potassium amplifies both of these effects, and both effects are dose-dependently attenuated and may be abolished either with dietary potassium or supplemental KHCO3. The pathogenic effects of a dietary deficiency of potassium amplify, and are amplified by, those of a dietary excess of NaCl and in some instances a dietary deficiency of bicarbonate precursors. Thus, in those ingesting the modern diet, it may not be possible to discern which of these dietary electrolytic dislocations is most determining of salt-sensitive blood pressure and hypercalciuria, and the hypertension, kidney stones, and osteoporosis they may engender. Obviously abnormal plasma electrolyte concentrations rarely characterize these dietary electrolytic dislocations, and when either dietary potassium or supplemental KHCO3 corrects the pressor and hypercalciuric effects of these dislocations, the plasma concentrations of sodium, potassium, bicarbonate and chloride change little and remain well within the normal range.

Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer
            (O'Keefe and Cordain, 2004) Download
Our genetic make-up, shaped through millions of years of evolution, determines our nutritional and activity needs. Although the human genome has remained primarily unchanged since the agricultural revolution 10,000 years ago, our diet and lifestyle have become progressively more divergent from those of our ancient ancestors. Accumulating evidence suggests that this mismatch between our modern diet and lifestyle and our Paleolithic genome is playing a substantial role in the ongoing epidemics of obesity, hypertension, diabetes, and atherosclerotic cardiovascular disease. Until 500 generations ago, all humans consumed only wild and unprocessed food foraged and hunted from their environment. These circumstances provided a diet high in lean protein, polyunsaturated fats (especially omega-3 [omega-3] fatty acids), monounsaturated fats, fiber, vitamins, minerals, antioxidants, and other beneficial phytochemicals. Historical and anthropological studies show hunter-gatherers generally to be healthy, fit, and largely free of the degenerative cardiovascular diseases common in modern societies. This review outlines the essence of our hunter-gatherer genetic legacy and suggests practical steps to re-align our modern milieu with our ancient genome in an effort to improve cardiovascular health.

The western lowland gorilla diet has implications for the health of humans and other hominoids
            (Popovich et al., 1997) Download
We studied the western lowland gorilla diet as a possible model for human nutrient requirements with implications for colonic function. Gorillas in the Central African Republic were identified as consuming over 200 species and varieties of plants and 100 species and varieties of fruit. Thirty-one of the most commonly consumed foods were collected and dried locally before shipping for macronutrient and fiber analysis. The mean macronutrient concentrations were (mean +/- SD, g/100 g dry basis) fat 0.5 +/- 0.4, protein 11.8 +/- 8.2, available carbohydrate 7.7 +/- 6.3 and dietary fiber 74.0 +/- 12.9. Assuming that the macronutrient profile of these foods was reflective of the whole gorilla diet and that dietary fiber contributed 6.28 kJ/g (1.5 kcal/g), then the gorilla diet would provide 810 kJ (194 kcal) metabolizable energy per 100 g dry weight. The macronutrient profile of this diet would be as follows: 2.5% energy as fat, 24.3% protein, 15.8% available carbohydrate, with potentially 57.3% of metabolizable energy from short-chain fatty acids (SCFA) derived from colonic fermentation of fiber. Gorillas would therefore obtain considerable energy through fiber fermentation. We suggest that humans also evolved consuming similar high foliage, high fiber diets, which were low in fat and dietary cholesterol. The macronutrient and fiber profile of the gorilla diet is one in which the colon is likely to play a major role in overall nutrition. Both the nutrient and fiber components of such a diet and the functional capacity of the hominoid colon may have important dietary implications for contemporary human health.

Paleolithic diet, sweet potato eaters, and potential renal acid load
            (Remer and Manz, 2003) Download

Stable isotope evidence for increasing dietary breadth in the European mid-Upper Paleolithic
            (Richards et al., 2001) Download
New carbon and nitrogen stable isotope values for human remains dating to the mid-Upper Paleolithic in Europe indicate significant amounts of aquatic (fish, mollusks, and/or birds) foods in some of their diets. Most of this evidence points to exploitation of inland freshwater aquatic resources in particular. By contrast, European Neandertal collagen carbon and nitrogen stable isotope values do not indicate significant use of inland aquatic foods but instead show that they obtained the majority of their protein from terrestrial herbivores. In agreement with recent zooarcheological analyses, the isotope results indicate shifts toward a more broad-spectrum subsistence economy in inland Europe by the mid-Upper Paleolithic period, probably associated with significant population increases.

Thirty years on the "broad spectrum revolution" and paleolithic demography
            (Stiner, 2001) Download
All Paleolithic hominids lived by hunting and collecting wild foods, an aspect of existence that began to disappear only with the emergence of the farming and herding societies of the Neolithic.

Cooperative hunting and meat sharing 400-200 kya at Qesem Cave, Israel
            (Stiner et al., 2009) Download
Zooarchaeological research at Qesem Cave, Israel demonstrates that large-game hunting was a regular practice by the late Lower Paleolithic period. The 400- to 200,000-year-old fallow deer assemblages from this cave provide early examples of prime-age-focused ungulate hunting, a human predator-prey relationship that has persisted into recent times. The meat diet at Qesem centered on large game and was supplemented with tortoises. These hominins hunted cooperatively, and consumption of the highest quality parts of large prey was delayed until the food could be moved to the cave and processed with the aid of blade cutting tools and fire. Delayed consumption of high-quality body parts implies that the meat was shared with other members of the group. The types of cut marks on upper limb bones indicate simple flesh removal activities only. The Qesem cut marks are both more abundant and more randomly oriented than those observed in Middle and Upper Paleolithic cases in the Levant, suggesting that more (skilled and unskilled) individuals were directly involved in cutting meat from the bones at Qesem Cave. Among recent humans, butchering of large animals normally involves a chain of focused tasks performed by one or just a few persons, and butchering guides many of the formalities of meat distribution and sharing that follow. The results from Qesem Cave raise new hypotheses about possible differences in the mechanics of meat sharing between the late Lower Paleolithic and Middle Paleolithic.

 

 


References

Colagiuri, S. and J. Brand Miller (2002), ‘The ‘carnivore connection’--evolutionary aspects of insulin resistance’, Eur J Clin Nutr, 56 Suppl 1 S30-5. PubMed: 11965520
Cordain, L., et al. (2000), ‘Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets’, Am J Clin Nutr, 71 (3), 682-92. PubMed: 10702160
Cordain, L., et al. (2002a), ‘The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic’, Eur J Clin Nutr, 56 Suppl 1 S42-52. PubMed: 11965522
Cordain, L., et al. (2002b), ‘Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease’, Eur J Clin Nutr, 56 (3), 181-91. PubMed: 11960292
Cordain, L., et al. (2005), ‘Origins and evolution of the Western diet: health implications for the 21st century’, Am J Clin Nutr, 81 (2), 341-54. PubMed: 15699220
Cunnane, S. C. (2005), ‘Origins and evolution of the Western diet: implications of iodine and seafood intakes for the human brain’, Am J Clin Nutr, 82 (2), 483; author reply 483-4. PubMed: 16087997
Eaton, S. B. and S. B. Eaton, 3rd (2000), ‘Paleolithic vs. modern diets--selected pathophysiological implications’, Eur J Nutr, 39 (2), 67-70. PubMed: 10918987
Eaton, S. B., M. J. Konner, and L. Cordain (2010), ‘Diet-dependent acid load, Paleolithic [corrected] nutrition, and evolutionary health promotion’, Am J Clin Nutr, 91 (2), 295-97. PubMed: 20042522
Halberg, N., et al. (2005), ‘Effect of intermittent fasting and refeeding on insulin action in healthy men’, J Appl Physiol, 99 (6), 2128-36. PubMed: 16051710
Jonsson, T., et al. (2006), ‘A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs’, Nutr Metab (Lond), 3 39. PubMed: 17081292
Jonsson, T., et al. (2009), ‘Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study’, Cardiovasc Diabetol, 8 35. PubMed: 19604407
Milton, K. (2003), ‘The critical role played by animal source foods in human (Homo) evolution’, J Nutr, 133 (11 Suppl 2), 3886S-92S. PubMed: 14672286
Morris, R. C., Jr., et al. (2006), ‘Relationship and interaction between sodium and potassium’, J Am Coll Nutr, 25 (3 Suppl), 262S-70S. PubMed: 16772638
O’Keefe, J. H., Jr. and L. Cordain (2004), ‘Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer’, Mayo Clin Proc, 79 (1), 101-8. PubMed: 14708953
Popovich, D. G., et al. (1997), ‘The western lowland gorilla diet has implications for the health of humans and other hominoids’, J Nutr, 127 (10), 2000-5. PubMed: 9311957
Remer, T. and F. Manz (2003), ‘Paleolithic diet, sweet potato eaters, and potential renal acid load’, Am J Clin Nutr, 78 (4), 802-3; author reply 803. PubMed: 14522740
Richards, M. P., et al. (2001), ‘Stable isotope evidence for increasing dietary breadth in the European mid-Upper Paleolithic’, Proc Natl Acad Sci U S A, 98 (11), 6528-32. PubMed: 11371652
Stiner, M. C. (2001), ‘Thirty years on the “broad spectrum revolution” and paleolithic demography’, Proc Natl Acad Sci U S A, 98 (13), 6993-96. PubMed: 11390968
Stiner, M. C., R. Barkai, and A. Gopher (2009), ‘Cooperative hunting and meat sharing 400-200 kya at Qesem Cave, Israel’, Proc Natl Acad Sci U S A, 106 (32), 13207-12. PubMed: 19666542