by John Peldyak, DDS
The newest way of eating is the oldest. What does it mean for our dental health?
The SAD Experience
The motives were noble. There had to be new ways
to supply food for a burgeoning population. Thanks to
mechanized agriculture and technology we can now
grow, fractionate, refine and recombine high-yield
foods into irresistible, some say downright addictive,
food-like products. Modern industrial food production
has become so successful that now its biggest challenge
is finding new ways to make "reduced calorie" foods.
Since World War II, the United States has taken the
lead in food technologies that supply an overabundance
of tasty calories while holding costs down.
But the Standard American Diet (SAD) is loaded
with high-calorie saturated fat, vegetable oils, processed
foods and sugar, leaving us overfed yet undernourished.
The SAD has been ridiculed for decades as the
junk food, fast food, refined food diet that makes
Americans fat and sick. Over two-thirds of Americans
are overweight, one-third are considered obese.
And the rest of the world is rapidly catching up.
In recent years, the SAD has spread into the Western
Industrial Diet (WID) and now more universally
morphed into the Worldwide Industrial Diet
(WWID). This WWID is firmly taking hold in most
urbanized, industrialized parts of the world, replacing
traditional foods with enticing mass-produced
calories. The high-calorie, low-nutrient WWID has
been linked to many diseases of civilization. The
United States is a leading indicator with a sharply
increasing incidence of obesity, diabetes and cardiovascular
disease. Other developed countries are following
the same pattern. Alarmingly, some of these
degenerative diseases are relentlessly creeping down
into younger age groups. The increasingly unaffordable
pharmaceutical, medical and dental establishments
struggle to keep pace with diet-induced
damage. Coupled with the WWID, a sedentary
indoor lifestyle under fluorescent lights contributes to chronic stress, low levels of physical strength, impaired sleep
patterns, and abuse of alcohol, drugs and food.
Where Did We Go Wrong?
Evolutionary anthropologists say we are genetically adapted
to the diet of our Paleolithic (Stone Age) ancestors. For more
than a million years humans were hunter-gatherers. Early use of
tools was to break bones to extract marrow and get omega-3
fatty acids, such as DHA critical for brain development. We
only began to organize settlements and agriculture around
10,000 years ago. Increasing cultivation of cereal grains supported
cities with larger populations. Establishing trade routes
helped to spread varieties of local food sources, such as sugar
cane from India to the Middle East. The Industrial Revolution
began to drive more agricultural mechanization and food technology
in efforts to create abundant affordable foods with
greater storage life. The 1800s brought us low-cost refined
flour, sugar, canned foods and bottled soft drinks that could
easily be transported and stored. Hydrogenated vegetable
oils, margarine and vegetable shortening were on the market
by the early 1900s.
The benefits, comforts and convenience of modern civilization
come with a high cost. Along with greater reliance on refined flour, sugar and vegetable oils, came the chronic degenerative
"Diseases of Civilization." Health authorities began to notice
more cases of bone deformities, obesity, digestive complaints and
overall physical degeneration, which now we would associate with
chronic inflammation or vitamin/mineral deficiencies.
Diet and Dental
It was also noted that when traditional cultures adopted the
new Western-style diet, their health and the health of their offspring
rapidly deteriorated. This was particularly apparent with
their oral structures. During the 1920s, Drs. Edward and May
Mellanby investigated the connection between diets and dental
health. They concluded that corn and wheat contain anti-nutrients
(phytates) that lock up minerals, and could cause even more
demineralization than sugar. They recognized the profound
importance of vitamin D for healthy teeth. Their recommendation
was a "tooth decay reversal diet" that eliminated grains but
supplemented with dairy calcium and vitamin D.
Around the same time Dr. Weston Price, a Cleveland dentist,
traveled around the world studying traditional diets and
dental health. Again and again he noted the ideal teeth and
broad dental arches in diverse cultures eating a variety of traditional
foods. As the younger generations adopted Westernized foods, flour and sugar, they developed dental problems. Dental
caries, gingival inflammation, crowded teeth, impacted third
molars and malocclusions became prevalent. After analyzing
these diets, Dr. Price realized there is another critical factor, later
identified as vitamin K2, necessary for proper development of
teeth and jawbones. Dr. Price published his results in 1938.
World War II, with food rationing and sugar shortages, diminished
the impact of these important findings.
Subsequent researchers have noted a shift from broad Ushaped
dental arches to crowded V-shaped arches with a generation
or two of exposure to the WWID. They agree that many
dental problems, including malocclusions, are not necessarily
genetic but more commonly diet-related, along with those other
recognized "Diseases of Civilization."
Problems with WWID
Early transitions from hunter-gatherer to settlements
dependent on agriculture began around 10,000 years ago. But
many of the profound dietary shifts are very recent. The last 200
years have brought us refined sugar, refined flour, canned foods,
carbonated soft drinks, polyunsaturated vegetable seed oils
(processed with hydrogen creating artificial trans fats), margarine,
vegetable shortening, fast foods, grain-fed livestock in
feedlots, high fructose corn syrup, engineered snack foods and a
host of artificial ingredients.
The result is a diet far removed from our hunter-gatherer
roots. Most WWID calories are from sources that would be
scarce or non-existent to our ancestors (grains, sugars, oils). The
WWID promotes insulin-resistance with overloads of harmful
sugars and fats. As cells become less sensitive to insulin, blood
sugar is not cleared effectively after eating. Excess sugars, particularly
fructose, are readily converted into fat. Sedentary inactivity
while frequently ingesting fast-acting starch (glucose polymer
readily broken into monosaccharides), sucrose sugar (glucose/
fructose) and high fructose corn syrup (HFCS, glucose and even
more fructose), wears out the insulin receptors. At toxic levels
sugars readily stick to proteins producing advanced glycation
end products (AGEs). Normal structure and function degenerate
as AGEs accumulate.
Hefty loads of saturated fats (particularly palmitic acid) and
artificial trans fats contribute to insulin-resistance. Over time,
insulin-resistance becomes worse, leading to metabolic syndrome.
This is a cluster of abnormal markers such as elevated blood sugar,
hypertension, high LDL with low HDL cholesterol, and the
dreaded belly fat or central visceral adiposity (a quick check is
waist circumference >40 inches for males, >35 inches for females).
The WWID is pro-inflammatory. The unsaturated fatty acid
profile is overloaded with (pro-inflammatory) omega-6 fatty
acids almost 20 to one over (anti-inflammatory) omega-3 fatty
acids, whereas the ideal ratio should be closer to even. The
polyunsaturated seed oils are easily damaged by heat or oxidation.
When stabilized by hydrogenation, trans fats are created. Artificial trans fats are believed to be particularly dangerous.
Grain-fed fattened livestock develops a similar deranged lipid
profile: a high omega-6 to omega-3 ratio along with large
amounts of saturated fat rich in (pro-inflammatory) palmitic
acid. (A newly recognized omega-7 fatty acid, palmitoleic acid,
is a promising counterbalance.)
On top of all this, the WWID fails to supply optimum or
adequate amounts of important nutrients. Calories can be excessive
while minerals, vitamins, antioxidants and essential fatty
acids can be extremely low. Taken together, the WWID creates
a pattern of hormone disruption and inflammation leading to
those chronic degenerative "Diseases of Civilization" such as
allergies, osteoporosis, gout, diabetes, some types of cancers, and
digestive and cardiovascular diseases.
Re-enter the Paleo Diet
Physical degeneration has been noted repeatedly in cultures
transitioning to the WWID. How about the reverse? In 1982 a
group of urbanized aboriginal Australians returned to the bush,
accompanied by nutrition researcher Kerin O'Dea. After only
seven weeks back on their traditional diet, the group lost an average
of 18 pounds with a vast improvement in blood pressure,
blood sugar and insulin-resistance. Their plasma lipids (cholesterol,
triglycerides, and omega ratios) completely normalized.
Many people would prefer to maintain comforts and convenience
of civilization but enjoy the physical health and
strength of ancestral hunter-gatherers. There is no way of determining
or duplicating exactly the "authentic" Paleolithic diet.
Besides, most of the harmful components of the WWID are
recent developments. Why go all the way back to 30,000 BC?
Most "Paleos" are flexible, and there are many variations with
"diet" names such as Caveman, Ancestral, Stone Age, Primal,
Evolutionary or Traditional. We can roll these into one theme,
the "Modified" or "Modern" Paleolithic Diet - MPD.
In general, MPD recommends eating "real" foods more in
tune with our hunter-gatherer genetics. Paleolithic nutrition is a
return to our ancestral past and a more natural way of eating. At
the core are the foods that could be hunted and gathered in the
wild: meat, fish, fowl, eggs, vegetables, fruit, along with some nuts
and seeds. Basic Paleo guidelines eliminate or greatly reduce all
grains, lentils, added sugars, industrial seed oils (cottonseed, corn,
soy, safflower, etc.), dairy and processed foods. The MPD encourages
animal protein and fats (including organ meats) preferably
from pastured, free-range or wild-caught sources. These have a
more favorable balance of omega-3 fatty acids than confined feedlot,
grain-fed sources. Virgin, non-hydrogenated oils such as olive,
coconut and palm are more likely to be accepted. There are many
gray areas with the different versions of MPD. Most permit moderate
amounts of starchy carbohydrates from non-grain sources.
Some versions of MPD take traditional foods into account such as dairy and fermented foods. A few allow beans or lentils that
have been soaked or sprouted.
The MPD encompasses more than food selection.
Preparation in more traditional ways is respected. Slow cooking
of bone broths is obviously more "Paleo" than microwaving or
deep frying. Hunter-gatherers (particularly in temperate zones)
went through cycles of seasonal food availability, and even times
of "feast or famine." Modern Paleos sometimes try to emulate
this on a small scale, believing it promotes metabolic flexibility,
resets proper hormone signaling and develops ideal strength and
health. Some strategies include intermittent fasting (most religious
traditions include fasting) - voluntarily avoiding calories
for 24 hours once a week, or shrinking their "feeding window"
to eight hours in a day. This is believed to parallel a hunter-gatherer
having a large community meal with foodstuffs accumulated
throughout the day. The emphasis is on meals not snacks.
Every so often, there may be a special occasion where a large
"cheat meal" or feast is encouraged.
For exercise some Paleos favor increased small movements
and leisurely walking throughout the day, with occasional
"bursts" of all-out sprints or strength movements. Paleos like to
get outdoors and soak up some natural Vitamin D from the
sunshine. Claimed benefits of the Paleo lifestyle are improved
overall health, increased energy, fat loss, a more aesthetic body
composition, enhanced athletic performance, improved sleep
and better oral health.
The WWID brought unimagined abundance, convenience
and irresistible flavors. It also brought along the chronic degenerative
diseases of civilization. Often overlooked in this category
are dental diseases - caries, periodontal disease and malocclusion.
Early on, researchers recognized populations in transition
from caries-free teeth in broad, strong dental arches to crowded,
rotted teeth surrounded by inflamed tissue as they adopted
Western-style processed foods. It is time to rediscover the link
between diet and dental health.
It remains to be determined if following a Paleo-style diet will
gain traction and improve dental health. In the meantime, we can
continue our best efforts utilizing modern dental hygiene strategies.
The harmful dental effects of the WWID can be mitigated
to some extent with saliva stimulants that increase pH, such as
calcium-rich aged cheese, arginine-rich walnuts or 100 percent
xylitol-sweetened gum or candy after meals and snacks. This
helps to maintain a more "paleo" non-acidogenic microflora.
Nutritional supplements are available to balance omega fatty
acid ratios, and to provide vitamins such as D3 and K2 that
might be critically lacking during pregnancy and development.
It really all comes back to diet. If the Paleos are right, it comes
all the way back.