The Paleo approach to meal frequency

Furthering our discussion of postprandial (after-eating) phenomenona, including chylomicron and triglyceride "stacking" (Grazing is for cattle and Triglyceride and chylomicron stacking), here's a comment from the recent Palet Diet Newsletter on the closely related issue, meal timing and frequency:


We are currently in the process of compiling meal times and patterns in the worlds historically studied hunter-gatherers. If any single picture is beginning to emerge, it clearly is not three meals per day plus snacking ala the typical U.S. grazing pattern. Here are a few examples:

--The Ingalik Hunter Gatherers of Interior Alaska: 'As has been made clear, the principal meal and sometimes the only one of the day is eaten in the evening.'
--The Guayaki (Ache) Hunter Gatherers of Paraguay: 'It seems, however, that the evening meal is the most consistent of the day. This is understandable, since the day is generally spent hunting for food that will be eaten in the evening."
--The Kung Hunter Gatherers of Botswana. "Members move out of camp each day individually or in small groups to work through the surrounding range and return in the evening to pool the collected resources for the evening meal."
--Hawaiians, Tahitians, Fijians and other Oceanic peoples (pre-westernization). 'Typically, meals, as defined by Westerners, were consumed once or twice a day. . . Oliver (1989) described the main meal, usually freshly cooked, as generally eaten in the late afternoon after the day’s work was over."

The most consistent daily eating pattern that is beginning to emerge from the ethnographic literature in hunter-gatherers is that of a large single meal which was consumed in the late afternoon or evening. A midday meal or lunch was rarely or never consumed and a small breakfast (consisting of the remainders of the previous evening meal) was sometimes eaten. Some snacking may have occurred during daily gathering, however the bulk of the daily calories were taken in the late afternoon or evening. This pattern of eating could be described as intermittent fasting relative to the typical Western pattern, particularly when daily gathering or hunting were unsuccessful or marginal. There is wisdom in the ways of our hunter gatherer ancestors, and perhaps it is time to re-think three squares a day.



In other words, the notion of "grazing," or eating small meals or snacks throughout the day, is an unnatural situation. It is directly contrary to the evolutionarily more appropriate large meal followed by periods of no eating or small occasional meals.

I stress this point because I see that the notion of grazing has seized hold of many people's thinking. In my view, grazing is a destructive practice that is self-indulgent, unnecessary, and simply fulfills the perverse non-stop hunger impulse fueled by modern carbohydrate foods.

Eliminate wheat, cornstarch, and sugars and you will find that grazing is a repulsive impulse that equates with gorging.


The full-text of the Paleo Diet Newsletter can be obtained through www.ThePaleoDiet.com. You can also read and/or subscribe to the new Paleo Diet Blog, just launched in November, 2009.

Comments (12) -

  • Kevin

    11/24/2009 3:18:05 PM |

    I can't rememeber exactly when but several years ago a melting glacier uncovered a 5000 year old man in the Pyranees area. He was dubbed 'Oetzi'.  Since he carried a bow and arrow and kit with seeds he was certainly a hunter-gatherer.   It's logical that he was hunting and carried seeds to sustain him during the day.  But he died of an arrow attack so possibly he was killed for the game he had found, or perhaps by a tribe mate wanting to move up the social ladder.  Who knows.  

    kevin

  • Adolfo David

    11/24/2009 4:10:24 PM |

    And what about 3-4 small high fat (Omega 6 free) low carbs (no glycemic) meals during the day? Its for example my case

  • KENNY10021

    11/24/2009 5:23:26 PM |

    Plus grazing would result in higher levels of digestive acid present in the stomach more often. More acid, more often.......This too is unhealthy...is it not?

  • Richard Nikoley

    11/24/2009 7:58:11 PM |

    Excellent data, doc.

    I rarely eat anything big during the day, and almost never before 10am. It's now 12:00 noon and I'll be headed for an intense workout at 12:30 lasting for 30 minutes and will include a lot of pushing weight around. I may eat a bit in the afternoon, but most probably will have a large meal this evening.

    This approach has worked wonders in terms of body comp and especially, hunger. I'm just almost never ravenous as I was with all the junk, which I think is the root cause of the grazing dysfunction.

    Also, note that it's probably far easier for them to keep their minds off food when they're busy hunting and gathering it.

  • UofMWolverine81

    11/24/2009 9:54:10 PM |

    ting caught up on what meal frequency or timing is "best" and shift the focus toward ensuring an adequate micro and macronutrient intake that supports your goals and lifestyle?

    If I am highly active and making quality food choices that fall in line with that activity level, it seems like there wouldn't be anything inherently wrong with eating 4-6 small meals/snacks per day .  That's not to say that 1 or 2 relatively larger meals wouldn't work as well, but I can't see there being much overall difference provided overall daily intake is roughly equivalent (if not the same) and and the focus is on undamaged fat sources, lean protein sources, plenty of vegetables, and a modest intake of fruit (especially things like berries).

    Some folks find that various styles of intermittent fasting work best for them when it comes to controlling intake, and others have found that a higher number of smaller feedings work better. So while I do not dispute the wisdom in observing patterns from various hunter-gatherers, I don't feel that mirroring their patterns is something that fits my lifestyle and individual tendencies.

    Of course I could be living with my head in the sand and the joke is on me, but I figured I'd just offer up my general thoughts.  I am far from being an expert on these issues.

    In any event, thank you for sharing this post, Dr. Davis.

  • Helen

    11/25/2009 12:21:24 AM |

    I'm against grazing (especially since it's usually crap that people graze on), but I do have a question about this.  I recently read that the rate of strokes increases during Ramadan, which mirrors this pattern - a large evening meal every day.  

    http://www.thaindian.com/newsportal/world-news/does-ramadan-fasting-increase-risk-of-stroke_10038409.html

    My father used to just eat one big meal a day at night.  He had a massive heart attack in his 50s.  He ate a lot of meat, butter, eggs, and bacon grease.  I doubt that all of that caused it - I think the primary cause was his two-pack-a-day unfiltered Camels habit.  But all of that didn't prevent it, either.

  • The Mick Solomons Experiment

    11/25/2009 1:59:47 AM |

    I've found going down to 2 main meals a day, and only eating between 11am and 6pm that my body fat has dropped considerably.  

    I was stuck on about 70kgs for 12 months after starting a high fat, low carb diet, since I've started IF I've dropped nearly a kg of body fat a week for the past 6 weeks (you can see photos on my blog) And I know its body fat because I'm maintaining and even increasing the amount of weight i'm lifting at the gym.

    I also feel great too Smile

  • Kathryn

    11/25/2009 2:44:44 AM |

    Then, why the insistence, heard over & over that breakfast is so important?  My body just doesn't seem to want something early in the day, & i've been trying to trust instinct.  But then i wonder if it is just a habit i've gotten into?  

    I'm not eating a lot of calories & i eat no wheat (on rare occasion i break this, but have been 95% gluten-free for about 4 years or more).  But no weight loss.  I sometimes wonder if it is because i'm resistant to having breakfast.  

    I really don't understand.

  • PERKDOUG

    11/25/2009 4:18:43 PM |

    I borrow here from the Diabetes community. Blood sugar spikes may be the root cause of or a major contributor to Type 2 diabetes. The bigger the meal the bigger the spike. Most of us that have endured the SAD for most of our lives are well on our way to Type 2 (in my opinion) even after taking to the Low Carb WOE. Thus we are damaged goods and probably would be well advised that if we eat fewer meals per day, we should test the effects on our blood sugar. I do this. Blood meters are dirt cheap. Low carbing no doubt helps but does not assure "no spikes".

  • Methuselah

    12/3/2009 2:16:43 PM |

    Kathryn, the answer to your question "then why the insistence" is because the people who are doing the insisting are basing their advice on little or no real evidence, just pseudo science and old-wivery. Don't confuse exposure with validity. Bad ideas very often get more air time than good ones and the world of medicine and nutrition is rich with examples.

  • buy jeans

    11/3/2010 6:40:00 PM |

    I stress this point because I see that the notion of grazing has seized hold of many people's thinking. In my view, grazing is a destructive practice that is self-indulgent, unnecessary, and simply fulfills the perverse non-stop hunger impulse fueled by modern carbohydrate foods.

  • mike

    5/29/2012 7:35:12 PM |

    If the typical hunter-gatherer tribe eats only once a day and if humans can only absorb around 35g of protein at one time, this would mean that even H-Gs eating very high protein diets would ACTUALLY be on very low protein diets. This is huge no?

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Omega-3 MUST be from fish oil

Omega-3 MUST be from fish oil

Despite my rants in this blog and elsewhere, at least once a day I'll have a patient say, "I cut back (or eliminated) my fish oil because I get my omega-3s from _______ (insert your choice of flaxseed oil, walnuts, yogurt, mayonnaise, bread, etc.)."

(See prior Heart Scan Blog post: Everything has omega-3.)

When I point out to them that the "omega-3s" in these products are not the same as the EPA and DHA from fish oil, they invariably declare, "But it says so here on the label: 'Contains 200 mg of omega-3 fatty acids'!"

Apparently, some of my colleagues have even endorsed this concept of replacing the omega-3s from fish oil with these "alternatives."

It's simply not true. The linolenic acid that is being labeled as omega-3, while it may indeed provide health benefits of its own, cannot replace the EPA and DHA that fish oil provides.

The most graphic example of the differences between the two classes of oils is in people with a condition called familial hypertriglyceridemia. People with this condition have triglyceride levels of 400, 600, even thousands of mg/dl--very high. Fish oil, usually providing EPA and DHA doses of 1800 mg per day and higher, reduce triglycerides dramatically. A person with a starting triglyceride level of, say, 900 mg/dl, may take 2400 mg of EPA and DHA from fish oil and triglycerides plummet to 150 mg/dl. This person then decides to replace fish oil with a linolenic acid source like flaxseed oil. Triglycerides? 900 mg/dl--no effect whatsoever.

Familial hypertriglyceridemia represents an exagerrated example of the differences between the two oils. Even if you don't have this genetic condition, the differences between the oils still apply.

EPA and DHA are activators of the enzyme, lipoprotein lipase, that accelerates clearance of triglycerides from the blood. Linolenic acid from flaxseed oil, walnuts, and other food sources does not. EPA and DHA block after-eating (post-prandial) accumulation of food by-products that can contribute to coronary and carotid plaque. Linolenic acid does not. EPA and DHA block platelets, reduce fibrinogen, and exert other healthy blood clot-inhibiting effects. Linolenic does not.

The 11,000-participant GISSI-Prevenzione Trial that showed 28% reduction in heart attack, 45% reduction in cardiovascular death with omega-3s used . . . fish oil.

The 18,000 participant JELIS trial that showed 19% reduction in cardiovascular events when omega-3s were added to statin therapy used . . . fish oil. (Actually, in JELIS, they used only EPA wtihout DHA.)

Linolenic acid is not a waste, however. It may exert anti-inflammatory benefits of its own, for instance. But it exerts none of the triglyceride-modifying effects of EPA or DHA.

EPA and DHA from fish oil and linolenic acid from foods each provide benefits in their own way. Ideally, you include both forms of oils--fish oil and linolenic acid sources--in your daily diet and obtain full benefit from each separate class. But they are not interchangeable.


Copyright 2008 William Davis, MD

Comments (14) -

  • Michael

    3/7/2008 2:59:00 AM |

    Anyone have any experience using krill oil, and how does it compare to fish oil?

    As for other forms of omega-3s, isn't flax considered dangerous for men, due to ALA content? There are conflicting studies, but I recall at least one that said ALA caused a rise in the rate or prostate cancer.

  • Zubin

    3/7/2008 3:31:00 AM |

    Is there any way for a vegetarian to replace fish oil and get the same benefits?

  • Missbossy

    3/7/2008 5:01:00 AM |

    I am definitely down with the fact that Fish Oil is vastly superior to Flax Oil. I've seen quite a few people touting flax oil lately so I'm glad you put that to bed.

    Question: You mention recommended doses of EPA and DHA for those with elevated triglycerides. Can you offer any guidance for supplement levels when triglycerides aren't an issue? IE a level for good preventative nutrition? I've looked around and recommendations are all over the shop.

    Thanks.

  • Anonymous

    3/7/2008 12:53:00 PM |

    I've read a few other articles about the differences between fish oil omega-3s and other sources, but this article spells it out very clearly about how those differences apply directly to heart disease. I'll be printing this one for my family. Thanks!

    S

  • Anonymous

    3/7/2008 2:11:00 PM |

    Vegetarian DHA is available. It is cultured from algae. That's where the fish get. EPA may be available now too.

  • Anonymous

    3/7/2008 3:52:00 PM |

    zubin:

    There are vegetarian DHA/EPA supplements made from algae.

  • Liss

    3/8/2008 12:09:00 AM |

    Zubin, when I followed a vegetarian diet I was able to find DHA supplements derived from algae, but EPA is harder to come by.  V-Pure is the only one I found that contained both EPA and DHA.  The capsules are costly, but might be a good option for you if you aren't comfortable taking krill or fish oil.

  • Zubin

    3/9/2008 2:06:00 PM |

    Thanks all, I will look into the algae supplements!

  • Anonymous

    5/12/2008 1:03:00 PM |

    As a newcomer to your blog please forgive me if this topic has been brought up before.
    There is a scathing attack in an article by Ray Peat,a noted Biology professor, on the damaging effects of fish oil.
    A few people have stopped taking fish oil after reading the article.
    Can you please comment?
    http://raypeat.com/articles/articles/fishoil.shtml

  • Anonymous

    7/8/2008 4:05:00 AM |

    http://www.westonaprice.org/knowyourfats/essentialfattyaciddef.html
    A Reply to Ray Peat
    on Essential Fatty Acid Deficiency

    By Mary G. Enig, PhD

    Ray Peat, PhD, is an influential health writer who claims that there is no such thing as essential fatty acid (EFA) deficiency. According to Peat, the body can make its own EFAs; furthermore, he claims that EFAs in the body become rancid and therefore cause cancer.

    Unfortunately, Peat does not understand the use of EFA by the human body. He is trained in hormone therapy and his training in fats and oils has been limited to misinformation as far as the polyunsaturated fats and oils are concerned.

    Research on EFAs is voluminous and consistent: EFAs are types of fatty acids that the body cannot make, but must obtain from food. We do not make them because they exist in virtually all foods, and the body needs them only in small amounts. The body does make saturated and monounsaturated fatty acids because it needs these in large amounts and cannot count on getting all it needs from food.

    There are two types of EFAs, those of the omega-6 family and those of the omega-3 family. The basic omega-6 fatty acid is called linoleic acid and it contains two double bonds. It is found in virtually all foods, but especially in nuts and seeds. The basic omega-3 fatty acid is called linolenic acid and it contains three double bonds. It is found in some grains (such as wheat) and nuts (such as walnuts) as well as in eggs, organ meats and fish if these animals are raised naturally, and in green vegetables if the plants are raised organically.

    Essential fatty acids have two principal roles. The first is as a constituent of the cell membrane. Each cell in the body is surrounded by a membrane composed of billions of fatty acids. About half of these fatty acids are saturated or monounsaturated to provide stability to the membrane. The other half are polyunsaturated, mostly EFAs , which provide flexibility and participate in a number of biochemical processes. The other vital role for EFAs is as a precursor for prostaglandins or local tissue hormones, which control different physiological functions including inflammation and blood clotting.

    Scientists have induced EFA deficiency in animals by feeding them fully hydrogenated coconut oil as their only fat. (Full hydrogenation gets rid of all the EFAs; coconut oil is used because it is the only fat that can be fully hydrogenated and still be soft enough to eat.) The animals developed dry coats and skin and slowly declined in health, dying prematurely. (Interestingly, representatives of the vegetable oil industry blame the health problems on coconut oil, not on fatty acid deficiency!)

    In a situation of fatty acid deficiency, the body tries to compensate by producing a fatty acid called Mead acid out of the monounsaturated oleic acid. It is a 20-carbon fatty acid with three double bonds named after James Mead, a lipids researcher at the University of California at Los Angeles who first identified it. An elevated level of Mead acid in the body is a marker of EFA deficiency.

    According to Peat, elevated levels of Mead acid constitute proof that your body can make EFAs. However, the Mead acid acts as a "filler" fatty acid that cannot serve the functions that the original EFA are needed for. Peat claims that Mead acid has a full spectrum of protective anti-inflammatory effects; however, the body cannot convert Mead acid into the elongated fatty acids that the body needs for making the various anti-inflammatory prostaglandins.

    Peat also asserts that polyunsaturated fatty acids become rancid in our bodies. This is not true; the polyunsaturated fatty acids in our cell membranes go through different stages of controlled oxidation. To say that these fatty acids become "rancid" is misleading. Of course, EFAs can become rancid through high temperature processing and it is not healthy to consume these types of fats. But the EFAs that we take in through fresh, unprocessed food are not rancid and do not become rancid in the body. In small amounts, they are essential for good health. In large amounts, they can pose health problems which is why we need to avoid all the commercial vegetable oils containing high levels of polyunsaturates.

    Peat’s reasoning has led him to claim that cod liver oil causes cancer because cod liver oil contains polyunsaturated fatty acids. Actually, the main fatty acid in cod liver oil is a monounsaturated fatty acid. The two main polyunsaturated fatty acids in cod liver oil are the elongated omega-3 fatty acids called EPA and DHA, which play many vital roles in the body and actually can help protect against cancer. Furthermore, cod liver oil is our best dietary source of vitamins A and D, which also protect us against cancer.

    Actually, Peat’s argument that polyunsaturated fatty acids become harmful in the body and hence cause cancer simply does not make sense. It is impossible to avoid polyunsaturated fatty acids because they are in all foods.

    EFAs are, however, harmful in large amounts and the many research papers cited by Peat showing immune problems, increased cancer and premature aging from feeding of polyunsaturates simply corroborate this fact. But Peat has taken studies indicating that large amounts of EFAs are bad for us (a now well-established fact) and used them to argue that we don’t need any at all.

    Finally, it should be stressed that certain components of the diet actually reduce (but do not eliminate) our requirements for EFAs. The main one is saturated fatty acids which help us conserve EFAs and put them in the tissues where they belong. Some studies indicate that vitamin B6 can ameliorate the problems caused by EFA deficiency, possibly by helping us use them more efficiently.

    About the Author
    Mary G. Enig, PhDMary G. Enig, PhD is an expert of international renown in the field of lipid biochemistry. She has headed a number of studies on the content and effects of trans fatty acids in America and Israel, and has successfully challenged government assertions that dietary animal fat causes cancer and heart disease. Recent scientific and media attention on the possible adverse health effects of trans fatty acids has brought increased attention to her work. She is a licensed nutritionist, certified by the Certification Board for Nutrition Specialists, a qualified expert witness, nutrition consultant to individuals, industry and state and federal governments, contributing editor to a number of scientific publications, Fellow of the American College of Nutrition and President of the Maryland Nutritionists Association. She is the author of over 60 technical papers and presentations, as well as a popular lecturer. Dr. Enig is currently working on the exploratory development of an adjunct therapy for AIDS using complete medium chain saturated fatty acids from whole foods. She is Vice-President of the Weston A Price Foundation and Scientific Editor of Wise Traditions as well as the author of Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils, and Cholesterol, Bethesda Press, May 2000. She is the mother of three healthy children brought up on whole foods including butter, cream, eggs and meat.

    IMPORTANT CORRECTION

    In the Winter 2004 "Know Your Fats" column we stated that Siberian pinenut oil was a good source of gamma-linolenic acid (GLA). This was indicated from fatty acid analyses performed in Siberia. We have since performed further tests on the oil and found that it does not contain significant amounts of GLA but rather a fatty acid called pinoleic acid, an 18-carbon fatty acid with three double bonds but with the first double bond on the fifth carbon, not the sixth, as in GLA. We are sorry for any inconvenience this may have caused.

    http://www.westonaprice.org/knowyourfats/essentialfattyaciddef.html

  • Arlie

    6/5/2009 4:26:30 PM |

    I'm a 57 year old grandma and have been vegan for over 6 years. I've run 3 marathons since turning 50, but took at 18 month hiatus to care for a grandson.  I was slowly trying to get back into running by starting out with 20 min. jogs and 3 minutes of jumping rope. Last October I developed painful tendinitis in my knee...my M.D. encouraged me to try O.T.C. painkillers (aspirin, acetaminophen, and ibuprofen) and take glucosamine all to no avail...he sent me to a physical therapist who gave me a few exercises said I shouldn't run at all, ever...that he quit running at age 30 and advises walking only. At that point my doctor wanted to prescribe some NSAID and give me a 2nd prescription for something that would allow my stomach to handle the prescription NSAID.   Without my M.D.'s recommendation I went to an acupuncturist for 3 months...no luck there.  Then a few months ago, again without my M.D.'s referral, I went to a chiropractor.  Since I was vegan, he prescribed flax oil, which seemed to help only a little, although the chiropractor said he really thought I would benefit the most from fish liver oil. Yesterday, in desperation, I took fish oil and felt much better.  I'm not pain free yet...but the improvement was quite dramatic.  I'll have to see how it goes.  I was vegan for personal, ethical reasons as opposed to health concerns...so even though this is a bit of a disappointment for me and my veganism...I think I will continue to use the fish oil and see if I benefit further.  By the way I had been taking vegan DHA for years from either "Omega Zen" or "Deva". Many, many years ago I heard that the playwright George Bernard Shaw had to take liver for a B-12 deficiency.  As the story goes someone said to him, "Is that liver you're eating...I thought you were a vegetarian."  Shaw replied "I am, this is my medicine."

  • Anonymous

    2/15/2010 9:11:25 PM |

    Ah, This is exactly what I was looking for! Clears up
    a few misnomers I've read

  • buy jeans

    11/3/2010 10:44:47 PM |

    Dr. Goldstrich has proven especially adept at understanding how to incorporate new findings from clinical studies in our framework of coronary atherosclerotic plaque management strategies.

  • moseley2010

    12/8/2010 4:40:26 PM |

    I have heard about acai berries and acai berry supplements containing sufficient Omega 3. I found out about this while I was looking for great alternatives for kids. Because for sure, they don't like fish oil supplements as they are huge and smelly, but I also believe they need the Omega 3 and all the good it brings. I found out about acai berry powder with Omega 3. I admit I am almost convinced.

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