We continue with the series of interviews of authors of international repute.
Please forgive some mistakes, we are not English-mother tongue… As you can see, the interview is in both, English and Italian.
It is with great pleasure that we welcome Maelán Fontes Villalba in our blog.
Maelán is PhD student in Food and Western Diseases at Lund University.
He is co-author of some of the most important published scientific papers about paleo nutrition and he has worked together with other important personalities from the paleo scientific community like prof. Loren Cordain, prof. Staffan Lindberg, prof. Pedro Carrera Bastos and prof. Lynda Frassetto.
The interview in italian.
Angelo: Hello , Maelán how are you? Can you give us a brief overview of your academic career?
Hi Angelo, I am pleased to contribute to your blog. I am doing fine!
My background is in physiotherapy and then I got interested in nutrition. I have always liked biology, so I started to read about nutrition, biology and evolution. Later I found some scientific papers on evolutionary nutrition and at that time I got really hooked by Staffan Lindeberg’s work. In 2009 I started a masters degree in Human Nutrition and Food Quality and finally, in 2013, I entered a PhD program on Human Nutrition at Lund University under Dr. Staffan Lindeberg, Dr. Tommy Jönsson and Yvonne Granfeldt’s supervision.
Angelo: do you follow a paleo lifestyle? Do you play some sports? Please give us some more information about your personal paleo approach
Yes, I would say my diet mimics (because, of course, we can not eat the foods we had in the Palaeolithic era anymore) what our ancestors probably ate by 90-95%. My diet is based on fruits, vegetables, tubers, fish, meat, poultry, eggs and nuts. I avoid foods introduced recently (from an evolutionary time scale) such as grains, dairy, legumes, salt, refined sugars and vegetable oils. These foods are considered Neolithic foods. But I don’t say no to those foods on special days such as my daughter’s or my wife’s birthdays.
Talking about sports, I’ve been a footballer since I was 9 and I still play. I also do weightlifting 3-4 times per week, and I hike a lot during certain times of the year. Regarding my “paleo” approach, first I would like to say that I don’t like that word very much because it has been misused, and now it is more a commercial brand than science. But to make things easy we say “paleo” as a proxy for Palaeolithic nutrition.
According to the scientific evidence it seems as if Europeans are better adapted to wheat and milk than non-Europeans, meaning that those foods may have produced a positive selection (because they reduced reproductive fitness) of protective variants in populations with a longer history of farming and stockbreeding.
Therefore, Europeans in general can cope better with Neolithic foods, nevertheless 10 000 years is not enough for complete adaptation. And the next question is, who bears those protective variants? Difficult to say right now, so I would rather be on the safe side and eat foods that I am likely to be adapted to.
Angelo: What is your personal view about fructose and/or eating too much fruit?
Eating fructose and eating fruit are two different things, mainly because it is very difficult to match the amount of fructose that is problematic in animal studies with fructose from fresh fruit. Eating a lot of fresh fruit (that’s what I do on a daily basis), together with vegetables, tubers, fish, meat, poultry, eggs and nuts won’t produce harmful effects in humans. Is it worth mentioning that it is easy to consume fructose in excess in the form of refined sugar but very difficult to eat it to excess in fruit. And that the concentration of fructose in fruit is much lower than in processed sweet foods, so the rates of absorption are very different as well.
Angelo: What is your perspective about coupling together paleo diet and intermittent fasting?
I think that food choice is more important than the number of times we eat. In controlled trials in patients with type 2 diabetes or ischaemic heart disease cardiovascular risk factors improved even when eating 5 times per day. Having said that, I don’t think that intermittent fasting on top of Palaeolithic-type foods is a bad idea, but I do think that we need more research into it.
Angelo: Let’s talk about saturated fats, cholesterol and arachidonic acid, what is your personal opinion about these fats? Are they healthy or not?
If you look at the evidence, i.e. at systematic reviews on these topics, there’s no clear evidence that changing the intake of these lipids will have a meaningful impact on your health. However, based on a recent systematic review, reducing saturated fats seems to significantly reduce cardiovascular events, but more importantly it makes no difference to overall mortality. Having said that, I am not concerned about saturated fats in the context of real food such as fresh meat, etc.
An important limitation of many dietary trials is that they investigate nutrients and not foods. Or to put it another way, a diet with 7% of saturated fats coming from processed red meats might be worse than a diet containing 13% of saturated fats but with no processed foods in the latter case.
The same applies to dietary cholesterol or arachidonic acid.
Angelo: what is your personal opinion about paleo diet perspectives in the immediate future: in particular for natural autoimmune disease therapy?
This is a big and important question mark. There’s some evidence from animal and molecular biology studies suggesting that avoiding Neolithic foods could probably improve some autoimmune diseases, but we clearly need randomised clinical trials to test this hypothesis. Nevertheless, avoiding Neolithic foods has no obvious risks for most humans, so there’s more to win than to lose even without the scientific evidence.
Angelo: I know that you are conducting an interesting pilot study in Lanzarote applying paleo diet to diabetic patients. Could you give us some previews?
Our working hypothesis is that avoiding grains, dairy products and legumes, independently of macronutrient composition, glycemic load, fibre content or weight loss can improve glucose tolerance in patients with type 2 diabetes. To test that hypothesis, we randomly allocated patients with type 2 diabetes to either start with a healthy diet with grains and dairy or to start with a healthy diet without grains and dairy. The patients followed the diets for 4 weeks and after a washout period of 6 weeks they switched to the other diet. For better compliance they had lunch everyday at a hospital lunchroom and we monitored weight stability every week. We were able to maintain their initial weights although it was very difficult in many of them because there was a tendency for their weights to go down (with both diets), which indicates that to be part of a clinical trial makes people eat better, independently of what diet they follow. We are still waiting for some outcomes to be analysed, and we will try to publish the results as soon as possible. Importantly, in order to avoid a common source of bias (less behavioural support in the control group) the patients were informed that we are testing two healthy diets, both of which meet the official dietary recommendations in the Canary Islands for patients with type 2 diabetes, but that we didn’t know which one, if any, would be better than the other.
Angelo: You have recently been in Grosseto (Italy) for the first Italian evolutionary medicine congress organized by Andrea Luchi. Can you describe your impressions about this first congress and your personal feelings about the paleo movement in Italy?
Oh, my experience in Grosseto was wonderful. The place and the people are lovely. I also enjoyed the productive comments from the audience in the Q&A sections. My feeling is that the paleolithic group I met in Italy are very knowledgeable, I was really impressed by your deep understanding of evolutionary nutrition, so I would encourage you to keep up the good work and run clinical trials in the near future.
Angelo: Would you like to add anything to the interview? Future projects, useful links…
I hope that with the help of people like you, the scientific community will start to think about nutrition from an evolutionary perspective. Nutrition research has focused too much on macronutrient composition and less on food choice. The recent systematic review and meta-analysis published this year in the American Journal of Clinical Nutrition on August 12th, showed that a Palaeolithic diet is superior in the short-term to other healthy diets when looking at certain factors of the metabolic syndrome. Therefore, this is a good starting point to test the Palaeolithic diet against other healthy diets in patients with western diseases.
Angelo: thank you Maelán for the interesting interview and for your enthusiasm! See you soon for the next interview!