The Mandible Claw

As an adolescent I used to occasionally watch professional wrestling on a dusty old black and white 12” TV set my parents kept in the attic. Catweazle, Mick McManus and Giant Haystacks grappled with simple morality tales in three rounds on Saturday afternoons when I returned home bruised and patched from playing rugby at Myreside.

Then I learned about kayfabe¹. The ring of pro wrestling is a stage, and the wrestlers mostly ringers. Catweazle played the underdog, McManus the heel, Haystacks the monster. I was, clearly, the Rube.

Childhood heroes and underdogs generally prevailed, even when – especially when – they seemed about to give up. But black and white gave way to colour TV, and morality shifted imperceptibly from black and white to black and grey and then to blue and orange, originally a literary trope² before it entered the wider world.

Now I see kayfabe everywhere. The current debate about how you should eat your colours, for example.

Many doctors currently promote the plant-based diet, in harness with a pack of companies mushing meatless dogs, burgers and bacon. Beyond Meat was the trail-blazer, and in 2022 the nerds behind Beyond trail-blazed their way to a loss of $23.7 million³. A negative gross margin of 5.7% reflects the fact that their ultra-processed products are both negative and gross. 

Cutesy-sounding rivals such as Amy’s Kitchen Inc (a spin-off from Mom’s Friendly Robot Company⁴), Gardein Protein Co. and Morningstar Foods are no better. They are all owned by the same multinationals which have been poisoning us for the last half century^{5, 6}. 

Customers and even doctors might imagine these plant-based products to be healthier than the originals, but there is little evidence for this luxury belief.

In fact, processed plant foods appear to be positively unhealthy.

A major new study which looked at the dietary habits of 200,000 adults over a 20-year period⁷, found that those who ate whole plant foods (whole grains, fruits, vegetables, nuts and legumes) did rather well. A second group which added meat and dairy to this diet also prospered, but a third group whose diet focused on processed plant foods including sugar, refined grain products and juices, experienced substantially higher rates of coronary artery disease and heart attacks.

This study did not prove that processed and ultra-processed plant foods were unhealthy, and in all fairness, it was not designed to do so. It simply showed an unhealthy association. However, the results fit neatly into an existing body of evidence that links ultra-processed foods to an extensive range of poor health outcomes including dementia and diabetes^8-10, and therefore accelerated ageing^11,12.

Q: Are synth-meat products an exception to this? 

A: They are not. A basic problem with many plant-based meat substitutes is the plant base. 

Check the nutritional label on the side (or back) of pack. Your plant-based chick’n nuggets might claim significant amounts of iron and zinc, but most plants also contain high levels of phytic acid which bind the iron and zinc to form insoluble and hence non-bioavailable phytates¹³. The same is true for calcium, magnesium, manganese¹⁴ and possibly copper¹⁵ – but see also¹⁶.

Iron depletion, which is very common, causes tiredness, weakness and lack of energy. Zinc depletion is almost as prevalent, and impairs immune function and wound healing. Going meatless will exacerbate these problems, and increase the numbers of people affected by them.

While phytates are insoluble, the phytate problem isn’t. It can be easily fixed with phytase or by prolonged soaking, fermentation and germination¹⁴. All of these steps make the food production process slightly longer and marginally more expensive, and will therefore probably not be used. 

If you are determined to be a leaf-eater opt for protein derived from mushroom or tempeh, both of which are naturally low in phytic acid¹³.

Another problem with fake meats is that due to the bland flavour of their main ingredients, they tend to be high in fat and salt^17-20. Excessive salt consumption carries health risks of its own⁶…    but with a passing nod to vitamin B12, let’s focus on fat. 

Plant-based meat substitutes rely on vegetable oils, which generally have a high or very high 6:3 ratio.

Consuming these elevates the 6:3 ratio in the cell membranes of the consumers, nudging them toward chronic inflammatory stress^{21, 22}. Plant-derived short-chain omega 3 (alpha-linolenic acid) is so poorly and variably metabolized^23-26 that claiming it on a fake meat pack label borders on deception. 

Graham Burdge, who I take seriously, suggests that as our capacity for EPA and DHA synthesis from ALA is the product of evolution, it follows that the levels of EPA and DHA it maintains are nutritionally appropriate²⁷.

My counter-argument would be that we have strayed well outside our dietary bailiwick, as our appalling public health stats indicate; and that today’s excessive intakes of linoleic acid flood the enzyme delta-6-desaturase, leaving us unable to metabolise alpha-linoleic acid as we were ‘designed’ to do²⁸.

Then there are carbs, which are almost exclusively plant-derived. 

Hot off the presses is a 25-year study of dietary carbohydrate intake and mortality out of Harvard, which found a U-shaped relationship between carb intake and mortality²⁹. In the meta-analysis of all cohorts (432,179 participants), both low carbohydrate consumption (<40%) and high carbohydrate consumption (>70%) conferred greater mortality risk than did moderate intake.

This was effectively a confirmation of earlier research by the same group³⁰:

Today’s high-carb diet is by definition a diet with a high glycemic load (GL), and in the developed nations today it is also, inevitably, a diet with a high glycemic index (GI). The high GI diet had already been shown to increase the risk of death from all causes³¹, likely involving excessive glycative stress, so no surprise there. A high GL diet is also likely to be a diet low in protective phytonutrients, which poses a complementary set of health risks.

At the other end of the scale, a low carb diet was recently found by a Polish group to increase the risk of coronary heart disease, stroke, cancer and premature death³²; so the second Harvard finding is also likely to be at least partly true.

But hold on a minute. Is eating too few carbs really unhealthy? It depends, surely, on the carbs. 

Digestible carbohydrates are dispensible carbohydrates. Humans are capable of making glucose and glycogen from a range of non-hexose precursors which occur in fats and proteins; and as we evolved in a pre-agrarian environment, we are very good at doing this.

Fermentable (prebiotic) carbs, however, fulfill all the criteria for being essential nutrients. They are essential for normal bodily function, cannot be synthesized by the body and must be obtained from the diet. 

Removing prebiotics from the diet starves gram-positive saccharolytic species, facilitating gram-negative dominance and therefore increased levels of lipopolysaccharide (LPS) in the gut. This creates local inflammation, breakdown of the gut epithelial barrier, chronic low-grade endotoxaemia, generalized inflammatory stress and a myriad of subsequent health problems^{ie 33}.

To illustrate how dangerously low intakes of prebiotics are today, consider the historical context. 

Quantitative archeologists have examined the dietary habits of pre-Christian meso-American culture. Basing their calculations on a detailed study of neolithic fields, mills, ovens and corproliths, contemporary agricultural records and current growth patterns, they estimate that groups such as the O’odham consumed around 135 grams of prebiotic fibers a day^{34, 35}. This was perhaps a fifth of their total calorie intake.

Dietary sources of these fibers included beans, maize, agave (nopales) and a range of other roots, shoots and tubers³⁴. The O’odham gut microbiota was therefore gram-positive dominant, anti-inflammatory, anti-neoplastic, an important component of the innate immune system³⁶ and significantly health-protective³⁶.

By the 2^nd half of the 19^th century, in early industrialised England, intakes of prebiotic fibers were at a lower but still healthy 20 to 40 grams a day³⁷. 

Jerusalem artichokes, which were widely grown and regularly consumed³⁷, contain approximately 15-20% inulin by served (wet) weight^{38, 39}. The mid-Victorians also ate significant amounts of legumes and whole grains and were, notably, a population with very low rates of inflammatory (degenerative) disease⁴⁰. Their gut microbiota, like that of the O’odham, was anti-inflammatory and protective.

Cut to North America, today. A diabetic, diseased and increasingly demented population⁴¹ consumes an average 15 grams of total fibers per day⁴², of which a mere 4-8g are prebiotic fibers^{43, 44}. As a result, the American and modern colonic microbiota in general has been degraded. Gram-positive saccharolytic species have been starved and displaced by proteolytic gram-negative species which are pro-inflammatory and thus likely to promote disease⁴⁵.

The colonic microbiota has transitioned from friend to foe.

Bowel disorders are becoming more common with IBS now affecting up to 14% of the population^{46, 47}, depending on the diagnostic criteria used. IBD currently affects as many as 1.3%⁴⁸, and is also increasing^{49, 50}. Colorectal cancer has doubled in the under-50’s within the last decade⁵¹.

(Full disclosure: colorectal cancer rates in older subjects are falling, likely due to population-based screening programs).

The Harvard and Polish studies which advertised the dangers of low carb did not discriminate between digestible and fermentable carbohydrates, and are therefore deeply unhelpful. Given that fermentable and digestible carbs co-exist in many unprocessed foods, I suspect the dangers associated with the low-carb diet were largely the results of a low prebiotic diet, combined with higher compensatory intakes of fat and/or protein. 

This is supported by the fact that the Harvard team found mortality increased when carbohydrates were exchanged for animal-derived fat or protein, and decreased when the substitutions were plant-based products intrinsically more likely to contain prebiotic fibers.

Dietary analysis is made more complicated by the asymmetric relationship between the two types of carbohydrates. Foods which are good sources of fermentable carbs (ie beans, oats) generally generally also supply digestible carbs, but most foods rich in digestible carbs (ie sugar, baked goods) contain little if any fermentable carbohydrates.

I would like to see more fermentable carbs incorporated into the next generation of ultra-processed foods; and, especially for the sedentary, fewer digestible carbs. But consumers need calories, and consuming very large amounts of fermentable carbs can create bloating. So should they replace digestible carbs with fats and protein, as the keto brigade suggests?

Fats and oils may not be glycemic, but they come with their own potential problems. The high fat diet increases intestinal permeability, directly and indirectly via increased bile acid secretion and microbiotal shift⁵². This may not be a problem if you are also eating prebiotic fibers, but if you are prebiotic-depleted and therefore dysbiotic, increased gut permeability will likely make endotoxaemia worse^53-55.

There is a cancer link here too. High intakes of fat are linked to increased breast⁵⁶, liver^{57, 58}, colorectal^{59, 60} and probably other forms of cancer, although the degree of risk seems to be relatively small⁶¹ and is probably determined by which types of fats are being consumed⁶². 

The same question mark hangs over protein. 

Many studies show a positive association between high meat intake and cancers of the esophagus, lung, pancreas, stomach, large bowel, breast and prostate. The associations are highest for processed meats, probably via the nitrate / nitrosamine route. Other mechanistic links include haem breakdown products, and the cooked meat carcinogens. These are heterocylic polyamines (HPA’s) and polycyclic aromatic hydrocarbons (PAH’s).

All proteins form ‘cooked meat carcinogens’ when cooking temperatures are high enough. Plant protein forms PAH’s and benzpyrene at the same levels as animal protein when grilled^63-65, and one of the reasons why plant proteins look safer is because we generally boil, steam or bake them. Conversely, animal proteins produce less carcinogens when cooked at low temperatures. 

The sous vide method is very easy to use, and produces meat dishes which are probably as safe as vegetable dishes. 

Which takes us back to the 19^th century.

The mid-Victorians consumed far more animal protein and fat than we do today⁶⁶, yet had very low rates of cancer⁶⁷. They generally stewed their meats⁶⁶, with the maximum cooking temperature set by the boiling point of water. Their stews inevitably contained onions, which provide compounds that reduce carcinogen formation^{68, 69}. Their high intakes of prebiotic fibers and other phytonutrients, high levels of physical activity and ultra-low levels of diabesity provided further protection.

Viewed from pre-Christian meso-America or from 19^th century England, our healthcare system is kayfabe. 

We are the Rubes, and the Underdogs. We accept and indulge in lifestyles that guarantee degenerative disease, spend vast sums of money on pointless research and throw ourselves on the treacherous mercy of the political class (the Heels). The Heels are owned by Big Pharma (the Monster), who long ago bumped the referee / regulator⁶⁸ in this over-extended metaphor and now owns the franchise.

Big Pharma does not have the right tools to cure us⁷¹, and could not afford to cure us even if it was able to do so⁷². If we wish to achieve better public health, and remain in the ring for a few more rounds, pharmaconutrition is the only way.

I’ll end with my favorite wrestler, Dr Sam Sheppard. A 3-time class president and qualified neurosurgeon, Sam became a professional wrestler after (possibly) killing his wife. He used his knowledge of anatomy to develop the infamous mandible claw hold, as illustrated by Mankind in the lead image⁷³, and went on to marry Joseph Goebbels’ half-sister. Sometimes, life is stranger than kayfabe.

Next week: Brains, bones and automobiles: the end of reactive healthcare and the death of doctoring Pt 1.

References:

1. kayfabe – noun, informal, USA. In professional wrestling, the convention of presenting staged performances as genuine. Derivation: possibly pig latin.  
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