In my last blog post I put forward the Discordance Theory of disease (specifically modern degenerative diseases such as type 2 diabetes, neurodegeneration, and cardiovascular disease) and introduced a rough timeline of change that humans have faced over the past 10,000 years. These changes are wide reaching and affect every element of the Four Pillars of health (Sleep/photoperiod, food, movement, community). It’s fascinating to me that many people find the Discordance Theory and associated concept of Ancestral Health to be incredibly informative and helpful for everything from orienting research to making clinical decisions, while other people dismiss both concepts out of hand and find no value in anything other than reductionist, symptom-based medicine. I’m of the opinion that we will not untangle chronic degenerative disease without some nod towards the Ancestral Health template. I might be wrong about that, perhaps there is a magic bullet waiting that can “fix” poor sleep+bad food+inactivity+inadequate social interactions….but I both think that is unlikely AND I’m not waiting around for that fairy tale to come to reality.
I’ve thought about this Discordance subject a lot and I have to admit: it’s a more nuanced topic than what I’d first thought or suggested. In the early days of the Paleo Diet movement, anything that was considered “non-paleo” was held as suspect. Salt, coffee, tea (to name a few items) have all been dismissed as “non-paleo” by the few folks who have turned paleo into a religion. Unfortunately these same folks seem to have missed all the research indicating reasonable amounts of the aforementioned substances are likely beneficial. So, we seem to have a few different competing concepts here:
1- The Discordance theory suggests that too rapid a change may produce deleterious health effects.
2- Some people interpret the above as meaning ANYTHING that is “evolutionarily novel” is inherently bad, somehow ignoring “the rest of science” (coffee for example).
3- Some of the people who dislike the Ancestral Health concept rightfully point out that some not insignificant genetic change has happened to humans since the paleolithic.
4- Despite point #3, we still see far more degenerative disease than what I think anyone would like. And as I mentioned in the previous post, those metabolic changes are of sufficient severity that the associated diseases (type 2 diabetes, CVD, neurodegeneration, certain cancers) are poised to cripple our economy and overwhelm our medical systems.
The trite advice of “eat less, move more” and “everything in moderation” (the singular message we seem to receive from the medical world, particularly mainstream dietitians) is, let’s face it, an epic failure. My wild suggestion, dripping in nefarious ulterior motives, is that we really do need to think about modern, degenerative disease from the perspective of the Discordance Model, but we can’t turn the implications of that theory into religious doctrine like the Orthodox Paleoites have done. We need a governing theory to direct our inquiry, but this must be coupled with good clinical outcome based medicine and the studies these clinical outcomes inevitably generate.
So, we are about 500 words into this mess and you may be wondering “Hey Robb, this is all nice, but the title of the article is about pandas and poo…what gives?” This build-up is likely attributable to equal parts senility and a borderline obsessive need to provide Framework and Context. I want to look at a critter we are all likely a bit familiar with, the Giant Panda. This cute, iconic Ursid is actually an interesting example case study of the Discordance Theory, but with some interesting subtleties. Giant Pandas evolved from ancestors which were, like most bears, omnivores. For as yet unknown reasons, panda ancestors likely started eating some amount of bamboo as part of their mixed diet, eventually shifting to a diet almost completely composed of bamboo. Estimates of this transition range from 2-5 million years ago, which is a decent period when considering evolutionary change. What this would suggest is pandas should be quite well adapted to their new dietary approach, and in some ways they are. Pandas have evolved a kind of false thumb (derived from a wrist bone of all things) which helps pandas to grasp and pull down bamboo.
But recent research looked at panda digestion and the findings were fairly surprising as they suggest that pandas are not that well adapted to their current diet of bamboo. Whether in the wild or captivity, pandas display a remarkable amount of GI problems. They are almost the IBS poster animal given how many problems they have. The GI physiology of the panda is quite close to that of a carnivore, with none of the specialized GI structure we see in animals that digest cellulose (fibrous plant material). Some cellulosic fermenters use multiple stomachs, some use a larger cecum to provide more time to ferment this plant material, coupled with more surface area to absorb the short chain fatty acids produced by cellulose fermentation. Most of these animals have a symbiotic relationship with certain strains of bacteria which possess the enzymes to degrade cellulose, yet pandas are interesting in that they seem to still, after 2 million years of mainly consuming bamboo, possess a gut microbiome that looks virtually identical to that of a carnivore. The panda is a potentially confusing critter! As interesting as all this might (or might not) be, what does it mean for you?
1- Despite 2 million years of evolution on it’s current diet, the giant panda still has serious digestive problems. Problems which are sufficiently severe as to limit panda reproductive success.
2- Even though the gut microbiome of pandas looks a lot like that of a carnivore, there MUST be something more to this story. Although the efficiency of converting bamboo cellulose to energy appears to be rather low (compared to the efficiency of say a cow converting grass to usable energy) clearly the panda is getting SOMETHING out of the bamboo. It may be that they are relying more on the protein and fat content of bamboo to make their living. It’s also possible that although the microbes they harbor are not typically associated with cellulose fermenters, that does not mean these bugs have not acquired the genes to do so. Bacteria are remarkably promiscuous little buggers and they appear to be able to swap genes at a rate that until only a few years ago was thought to be impossible.
3- Given point #1, if we see a chronic disease (in humans, pandas, or sand flies) it might be helpful to start asking questions using the Discordance Theory as a means of orienting our thinking. This is not the end of that investigative process, but may prove to be a critical beginning.
4- Given point #2, we need to be cautious in how we interpret and promulgate the Discordance Theory. Of particular note I think we need to be very careful in how we treat the topic of the human microbiome. Despite a relatively short period for evolution to occur on the human genome (10,00 years since “the paleolithic”), there is a remarkable amount of time available (in bacterial terms) for a symbiotic organism to develop or obtain the genes necessary to help it’s host organism (that’d be us). We are in the absolute infancy of understanding this story, so I think we need equal parts caution and optimism in how we approach this material. In my next blog post I’ll look at some human symbiotic bacteria which have proven to be remarkably helpful for a very pesky condition.
I am one of the folks that really went whole-hog into the Discordance Theory and unfortunately did not see the details and caveats to make that model work better. Time and pain have been good instructors and have hopefully moved me a bit down the Dunning Kruger graph. In my second book Wired to Eat (available for pre-order everywhere books are sold, release date March 21) I do my best to talk about these subtleties and to provide a path for you to find your own truth with regards to health. I lean heavily on the Discordance model as so far it has provided what appears to be an unfair advantage in unraveling complex degenerative disease. I do however try to temper that message with an honest appraisal of what we do and do not know, what we can only discover via self experimentation.
ALSO!! If you pre-order Wired To Eat I have several fantastic bonuses here.
Drew says
Fecal transplant not even mentioned despite title ? Huh ?
Robb Wolf says
It’s in the celiac link!
Robb Wolf says
UGH!! I totally got my wires crossed and botched the title….the fecal transplant stuff (and celiac into) is in next weeks post.)
Alessio says
Great approach.
I’m among the guys really compelled to the paleo framework.
I have to admit that I lost a lot of nuances either.
Biology is not black and white but there are obviously many shades of grey.
Anyway I still think that when it’s time to take practical decisions, the “good” sense may still be in the conservative direction, evolutionarily speaking and then we should be in the position to demonstrate that the novel is harmless instead of all the other way around as it happens.
The panda story is fascinating and leaves me with a bunch of questions.
It may be possible the well explained microbiota gene transfer really works, but up to what extent?
Does this nuance really eclipse the discordance model?
Why “well” adapted animals show also physiological features (anatomy and metabolic patways) when it would be far simpler to rely on bugs?
We could lead to the absurd theoretical assumption to have all the animals identical with even the same gut critters but just genetically different.
I still think that the master role is still played by the host physiology, though with a great help by gut critters.
I think this approach is still more consistent with the evidence, though the microbiome nuance is highly useful to understand the boundaries.
Nevertheless, when I look at the giant Panda I still see an evolutionary “half failure”, though not all black and white like the animal itself.
And when I look at the promise of probiotic companies that promise to cure celiac disease I wonder:”Is it to allow people to enjoy a weekly pizza with good friends or it is an excuse to eat junk food every day with zero nutrient density?”.
Even if I might tolerate better gluten, what about ATIs, lectins, and carb cellularity that drives dysbiosis in the small intestine?
Why should we invest billions to be barely able to tolerate in the short term a food with zero value that is destroying the planet?
How the microbiome metabolites really interact with the host in the long run?
Do you prefer to be like a Panda, a slow bunch of flabby fat unable to mate even with Panda-porns a go-go, or like a grizzly or a polar bear?
I prefer the latter…
Said that, I really appreciate the effort to remain unbiased, I’ve been trapped in religious perspective and changed my mind many times in my life.
Now I use the evolutionary paradigma as the skeptical perspective keeping eyes opened in front of a new proof.
But the burden of the proof is on the evolutionary novel advocate, not all the other way around.
Alessio says
I always like to point that the discordance theory is not a fancy theoretical whim.
It’s the explanation of the phenomena.
If everything went well, there would be no need of a theory to explain why things don’t go well.
‘Things don’t go well’ is the phenomena. Why? Because of the discordance theory. There’s something wrong somewhere in the delicate interaction between animals, microbes and environment.
Why dinos got extinct? The dinos got extinct is the phenomena and the explanation is the discordance theory.
Their physiology was not suitable to whitstand with the new environmental condition. Simple. Linear.
Then we can argue about all the shades of gray typical of nature.
Robb Wolf says
Love it!