Bio
Hi! My name is Katherine (Kiki) Tolles. I began the STEM Science Research Program in 10th grade where I explored my varied scientific interests concerning architecture, sustainability, human health, and many more. Over the course of the program, I focused primarily on anthropology and epidemiology.
I completed my main research project in 11th grade under the mentorship of Michael Gurven and Thomas Kraft from UCSB. Please see below for project details.
Class of '20
kiki tolles
Project Overview
Presentation Snapshot
^Kiki Tolles presenting at the annual STEM Science Research Program presentations held on June 5, 2019 at Laguna Blanca School. STEM students presented to an 85-person audience of Laguna Blanca Board Members, faculty, parents, and fellow students.
Presentation Snapshot
-
Introduction and Background
The term “WEIRD” has become a bit of a buzzword these days. It’s an acronym that stands for western, educated, industrialized, rich, and democratic. This specific demographic represents the group of people most often researched in human studies. For example, in behavioral science, WEIRD people make up 96% of subjects. In American psychology research, 67% of studies use college students alone as their study example (Henrich et al.). Noy surprisingly, this demographic is also most often researched in anthropological studies, which is the field I studied during this second year of STEM. Anthropology is essentially the study of humans, with emphasis on our biological, physiology, and developmental aspects. Not only is studying anthropology crucial in understanding ourselves, but also understanding our health. However, WEIRD people make up just 12-15% of the world’s population, and therefore are not representative of all humankind. And in fact, a study published in 2010 revealed that WEIRD societies are “among the least representative populations one could find for generalizing about humans” (Henrich). What’s more, the rise of western, educated, industrialized, rich, and democratic people has only occurred very recently in the span of human evolutionary history. So, not only are researching analyzing a very limited "sample size," but a very abnormal one at that. The goal of my research project sought to rectify that.
There were two major historical events that enabled the birth of WEIRD people. The first event was the Neolithic Revolution, otherwise known as the Agricultural Revolution, that began around 12,500 years ago. This was a time where most cultures around the world began transitioning from hunting and gathering to agriculture and settlement. Stable food production allowed for cities and populations to skyrocket. What's more, the Neolithic Revolution brought about massive changes in diet and lifestyle. Such lifestyle changes were later exemplified by the Industrial Révolution, beginning around 250 years ago, which further encouraged settlement and civilization. The changes in lifestyle happened very rapidly in terms of the human evolutionary scale, and many anthropologists hypothesize that these changes have happened too rapidly for the human genome to have adapted. In other words, there is a “mismatch between our ancient physiology and the western diet and lifestyle that underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis” (Carrera-Bastos). These “diseases of civilization” are rare to nonexistent in hunter-gatherer and other un-acculturated populations.
Thus, there is value in researching indigenous populations with more traditional lifestyles because they represent the previous lifestyles of all humans for over 90% of our existence. Questions about human health require anthropologists to look at the big picture, which is not feasible when studying only the WEIRD demographic. For such reasons, my STEM project was devised. Under the mentorship of Michael Gurven, head of Anthropology at UCSB, and Thomas Kraft, postdoctoral scholar at the Gurven Lab, I worked to make health data on indigenous populations more centralized and accessible. Specifically, I was tasked with creating a comprehensive database that notated for population descriptors and health factors among these indigenous--more traditional--groups. For decades, doctors, scientists, governments have been collecting in piecemeal fashion bits of data on different populations all around the world. These health records exists in hundreds and hundreds of research papers, books, and journals dating to the late 1800’s to just this year. Unfortunately, this health data does not exist all in one place. Therefore, it is very difficult for anthropologists and other scientists to not only access this existing information, but also visualize broad patterns of human health within traditional lifestyle settings. With the database I helped to design, we were able to locate and analyze these research papers, and tabulate their health statistics into a centralized location.
II. Objective
To compile a comprehensive database of population characteristics and health factors among indigenous groups in order to identify patterns and comparisons of human health.
III. Materials and Methods
Population information and health data was sourced primarily from research papers in journals of anthropology. The first step in the process, however, was designing a database that could collect and organize certain health aspects and identifiers of indigenous populations. The database consisted of a “master spreadsheet” divided into sections. The first section included population descriptors and identifiers. These are the characteristics that define the culture and lifestyle of a population, such factors that will help draw comparison between different groups later. In this section, we identify the name and location of each population or subpopulation--specifically, their latitude, longitude, country, region, and biome. We further characterize a population by taking notes on their acculturation level (level of westernized or modernized influence), sedentary level (nomadic, semi-nomadic, etc), diet staples, and smoking and alcohol habits. Specific identifiers such as study ID, publication date, time frame (when the actual study was performed), and reference source are also notated. The second section of the database is devoted to blood pressure, primarily systolic and diastolic blood pressure. Prevalence of hypertension, pulse pressure, and pulse rate are also included. In the third section, we mark for health factors related to atherosclerosis--which is the buildup of cholesterol and other substances in artery walls that can restrict blood flow and lead to heart disease and stroke. Within this category, we have both prevalence of Coronary Heart Disease and prevalence of Angina Pectoris (a symptom of Coronary Heart Disease), in addition to Maximum Oxygen Uptake. In terms of cholesterol, we notate several different components: Serum Level (total) Cholesterol, HDL (High-Density Lipoprotein) Cholesterol, Non-HDL Cholesterol, LDL (Low-Density Lipoprotein) Cholesterol, Triglycerides, Apolipoprotein A1, Apolipoprotein B, Lipoprotein (a). Apo-A1, Apo-B, and Lp(a), are all proteins carried in cholesterol that help predict risk of cardiovascular disease. The fourth section looks at diabetes, including prevalence of Glycated Haemoglobin (helps determine average glucose level of past two to three months), Fasting Glucose, 2-Hour Glucose, Insulin, Fasting Insulin, 2-Hour Insulin, Fructosamine, Albumin to Creatinine Ratio, and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance, fasting serum insulin times fasting glucose). In the fifth and final section of the database, we look at anthropometrics, otherwise known as the study of human body measurements. Within this category, we notate weight, height, BMI (body mass index), weight per height ratio, body fat percentage, waist circumference, waist to hips ratio, and triceps skinfold. In each section of the database, all health data is organized by males, females, and age, with a standard deviation value for each dataset. Documentation of the method and instrument (eg. mercury sphygmomanometer) is also recorded for each population study. Once the task of creating the database was completed, the work of analyzing and tabulating the health data from research papers began!
IV. Results
Given the number of existing research papers on indigenous health the database is not yet completed. So far, we’ve taken data of almost 100 subpopulations across all continents (excluding Antarctica) from records published as early as 1916 to 2018. While the spreadsheet is a still a work-in-progress, there are many comparisons we can draw to illustrate how the database can be beneficial in anthropological and epidemiological research.
Not only can the database compare health data across multiple groups, but it can also look at divergent health within a population. A case study of a single people can reveal how changing lifestyle habits can alter their health outcome. For example, a paper published in 1991, “Migration, Blood Pressure Pattern, and Hypertension: the Yi Migrant Study” (He et al.) contains the health data of three “subgroups” within the Yi people. The first group are Yi farmers who live in remote mountain areas at an altitude of 1,500 feet or higher. Their economic base is subsistence agriculture and their villages are “isolated from the rest of the world,” such that the Yi farmers have “preserved their own language and primitive lifestyle.” Based on the research, we know that the Yi farmers are an exceedingly unacculturated group. The next subgroup are the Yi Migrants--people who have migrated from the mountains to Xichang city or county seats (Butuo, Meigu, and Zhaojue) in the least 5 years relative to the study. From the research, we know that this group is at a “transitioning” level of acculturation. Finally, the third subgroup are Han people, who have been residents of Xichang city or county seats for many generations, and thus, very acculturated to a modernized lifestyle.
These three distinct levels of acculturation make the Yi Migrant Study a strong case study comparison. This is because all groups come from a relatively similar gene pool, while lifestyle (acculturation level) is the factor that’s changing. As one measure of health, we compared the systolic blood pressure across the three groups from ages 15 to 65 years separated by gender.
The database can also be used to look at a case study between two different populations. We can compare groups with different economic base, different climate, different dietary staples, and more. For example, a paper published in 1972, “Blood Pressure of !Kung bushmen in Northern Botswana” (Truswell), considers the health of the Kung Bushmen, while a paper published in 1961, “Cardiovascular disease in African Pygmies: A survey of the health status, serum lipids and diet of Pygmies in Congo,” (Mann) covers the health of the Congo Pygmies. Both groups live predominantly as hunter-gatherers. In addition to that, both groups are very unacculturated to modern or western lifestyles at the time of publication. Given these foundational similarities, we might assume that both populations would have near identical health outcomes, at least relative to blood pressure.
When the database is finished, we’ll have access to a greater amount of health statistics, making it easier to homogenize the data in order to draw comparisons over multiple populations.
V. Discussion
In regards to graphs 1 and 2, the variance in systolic blood pressure among the Yi farmers, Yi migrants, and Han people over time is significant. Firstly, the Yi farmers (green line) have the most stable blood pressure across their lifetime. For reference, a systolic blood pressure above 120 mmHg is considered “elevated,” while above 130 mmHg is considered “high,” or stage 1 hypertension. The Yi farmers, the most un-acculturated group, do not even breach the 120 mark. The Yi Migrants, at a transitioning level of acculturation, have the second highest blood pressure. And the Han (city) people, the most acculturated group, have the highest rates of blood pressure, reaching the stage 1 hypertension mark (130) at earlier ages than the migrants. The graphs imply that increasing levels of acculturation lead to increasing levels of blood pressure. This conclusion helps support the notion that westernized lifestyles promote diseases of civilization like hypertension.
Concerning graphs 3 and 4, a significant difference in blood pressure between the Kung bushmen and Congo pygmies can be observed. Looking at the female graph (graph 4) in particular, both groups experience a rise in blood pressure with respect to age, however the Kung are at consistently lower levels. For both males and females, the Kung never surpass 130 mmHg (stage 1 hypertension). While the Congo pygmies (male) are close, only the Congo pygmies (female) breach the “high” blood pressure mark between 40-50 years of age. Despite the underlying similarities between the two groups, their divergent blood pressure patterns is perhaps a result of their different climates. While the Kung bushmen live in a desert biome, the Congo pygmies are in a tropical rainforest. Rather than the climate in itself affecting blood pressure, the difference in climate is influencing the kinds of foods (dietary staples) they eat, and the mobility of they lead. Specifically, the Kung bushmen are nomadic whereas the Congo pygmies are semi-nomadic. The difference in dietary staples and sedentary level are most likely the reason for blood pressure variation between the two groups. The biggest lesson we can learn is that questions about human health don't always have simple answers, as there are countless factors to consider. But, the database we're assembling gives us the opportunity to study health trends and comparisons all around the world.
VI. Reflection
I honestly don’t know what to say about the STEM Research Program. I think the biggest thing I want to express is gratitude. While physics, chemistry, and environmental science have all been very interesting courses, this class gave me the opportunity to research something I’m actually very passionate about. So, I want to say thank you to the program, and thank you to Ms. Richard especially.
Some of the biggest takeaways I have from the experience of working with a mentor has been the understanding of what anthropological research might look like during and after college. And in general, it’s given me a glimpse of what a career in the sciences might consist of--even though anthropology doesn’t take place in a traditional “lab” per say.
The other big thing I’ve learned is how much work and dedication it takes to accomplish just one bit of research or one project. This understanding has come not only from my own project, but also hearing about the projects of my classmates.
Thinking about my project specifically, the experience taught me so much about anthropology. First, I had the opportunity to learn about different groups and populations around the world, some that I had never even heard of before. The research papers I read were also, in many ways, a window to the past, which was very cool. But more than that, I experienced what makes answering questions about human health so difficult. It’s such a challenging area, because it draws on so many different field and it requires so much information and data. “Health” does not look the same for everyone, as factors like lifestyle and environment have major influence. That being said, I now realize the importance of how a database can be used to see greater health trends, and why that’s crucial for anthropologists and other researchers.
Works Cited
https://www.theguardian.com/lifeandstyle/2010/sep/18/change-your-life-weird-burkeman
2018 Research Paper
PROTEIN
PROBLEM
the
A Comparison of the Macronutrient Intake Between Cultures and the Effect on the Mindset Towards Protein
Protein is a macronutrient; in other words, living organisms require it for survival. Almost everybody on the planet knows this. When asked, most people will say that protein (or at least, the best protein) is found from animal products (meat or eggs or milk). And if you’re an athlete, eat more protein. If you have a test today, make sure to eat more protein. If you’re going to be up late, don’t forget to eat more protein. This protein persuasion seems inextricably linked with culture, mindset, and habit all across the world. But is it true?
More importantly, is it healthy? This is the protein problem.
This paper will explore the nutritional profile and resulting health conditions of four cultural groups—the Maasai of East Africa, the Inuit of the North, the Okinawans of the Okinawa Islands, and the Papuans of Papua New Guinea. The role of protein, and its relationship to carbohydrate and fat, will be analyzed in attempt to understand the role of protein in human health.
Both the Maasai and Inuit people maintain a high animal protein lifestyle, thought the Okinawans and Papuans favor carbohydrates from plants. A comparison will reveal their traditional cuisine and the implications for diet-related disease.
THE MAASAI
The Maasai (Masai) people of East Africa live among the semi-arid lands of the Great Rift Valley in Kenya and Tanzania. They occupy nearly 160,000 acres with a population of over 500,000 (Maasai Association). Although sensitive to government surveys, censuses, and study research, it is widely accepted that the Maasai Tribe maintains a diet almost exclusively of blood, meat, and milk. Many use this information as proof that a low carbohydrate, high animal-protein regime is not heart-damaging. However, research into the nutritional behavior of the Maasai people is limited and oftentimes misconstrued.
In 1964, researcher George Mann and collaborators published a study in the Journal of Atherosclerosis Research. It found among the Maasai men not only a lack of heart disease and high blood pressure, but also low cholesterol and slim build throughout. (Campbell). At the time, many might consider this study complete. But today, we understand that Mann’s data was defined due to certain limitations. Thomas M. Campbell, MD, Medical Director of the T. Colin Campbell Center for Nutrition Studies, points out the restrictions in the 1964 documentation techniques. Risk for heart disease was determined by
only a basic physical exam and EKG (recording of the electrical activity of the heart).Campbell argues, “As any physician can attest: a patient can have a normal EKG and physical exam and still might drop dead a week later of a heart attack related to atherosclerosis that has been progressing for decades.”
More than that, 60% of the Maasai men tested were under 44 years of age, and only three out of the 500 participants were above 55. Despite such limitations, a replica study on American men would have found several patientswith detectable signs of heart disease, but no more than four Maasai were determined to be ‘at risk.’ Campbell reveals two other factors for consideration: physical activity and calorie deficiency. The Maasai tribe achieve much higher levels of daily exertion than the typical American (on average 12 more miles a day). Physical activity enlarges blood vessels, which in turn prolongs a potential heart attack
(Campbell). Furthermore, a 1982-1983 survey from the International Livestock Centre of Africa found that Maasai women and children consumed only 50-70% of their “estimated average energy requirement.” Such a calorie deficit warrants the slimness of the Maasai population.
A later study from George Mann detailed the autopsy report of 50 Maasai men. He found extensive atherosclerosis, “a disease (coronary intimal thickening) on par with older American men” (Campbell). Not only that, but over 80% of the men suffered severe fibrosis in the aorta (the main blood vessel from the heart that supplies the body with blood).
As active as they are, the Maasai sustained heart disease tantamount to senior Americans. What dietary factors prompt such internal deterioration? Unfortunately, food intake is erratic among the Maasai and difficult to quantify. Researchers with George Mann measured the nitrogen and creatinine output in men’s urine. Creatinine is a chemical waste molecule produced from muscle metabolism, transported to the kidney, and disposed in the urine. Elevated creatinine levels indicate impaired kidney function (oftentimes kidney disease) due to large amounts of high protein animal foods such as eggs, milk, and meat. Such measurements indicated that the Maasai men consumed large amounts of milk and meat. The women and children ate meat only 1-5 times every month, but they drank great amounts of milk from herd animals (Campbell).
Although data for the nutritional behavior of this culture is limited, researchers can attest that while the Maasai diet isn’t nearly as ‘meaty and bloody’ as popular dogma dictates, large quantities of milk are consumed. Moreover, calorie deficiencies and physical activity spurs intermittent fasting, which contribute to the mirage of a ‘heart-healthy’ people.
Elevated creatinine levels indicate impaired kidney function due to large amounts of high-protein animal foods such as eggs, milk, and meat.
Maasai
Percentage of Dietary Energy Supply
Carbohydrates*
from tubers, honey, and other foraged plants.
more recently, from maize (corn)
Fat*
predominantly saturated fat from herd animals (cattle)
Protein*
primarily animal protein
Drummond, J. C. Lane Medical Lectures Biochemical Studies of Nutritional Problems. Stanford
University Press, 1934.
THE INUIT
The Maasai aren’t the only cultural group believed to be disease-free despite a diet of mostly animal-derived protein. The Inuit (Inuktitut) are an Aboriginal people who inhabit parts of Greenland, Alaska, and Northern Canada, with a small contingent in eastern Siberia (Bjerregaard). As popular opinion denotes, the Inuit people thrive on a diet of chiefly animal foodstuffs. Inupiat Patricia Cochran remembers the traditional meals of her childhood: seal, walrus, moose, caribou, reindeer, ducks, geese, ptarmigan (quail), crab, salmon, whitefish, tomcad, pike, char, and whale. It was only in the brief subarctic summers did Cochran consume plants such as roots, greens, wild blueberries, crowberries, or salmonberries.
As with the seasons and movements of the Inuit lifestyle, definitive data on their carbohydrate (from plants), protein, and fat intake is varied. To make matters more complicated, the last 40-50 years of rapid westernization has shifted much of the modern-day Inuit diet. Processed foods and fast foods have impressed upon the Inuit as much as with industrialized areas. For the purposes of this paper, the following will examine a traditional Inuit lifestyle preceding the ‘McDonald’s’ era.
The Inuit people have survived for thousands of years on predominantly marine and land mammals. But many researchers wonder how this unique people could withstand the bitter, arctic tundra with only these foods, in such contrast to the motley of colors that make up conventional Western food pyramids. Specifically, it is difficult to see where the Inuit people find adequate sources of dietary fundamentals such as Vitamin A, B, and C.
Vitamin A is taken from colorful food plants, contrived from pigmented plant precursors called carotenoids. But many don’t realize that Vitamin A is oil-soluble, which means it can also be found in cold-water fishes and in the liver (where fat is processed) of certain marine animals. And as Patrician Cochran details, “[the Inuit] use lots of fat.” In warmer climates, Vitamin D is constructed from exposure to strong sun—though hardly realistic for these Northerners. The Inuit obtain Vitamin D from the fat and liver of select sea animals much like with Vitamin A. In other words, the Inuit people have managed to obtain sustainable measures of Vitamin A and D due to their consumption of fat and liver from certain marine animals.
Moreover, Vitamin C is yet another essential nutrient seemingly unattainable
for the Inuit. Unlike most species, human beings cannot synthesize this
nutrient in the liver and therefore must seek it from citrus fruits and fresh
vegetables. Lacking Vitamin C, 18th and 19th century arctic explorers
suffered symptoms of Scurvy “joint pain, rotting gums, leaky blood vessels,
physical and mental degeneration” (Gadsby). For a long time, the Inuit’s
supply of Vitamin C was unknown. But in a 2002 study, Harriet Kuhnlein,
director of the Center for Indigenous Peoples’ Nutrition and Environment at
McGill University, concluded that Vitamin C is found wherever collagen is
made. In fact, sources like raw seal, whale, and muktuk hold impressive
amounts up to 36 milligrams. What’s more, the Inuit tendency for consuming
raw meats helps to preserve the Vitamin C otherwise lost in cooking or
processing techniques (Gadsby).
In addition, knowing that the Inuit protein intake of energy falls between
35-40%, Loren Cordain, a professor of evolutionary nutrition at Colorado
State University at Fort Collins, believes that this is all the human body can
‘comfortably’ handle. This ‘protein ceiling’ is defined by how human beings
attain energy from macronutrients. Most of the time, the human body will convert carbohydrates into energy, and then if needed, burn fat. But, through the ‘convoluted business’ of gluconeogenesis, the liver can also obtain energy by breaking down protein. This process creates nitrogen waste that must be converted into urea and disposed through the kidneys. In response to their reliance on gluconeogenesis, the Inuit people generally have larger livers to handle the extra effort as well as larger urine volumes to handle the extra urea (Gadsby).
It would seem that the Inuit’s increased intake of marine animals mitigates the evident lack of plant foods. Researchers wonder if this Northern diet, “lowest in carbohydrates and highest in combined fat and protein” (Gadsby) proves that such a lifestyle is healthy. But much like with the Maasai people, there other factors to consider. These slight adaptations have allowed this Arctic people to subsist amid the ice and snow and sea, but these advantages do not absolve the Inuit from disease. In other words, although the Inuit people have managed to obtain Vitamin A, B, and C from the fat and collagen of marine animals, as well as obtain energy by exploiting gluconeogenesis, there are consequences that offset the benefits.
From the National Institute of Public Health, a study published in 2003 by Peter Bjerregaard sought to analyze officially collected mortality information from three larger populations of the Inuit people (from Alaska, Greenland, and Northern Canada). The purpose of such a publication was to either confirm or discredit certain statements about Inuit disease prompted by their nutritional behavior.
Bjerregaard begins with reference to research from A. Bertelsen, the ‘father of Epidemiology in Greenland,’ in which, “arteriosclerosis and degeneration of the myocardium are quite common conditions among the Inuit, in particular considering the low mean age of the population.” Bertelsen’s findings in 1940 stemmed from years of clinical research in Greenland, as well as reports from medical officers dating back to 1838. He continues with, “…a general statement that mortality from cardiovascular disease is high among the Inuit seems more warranted than the opposite.”
In other words, even before westernization influenced the Inuit population, documented autopsy studies and clinical observations recorded cases of Ischemic Heart Disease (IHD). Bjerregaard’s research further concludes that fatalities from stroke were higher among Inuit populations than in western comparisons. The notion that the Inuit people enjoy low rates of IHD is based on “unreliable mortality statistics” (Bjerregaard).
Moreover, the Inuit people face not only heart problems, but issues concerning bone health as well. In 1974, Richard B. Mazess, Ph.D. and Warren Mather, B.S published a paper in the The American Journal of Clinical Nutrition that found Eskimos after the age of 40 experienced a deficit of 10-15% of bone mineral content in comparison to white standards. Their research seems to suggest this insufficiency as a result of high protein, high nitrogen, high phosphorus, and low calcium -- all stemming from a diet high in animal-foodstuffs. (Mazzes).
The Inuit people have a reputation for thriving in the Arctic cold while consuming only land and sea animals. But, despite attaining survivable amounts of Vitamin A, B, and C, as well as converting protein to energy, these Northerners still suffer health problems. Heart disease and bone degradation are brought on by the inflation of fat and protein from animals and the subsequent lack of carbohydrates from plants.
These adaptations have allowed this Arctic people to subsist amid the ice and snow and sea, but these advantages do not absolve the Inuit from diet-related disease.
Bjerregaard’s research further concludes that fatalities from stroke were higher among Inuit populations than in western comparisons.
Carbohydrates*
from summer roots, greens, wild blueberries, crowberries, or salmonberries.
Fat*
from mainly marine animals but also land animals
Protein*
primarily animal protein
Inuit
Percentage of Dietary Energy Supply
THE OKINAWAN
The Okinawan Islands are a prefecture of Japan and are apart of the larger Ryukyu Islands group. The main island, Okinawa Island, is 360 miles off the coast of Japan with approximately 463 square miles of territory (Britannica). Despite its smaller size, the Okinawan people have as many as five times more centenarians than any other nation in the world (Couteur). What’s more, residents are known for a higher average life expectancy and subsequent reduced risk for “age-associated diseases” (Willcox).
Many attribute this ‘phenomenon’ to uniquely remarkable genes that
promise longevity. However, a distinct shift in the general Okinawan
health between the 1980’s to the 2000’s proves this stereotype to be
less than accurate. The Okinawans went from having the longest
lifespans in Japan to standards no higher than the national average. In
1988, daily consumption of green and yellow vegetables was 50%
greater than the national average. But by 1998, daily meat and fat
energy intake surpassed 100 grams and 30% respectively, while green
and yellow vegetables decreased to the national standard (Miyagi).
Much like with the Inuit people, westernization has influenced the
Okinawan lifestyle with fast and processed foods, not only affecting
their health, but their cultural identity as well. For the purposes of
understanding the relationship between protein and health, the
following will focus on a traditional Okinawan lifestyle.
The traditional Okinawan diet is low in calories yet nutritionally dense,
especially with phytonutrients (antioxidants and flavonoids). In sharp contrast to the Maasai and Inuit, the Okinawan people consume a fruit and vegetable-heavy plate with reduced meat and dairy. It is important to note the added absence of sugar, salt, and refined grains. Such characteristics of “low levels of saturated fat, high antioxidant intake, and low glycemic load in these diets are likely contributing to a decreased risk for cardiovascular disease, some cancers, and other chronic diseases…” (Willcox). Put simply, the traditional Okinawan diet is one of the lowest in fats (pointedly saturated fat) and highest in carbohydrates from plants (Willcox).
This nutritional behavior is due to an exceedingly high intake of root vegetables such as Ninkin (carrot), Satsumaimo (sweet potato), and Shoga (ginger); as well as ‘dark leafy-green’ vegetables such as Okura (okra), Goya (bitter melon), and Umjanabaa (Nigana). A 2007 study from the Annals of the Academy of Sciences found that over 70% of the daily caloric intake of Okinawan centenarians came from a kind of purple yam (sweet potato)—both antioxidant-rich yet low in calories and glycemic load. The same study determined other Okinawan food staples to be, in descending order, rice, grains and wheats, soy and legumes, additional vegetables, and fruit. Animal products such as pork, eggs, dairy, and fish comprised less than 1% of the daily caloric intake respectively (Willcox).
All said, the traditional Okinawa carbohydrate to protein ratio is 10:1. A 2016 study published by Le Couteur in the Oxford Academic sought to interpret how this macronutrient relationship affects longevity. Research with insects and mice demonstrated that animals with ad libitum access to low-protein, high-carbohydrate (LPHC) diets have the longest lifespans” (Couteur). What’s more, the study concluded that the optimum ratio of dietary protein to carbohydrate for health in animals was almost identical to that of a traditional Okinawa diet.
Popular dogma states that elderly people especially must consume more protein in order to maintain strong bones, improve recovery from illness, and accomplish an array of other health benefits. Such beliefs are derived from protein’s ability to spur anabolic responses in the muscle. But, this endorsement disagrees with elemental research in which animals and humans alike enjoy longer lifespans given LPHC foods. Willcox continues this sentiment with, “the lifespan-extending effects of these types of diets are consistent with current understanding of cellular mechanisms that link nutrition with ageing biology.”
Traditionally, the Okinawans are some of the longest-living, heart-healthiest people in the world. With understanding to mild caloric restriction, certain genes, and physical activity, researchers predominantly ascribe their longevity to diet—low in protein from animals and high in carbohydrates from vegetables, whole grains, legumes, and fruit.
Despite its smaller size, the Okinawan people have as many as five times more centenarians than any other nation in the world.
This endorsement disagrees with elemental research in which animals and humans alike enjoy longer lifespans given LPHC foods.
Couteur, Le, et al. “New Horizons: Dietary Protein, Ageing and the Okinawan Ratio | Age and Ageing | Oxford Academic.” OUP Academic, Oxford University Press, 28 Apr. 2016, academic.oup.com/ageing/article/45/4/443/1680839.
Okinawan
Percentage of Dietary Energy Supply
Carbohydrates*
from sweet potato, other vegetables, rice, whole grains, soy, legumes, and fruit
Fat*
from oils, nuts
all animal products (<1% respectively)
Protein*
primarily plant-protein from sweet potato, other dark vegetables legumes, soy, and rice
THE PAPUAN
Papua New Guinea is an island nation located in the Southwestern Pacific Ocean. Although generally tropical, its climate can vary depending on region. Mangrove swamps encompass the coastal areas while sago palms, rivers, valleys, and lowland rainforest comprise the inland territory (Britannica). Unfortunately, the Papuan people face health challenges such as malaria, diarrhoeal diseases, acute respiratory disease, child mortality, and other issues. This is in part due to poor health care networks as approximately 90% of the people live in rural areas (Burnett Institute).
That being said, the Papuan people are known for low rates of
cardiovascular-related fatalities. Many researchers attribute this
‘heart-health’predominantly to nutritional behavior. Much like with the
Okinawans, data for Papuan food consumption varies between past
and present—those influenced by Western conveniences and those who
are not. Around World War II, 95% of Papua New Guinea relied on
subsistence farming, but by 1992, that number dropped to around
85% (Encyclopedia). To avoid reliance on subsistence agriculture,
‘better-off households’ purchase imported ‘Western’ foods such as canned
beef, bread, and beer (Hodge).
For example, the urban, and therefore more ‘affluent’ Wanigela people
of Koki in port Moresby, Papa New Guinea, experienced a surge in
non‐insulin‐dependent diabetes mellitus (NIDDM) and cardiovascular
disease as a result of a major dietary shift beginning in the 1990’s.
Researchers from the National Diabetes Institute in Melbourne, Australia,
attribute the rise to extended consumption of saturated fat, and a
diminished fiber intake (which was unforeseen given the local stature of
starchy vegetables) (Hodge). In fact, a 2010 Global Burden of Disease Study from the Institute of Health Metrics and Evaluation at the University of Washington found that Ischemic heart disease had risen 86% overall. While other potentially diet-related illnesses like chronic kidney disease had increased by 165% (Global Burden).
These examples are in no way representative of the entire Papuan people, especially when considering how many still live in rural areas. In order to grasp a comprehensive look at their protein intake, this paper will focus on the Papuans leading a traditional lifestyle.
As mentioned before, the people of Papua New Guinea rely largely on subsistence farming, but also a degree of hunting, fishing and gathering (Encyclopedia). That being said, the traditional Papuan diet is predominantly vegetarian. Chicken and pork are most often reserved for feasts and special occasions, however some communities will include crab, fish, and crayfish to their diet (Culture). Staples of the traditional Papuan diet include sago, kaukau (sweet potato), taro, cassava, breadfruit, edible leafy greens, nuts, yams, plantains, and coconut. Of course, diet specifics differ between regions. In the Coastal zones, starchy foods like rice, root vegetables, and sago are typically eaten during the morning meal while a similar menu is found during evening meal (with a potential addition of meat). In the highlands and inland areas, meals consist largely of green vegetables, gourd vegetables, and starchy vegetables (again with the intermittent addition of meat).
A Nutrition Country Profile published in 2003 indicates the percent carbohydrate for dietary energy supply was 80.1% from 1964-66 (Saweri). Another study published in the Journal of Chronic Diseases in 1973 cited that carbohydrate accounted for as high as 90% of daily caloric intake (Sinnett). As stated above, definitive data of any cultural group for macronutrient consumption is difficult to quantify. But, researchers can safely assume that percent carbohydrate for dietary energy supply of the Papuan people lies somewhere around 85%.
In his 1973 research, Peter Sinnett, Professor of Department of Human Biology from the University of Papua and New Guinea, conducted a study of over 779 persons with the goal of identifying incidence of cardiovascular disease. Unlike most other places at the time (and today), Sinnett found no increase with age in mean blood pressure, serum cholesterol, fasting blood glucose, or obesity. What’s more, there was absolutely no evidence for diabetes or gout—illnesses brought on by poor nutrition. By using resting and post-exercise electrocardiograms, Sinnett registered a “low prevalence of diagnosable cardiovascular diseases: hypertension, valvular disease, cardiac decompensation (mostly cor pulmonale) and cerebral and peripheral vascular disease. Ischemic heart disease was rare if not absent…” All the presented health problems are accepted as either a direct or contributing result of nutrition.
In 1971, Robert Cooke, MD, in the department of Pathology from the University of Queensland, conducted a morphological study of human disease over Papua New Guinea. He, too, found cardiovascular disease to be uncommon, covering for only 0.2% of the country’s total hospital admissions. A later autopsy report of 995 persons between 1962 and 1968 found only 8 cases of cardiovascular disease, “which is so prevalent in the technologically advanced countries of the world." Further on, Cooke again corroborates with Peter Sinnett’s research as he documents that hypertension was extremely rare.
The near absence of cardiovascular disease, gout, diabetes, and hypertensions seems to parallel with the intake of animal protein and saturated fat, or lack thereof. It appears that the Papuan people maintaining a traditional lifestyle--high in carbohydrates from plants such as sweet potato, dark greens, and sago—are at low-risk for many diet-related diseases.
Staples of the traditional Papuan diet include sago, sweet potato, taro, cassava, breadfruit, edible leafy greens, nuts, yams, plantains, and coconut.
Sinnett found no increase with age in mean blood pressure, serum cholesterol, fasting blood glucose, or obesity.
Carbohydrates*
from sweet potato, sago, rice, vegetables, fruits
Fat*
from some oils and nuts
certain animal products
Protein*
primarily plant-protein from sweet potato, dark leafy greens, rice.
animal protein from pork, chicken, some seafood
Saweri, Mila. “Nutrition Country Profile - Papua New Guinea.” Nutrition Country Profiles, July 2003, www.bvsde.ops-oms.org/texcom/nutricion/pngmap.pdf.
Papuan New Guinean
Percentage of Dietary Energy Supply
In the end, each cultural group eats, works, and lives differently. But similar trends help identify the relationship between human beings and protein, and therefore protein and human health.
Many people believe the Maasai people are virtually disease-free. However, a closer look reveals extensive atherosclerosis and kidney impairment as a result of high meat and milk intake. Combined fat and protein lends to 86% of their caloric intake. Secondly, the Inuit have survived by finding sustainable amounts of Vitamin A and B in the fat of some marine animals. They obtain Vitamin C from the collagen of other animals, while using gluconeogenesis to get energy. Unfortunately, such a lifestyle has lead to atherosclerosis, degeneration of the myocardium, stroke, and poor bone health. 85% of the Inuit’s dietary energy supply comes from combined fat and protein. In the Pacific, traditional Okinawans are known for their longevity and subsequent lack of illnesses such as cardiovascular diseases or bone degradation. The Okinawan diet parallels with research revealing that animals with ab libitum access to low-protein, high carbohydrate foods have the longest lifespans. About 85% of the Okinawa people's caloric intake comes from carbohydrates. Finally, research has shown that with a traditional Papuan lifestyle, there is no increase with age in mean blood pressure, serum cholesterol, fasting blood glucose, or obesity. In addition, there is little to no presence of hypertension, valvular disease, cardiac decompensation, vascular disease, gout, or diabetes. Much like in Okinawa, the people of Papua New Guinea find over 80% of their dietary energy supply from carbohydrates.
Both the Okinawans and the Papuans attain only 8-9% of their daily caloric intake from protein. And still, much of this protein comes from plants not animals. It would appear that the cultural groups lowest in protein intake yet highest in carbohydrate face the smallest risk for disease and greatest chance for longevity.
Nutritional analysis can be hard to procure definitive answers. But if anything, the comparison clearly demonstrates that eating more plants than animals can only help.
OVERVIEW COMPARISON
Maasai
Inuit
Okinawan
Papuan
WORKS CITED
B., Richard, and Warren. “Bone Mineral Content of North Alaskan Eskimos | The American Journal of Clinical Nutrition | Oxford Academic.” OUP Academic, Oxford University Press, 1 Sept. 1974, academic.oup.com/ajcn/article-abstract/27/9/916/4911797?redirectedFrom=PDF.
Bhatia, Aatish. “Milk, Meat and Blood: How Diet Drives Natural Selection in the Maasai.” Wired, Conde Nast, 3 June 2017, www.wired.com/2012/09/milk-meat-and-blood-how-diet-drives-natural-selection-in-the-maasai/.
Bjerregaard, Peter, et al. “Low Incidence of Cardiovascular Disease among the Inuit*/What Is the Evidence?” Elsevier, Atherosclerosis, citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.496.1664&rep=rep1&type=pdf+.
Britannica, The Editors of Encyclopaedia. “Okinawa.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 27 July 2016, www.britannica.com/place/Okinawa-prefecture-Japan.
Campbell, Thomas. “Masai and Inuit High-Protein Diets: A Closer Look.” Nutrition Studies, Center for Nutrition Studies, 5 Oct. 2016, nutritionstudies.org/masai-and-inuit-high-protein-diets-a-closer-look/.
Cooke, Robert Arthur. “New Guinea Pathology.” Espace Library, University of Queensland, espace.library.uq.edu.au/data/UQ_207197/New_Guinea_Pathology_v1.pdf?Expires=1523166158&Signature=N~Y0qVSQpPEaX63YhvbPJ9hWxqeeK6M8aeZuAfoOhZMp7po0YQ3B-DViBhR4ZNbWnK~TqzD6SUdDbOTfZO8nBwFpHfPKAeyaJvLoO4dhrWODz45HCIHUv9uxHNyRkX3ht3jE646T2ZH4SF3HmHbY3YwSaUhMRf-itsJV7aZQ1TdMKl-le02nPX3Y99eRJapdOyaUCMHot41OGLzDtjoG8AUgd0pif3OXt9zqBcfB0kczzrXRmBxzR~a-VmL5bGUqC9ZBtr5m-MiJIwVC5vuhxjS17fuDcBJ8qYFadoMBTMThvLaofo74oFCs1QOKvX5uDoHNOeQvQJfR9DrdswUTxw__&Key-Pair-Id=APKAJKNBJ4MJBJNC6NLQ.
Couteur, Le, et al. “New Horizons: Dietary Protein, Ageing and the Okinawan Ratio | Age and Ageing | Oxford Academic.” OUP Academic, Oxford University Press, 28 Apr. 2016, academic.oup.com/ageing/article/45/4/443/1680839.
Davis, Charles Patrick. “Creatinine (Low, High, Blood Test Results Explained).” MedicineNet, Medicine Net, www.medicinenet.com/creatinine_blood_test/article.htm#who_has_low_or_high_blood_creatinine_levels.
“Food in Papua New Guinea.” Culture of the Countryside, www.cultureofthecountryside.ac.uk/resources/food-papua-new-guinea.
Freeman, Minnie Aodla. “Inuit.” The Canadian Encyclopedia, Historica Canada, www.thecanadianencyclopedia.ca/en/article/inuit/.
Gadsby, Patricia, and Leon Steele. “The Inuit Paradox.” Discover Magazine, Science for the Curious Discover, discovermagazine.com/2004/oct/inuit-paradox.
“GBD: Papua New Guinea.” Health Data, 2010, www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_papua_new_guinea.pdf.
G. Solon-Biet, David, et al. “New Horizons: Dietary Protein, Ageing and the Okinawan Ratio | Age and Ageing | Oxford Academic.” OUP Academic, Oxford University Press, 28 Apr. 2016, academic.oup.com/ageing/article/45/4/443/1680839.
Hodge, Allison M., et al. “Diet in an Urban Papua New Guinea Population with High Levels of Cardiovascular Risk Factors.” Taylor & Francis, Ecology of Food and Nutrition, www.tandfonline.com/doi/abs/10.1080/03670244.1996.9991500.
Le, D G, et al. “The Impact of Low-Protein High-Carbohydrate Diets on Aging and Lifespan.” Cellular and Molecular Life Sciences : CMLS., U.S. National Library of Medicine, Mar. 2016, www.ncbi.nlm.nih.gov/pubmed/26718486.
“The Maasai People.” Maasai Association, Maasai Association, maasai-association.org/maasai.html.
Mirzaei, Hamed, et al. “Protein and Amino Acid Restriction, Aging and Disease: from Yeast to Humans.” Trends in Endocrinology and Metabolism: TEM, U.S. National Library of Medicine, Nov. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4254277/.
Miyagi, S, et al. “Longevity and Diet in Okinawa, Japan: the Past, Present and Future.” Asia-Pacific Journal of Public Health., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/18924533.
Saweri, Mila. “Nutrition Country Profile - Papua New Guinea.” Nutrition Country Profiles, July 2003, www.bvsde.ops-oms.org/texcom/nutricion/pngmap.pdf.
Sinnett, Peter F., and H. M. White. “Epidemiological Studies in a Total Highland Population, Tukisenta, New Guinea: Cardiovascular Disease and Relevant Clinical, Electrocardiographic, Radiological and Biochemical Findings.” Journal of Chronic Diseases, Elsevier, 24 Mar. 2004, www.sciencedirect.com/science/article/pii/0021968173900313#!
Standish, William, and Richard T. Jackson. “Papua New Guinea.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 5 Oct. 2017, www.britannica.com/place/Papua-New-Guinea.
Willcox, D C, et al. “The Okinawan Diet: Health Implications of a Low-Calorie, Nutrient-Dense, Antioxidant-Rich Dietary Pattern Low in Glycemic Load.” Journal of the American College of Nutrition., U.S. National Library of Medicine, Aug. 2009, www.ncbi.nlm.nih.gov/pubmed/20234038.
WORDS FROM THE TEXT
anabolic: relating to or promoting anabolism. Anabolism is the synthesis of complex molecules in living organisms from simpler ones together with the storage of energy; constructive metabolism.
antioxidants: a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction that can produce free radicals, leading to chain reactions that may damage cells.
atherosclerosis: the build-up of fats, cholesterol, and other substances in and on the artery walls.
cardiac decompensation: A chronic condition in which the heart doesn't pump blood as well as it should (heart failure).
carotenoids: any of a class of mainly yellow, orange, or red fat-soluble pigments, including carotene, which give color to plant parts such as ripe tomatoes and autumn leaves.
cassava: the starchy tuberous root of a tropical tree
centenarians: a person of 100 years or more
collagen: the main structural protein in the extracellular space in the various connective tissues in animal bodies
fibrosis: thickening and scarring of connective tissue
flavonoids: a colorless crystalline compound that is the basis of a number of white or yellow plant pigments. Flavonoids are believed to to have antioxidative activity, free-radical scavenging capacity, coronary heart disease prevention, and anticancer activity.
gluconeogenesis: a metabolic pathway that results in the generation of glucose from non-carbohydrate carbon substrates. Converting protein into energy.
gout: A form of arthritis characterized by severe pain, redness, and tenderness in joints. Triggers for acute attacks of gout include surgery, dehydration, beveragessweetened with sugar or high fructose corn syrup, beer, liquor, red meat, and seafood
saturated fat: fat molecules that have no double bonds between carbon molecules due to saturation with hydrogen molecules. saturated fat raises LDL cholesterol in the blood, and therefore increases risk for heart disease and stroke.
Inupiat: a subdivision of the Inuit people. Inupiats are native to Alaska whose traditional territory spans Norton Sound on the Bering Sea to the Canada–United States border.
LPHC: low protein, high carbohydrate
macronutrients: carbohydrate, fat, and protein. A type of food required in large amounts by living organisms.
mangrove: a tree or shrub that grows in chiefly tropical coastal swamps that are flooded at high tide
scurvy: a disease resulting from the lack of Vitamin C.
As scurvy worsens there can be poor wound healing, personality changes, and finally death from infection or bleeding.
myocardium: the muscular tissue of the heart.
nigana: a wild, bitter, indigenous leaf-grass vegetable often used in soup
phytonutrients: a substance found in certain plants which is believed to be beneficial to human health and help prevent various diseases.
sago: a starchy substance obtained from the sago palm. Sago is extracted from the trunk of the palm, and pounded with blunt wooden implements into a very versatile powder that can be easily stored to be used when needed
subsistence farming: a self-sufficiency farming system in which the farmers focus on growing enough food to feed themselves and their entire families
taro: a tropical Asian plant of the arum family that has edible starchy corms and edible fleshy leaves
tubers: enlarged structures in some plant species used as storage organs for nutrients. tuber crops consist of potatoes.
urea: a colorless crystalline compound that is the main nitrogenous breakdown product of protein metabolism in mammals and is excreted in urine.
valvular disease: a type of heart disease characterized by damage to or a defect in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary.
vascular disease: another term for heart disease