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I think this is going to lead to some tense conversations around the table at Thanksgiving as children and grandchildren try to tactfully interrogate their mothers and grandmothers about their pregnancy eating habits. I think it might be best to not mention why you are asking because it could be interpreted as a little "blamey". – Happy Now Jul 10 2011 at 8:29
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I find it almost impossible to read due to the errors in spelling, grammar and syntax. – Katherine Jul 10 2011 at 11:19
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I only found paleo within the last 2 years - When I was pregnant with my son 15 years ago all I craved to eat was Taco Bell and Chinese Food. So let me get my apology out now, I'm sorry son, I gave you Asperger's Syndrome and whatever other ailments you end up dealing with. Although, considering my father has Asperger's, and I have a mild case myself, that one might not be entirely my fault. – HeatherC Jul 10 2011 at 13:37
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it seems the ideas got thru to many people considering the email and comments I have gotten so far. Sorry to disappoint you Katherine. I wrote that blog on the fly in between surgery cases as I read Jack's VAP. When a thought comes to me I write my thoughts. That works for me. The concepts to me are paramount. – The Quilt Jul 10 2011 at 16:37
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Quilt, please, please, partner with a journalism student to make those concepts more concise and the English more correct. It would take a journalist no more than 10 mins to parse through your work prior to your posts. While theories may be paramount to you (being an NT), the message is getting lost for many who can't ignore "mistakes" no matter how small. A Jr or Sr interested in pursuing a journalism career in the medical investigations field could learn a lot from you, right? – Marie Jul 10 2011 at 18:47
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10 Answers

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Epigenetics are a BIG deal. Transgenerational epigenetics + eating Paleo = an even BIGGER deal.

http://en.wikipedia.org/wiki/Transgenerational_epigenetics

Kudos to Dr. K for following this line of thought.

The Shanahans of Deep Nutrition have also advocated for a similar position on diet and health.

http://www.amazon.com/Deep-Nutrition-Your-Genes-Traditional/dp/0615228380

PS my pet theory is that transgenerational_epigenetics might go a looooong way in explaining the obesity epidemic -- as in, the travesty of formula-fed infants who grow up to have children.

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I totally agree. It's also probably the answer for yesterdays question "Hack my wife's Vitamin D status". The poster was asking why she hadn't suffered ill effects from low vitamin d. Chances are her mom had good nutritional status and/or D status during pregnancy, born in late summer/early fall (indicating a better chance of good maternal D status), perhaps she was breastfed etc etc – Katherine Jul 10 2011 at 11:22
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This story is going to be big. If you read the oncologic and genetic journals as I do....genetic determism is dying quickly. Soon many disease we all have no idea what causes them will have etiologies and open the eyes of many of my fellow MDs. I guess I am going to have to do my AD series early. Epigentics is critical to incidence and prevalence curves. Samething with osteopenia and porosis. – The Quilt Jul 10 2011 at 16:07
chances are Kathern she has done immeasurable damage to her stem cells if the D level is low.....and she will pay for it down the road. Nothing gets a free pass in biology. – The Quilt Jul 10 2011 at 16:40
How about women who IVF have offspring with 3-4 times the rate of Beckwith-Wiedemann Syndrome.......all epigenetically based. Go read about the Nazi induced Dutch Hunger Winter of 1944. Another epigenetic effect documented. How the latest one I know of.....Dr Yehuda study on pregnant women during the trade center disaster in NYC. All epigenetic effects. Its going to be bigger than we all think. – The Quilt Jul 10 2011 at 22:18
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Deep Nutrition is a good book. It's on my bookshelf right beside Robb Wolf, Mark Sisson and Art de Vany. – Andrea Jul 10 2011 at 23:05
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He makes so many assumptions based on jack kronk, he blames his weird lipid panel on his very moderate carb intake of 150-200g based on nothing. We have no idea what jack kronk does everyday. Its a joke.

I definitely agree with the epigentics part somewhat though.

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If what I did was totally horseshit my clinic would be empty. Im fine with criticism.....but you two have have a closed mind and it safe to say we should just agree to disagree on everything one another says here and anywhere else and we should be fine. – The Quilt Jul 10 2011 at 16:15
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"it safe to say we should just agree to disagree on everything one another says here and anywhere else and we should be fine" lol it doesn't have to be so absolute, I agree with people on stuff and disagree on other stuff, no biggie, I wasn't trying to discredit you, I;m sure you help out a lot of people, I just don't agree with this specific issue – cliff Jul 10 2011 at 16:24
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i know you have not.....but saying carbs are fine for everyone is not biologically correct either and that shows up here in many threads. Their are people here who realize they have to do things some of us dont. My job is to explain why and not keeping allowing the excuse of n-1 and genetics be the default answer. It has zero to do with our genes and has everything to do what signals we give our genes over time. The stronger the signal the more hard wired changes we see in the brain. That is why I dont buy SG theory at all on reward and obesity – The Quilt Jul 10 2011 at 17:07
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Quilt, the basic problem with what you're saying, and what you've said repeatedly on this site, is that you are always harping against a straw man. You always go on and about how diet is not a one size fits all approach, it needs to be done in context, everyone is different. Yeah, no kidding. We all know that. Your entire premise is against this supposed foe. Its not that big a deal. Avoid grains, legumes, dairy and alter to each person's needs given their lifestyle and history. You're trying to be so novel, so different than everybody, with some supposed breakthrough. – ben61820 Jul 10 2011 at 18:44
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I highly doubt that ben61820 is disenfranchising people who have questions about tweaking paleo. Take a gander at questions he poses and answers he gives. Just because someone criticizes your logic does not mean that they fit into a neat little box of "closed-minded" paleohackers. Other people write about self-experimentation, leptin, and epigenetics. They just don't necessarily post on paleohacks, and they don't brand it "Paleo 3.0". Not to mention that comparatively few people abandon paleo, and anecdotally the lion's share of paleo practitioners get better results than anything else. – Kamal Jul 10 2011 at 20:22
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First of all, I think it was thoughtful of Quilty to write the post. Irrespective of whether you are a Quilt fan, to the extent he was motivated to write the post to address concerns that Jack raised, props where props are due!

Secondly, I think Epigenetics could be big deal as the science unfolds. Stephan Guyenet wrote an article discussing epigenetics over 1 year ago (cannot find it at the moment) and it definitely left me with a "holy sh*t, that would be a HUGE deal if the acceleration of DOCs are being fueled by this concept".

Having said that, the science behind this is still quite nascent from what little I've read (and yes it's little so maybe I'm grossly wrong). Here is what I fear short term until the science evolves - it would be very easy for people to adopt the mentality of "I'm screwed because of what my grandmother did so screw it, pass me another twinkle, coke, and slice of pizza".

So I have to ask myself, what is actionable and would materially impact the choices I would make as a result? There is nothing about epigenetics theory right now that materially changes my view of diet and lifestyle

  • Avoid excess fructose (cut the bananas Jack!!!)
  • Avoid grains
  • Avoid excess Omega-6
  • Avoid soy
  • Focus on real foods that my ancestors ate....or should have eaten so as to have not screwed me over today vis-a-vis epigenetics so that at least my progeny aren't further damaged
  • Get adequate sleep
  • Move around and stay active
  • Have sex with the woman I love

Everything else - tweaking macronutrients, debating the minutia of biochemistry, and other orthorexic tendencies will continue evolve, but at the end of the day I do not see epigenetics materially changing the 80-90% of what I already do or at least should be doing. Maybe that will change once I understand this concept more and the scientific details behind it.

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im with you on this, aravind. i sometimes geek out over the next new thing we find out concerning the body and optimallity. however, when i step back to see if the new information alters what ive been doing and recommended others do, it really doesn't. and that's what the mainstream are more interested in- how is all of this knowledge applicable to their everyday life. – luckybastard Jul 10 2011 at 13:43
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Some wait for causation.....I get paid to treat now.....so I need to read between the lines of correlation studies and look at biologic plausibility. If not all I can offer is statins and whole grains. That is the conundrum we docs face. As I post above to ben and cliff it appears some patients would prefer docs wait until we know it all. Well in my clinic thankfully I dont have a lot of ben's or cliff's. People want help from their docs now. And they know they have not gotten it for a long time. Im trying to change that. – The Quilt Jul 10 2011 at 16:19
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@quilt - I did not write that I need complete certainty to embrace a concept if it has plausibility and the costs/risks of accepting are low to nil. Having said that, there is nothing I wrote that I would expect to materially change if/when epigenetics reveals something novel. I still think the bullets I wrote above would be valid. Do you disagree? Regardless I again reiterate that it was thoughtful of you to write the post – Aravind Jul 10 2011 at 17:23
i do agree.....I think my displeasure comes from the belief here docs wont help you so forget them and then when they do you face attacks about your writing or the science is not vetted enough. You cant have both ways. If you want change you do things that make that change occur. If you dont want change stay dogmatic and attack the grammar. That is my point. And I do appreciate your kind words. I posted because Jack wanted feedback. I think his case can help thousands of hackers. – The Quilt Jul 10 2011 at 19:10
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i don't buy the epigenetics explanation to the extent that i think some people are trying to take this. if this theory concerning epigenetics and obesity and DOC's is to hold up, then why do second generation immigrants in this country- and even the immigrants themselves- succumb to the same same maladies that people on the standard American diet suffer from when they start to consume our diet? i helped my boss lose a lot of weight for her daughter's wedding. she is a filipino immigrant who's been here 30 years. she was one of the easiest people to deal with because all i had to tell her was to go back eating like she did as a child in the phillipines with some advice about oils and such. the weight fell off of her.

i also don't buy it because of my own experiences. i was obese basically from birth: formula fed and the whole bit. all of my mom's kids popped out the womb well over 8 lbs with my youngest brother weight 9lbs 6oz. now being that my mom gave me some pretty sucky genes to start with, according to jack kruse, i would have to stay low carb the rest of my life to keep a decent weight, which i've only recently attained in the last couple years. how is then that i can eat copious amounts of starch and fruit while adjusting my fat intake depending on how much carbs i'm taking in, and keep a stable weight?

from my perspective- again i'm not a dr and don't even play one on tv- the simplest and probably most correct way to look at the obesity and DOC's situation in this country is not to look backwards but to look around you. tweak your diet to see what degree you can heal your metabolism and from there see what you can tolerate. i do think low-carb paleo is a good place to start to heal metabolic syndrome but after that, i think people definitely need to start messing around with cycling carbs to break the physiological insulin resistance that sets in with going low carb for too long.

btw, that momma who gave me the bad genes has dropped 50lbs this year so far with low carb paleo and has been easing into a moderate carb version and still doing well. happy birthday, ma :-)

Edit: Thinking more on the subject, wouldn't the argument from a cursory observation standpoint that the parent's or grandparents diets are the cause of some maladies be confounded by the fact that as a child, in most cases, you are reared on nearly the identical diet of your parents? considering many times that the quality of diet is based on things such as location and socioeconomic status, i think there are too many confounders to start laying it at the door of epigenetics- a study that is very new and not thoroughly understood. i've been reading and listening to chris kresser regarding prenatal and childhood care and i totally agree with what he's saying. i guess what is messing with me, unless i am reading it wrong, is that kruse insinuated that the macronutrient ratio you should eat is determined by epigenetics- outside of your hypothalamus leptin signaling being destroyed by fructose and excessive o6- just seems not to jive with what i've observed and experience.

" That is why people like JK have always believed that high carbs are not a problem for their entire life. Their experience made them believe that. The converse is also true for someone like me. I knew carbs had to be kept low because of what I knew about my own grandmother and mother and what I did to myself the ten years before I became a morbidly obese surgeon"

my question is to other people well-versed in it. is this where the science is taking us on epigenetics?

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LB, your edit leads off with an excellent question. I'm only an N=1, but I'm an adopted N=1, lol. And I've definitely inherited my (obese) birth mother's body/metabolism, despite being raised by a thin woman, and being fed the thin woman's (high-carb) diet. Again, just one anecdotal data point. – Rose Jul 10 2011 at 14:54
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Having said that, I do think your caution is correct. I tend to be a bit of a cowboy, and I don't mind when people like Kruse push a new theory too far, but your general point -- that we don't know enough to start slinging around theories as if they're Truth -- is valid. – Rose Jul 10 2011 at 14:56
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because epigentics plays a role on three levels......your mom's when she was an oocyte in your grandmother, your mom on your egg.....and lastly what you have done to your switches. No one knows the true impact of each level.....but there is no doubt there is an impact. And why do I think JK VAP opens up this discussion in a huge way to this community.....many of you dont realize just how dynamic the system is......and how the switches can be flipped. And what the results of long term flipping on or off are. Obesity is the chronic flipping off of the hypocretin neurons. Not food reward. – The Quilt Jul 10 2011 at 16:23
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Thanks for responding, doc. I'm not opposed to the idea of epigenetics- the way that mark sisson explained it in the context of paleo seemed very plausible- it's how the original(and very ltd)understanding of it has been extrapolated to include macronutrient ratios being affected by them. I am still in the camp of metabolic derangement and the damage-some reversible, some not- it inflicts on different mechanisms, ranging from the brain to the liver,being the main culprit behind obesity and other modern diseases. – luckybastard Jul 10 2011 at 16:42
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Even though my level of understanding is fairly preschool comparatively, I've always felt epigenetics comes into play for the following reasons:

Skinny people are born skinny, pretty much regardless of what they eat. Many people who eat appropriate quantities of the healthiest "SAD" food seem to be sick and fat.

I've tried, after a year of paleo, to reintroduce carbohydrate and it resulted in meteoric weight gain, 15lbs in two months time! The reintroduction of carbs also brought back my severe leaky gut symptoms (that I had previously associated solely with my gluten intolerances).

I don't need to have someone tell me "yr doin it wrong" because they have no clue about my genetic predispositions, the fact that my paternal grandmother was morbidly obese, my maternal grandmother despite hard farm living for most of her life and a fairly healthy WAPF-type diet, struggled with her weight (although she was blessed with some longevity).

I've always felt that people who are "born thin" and try to lecture the overweight on how to be thin is ridiculous. When I meet someone who was once morbidly obese and lost a few hundred pounds, then kept it off through diligence and maintenance - that's the person I want to listen to.

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Big props. Yer singin' my song, here. – Rose Jul 10 2011 at 14:46
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really well said. i totally agree. i have always had the healthiest diet of anyone in my peer group. i move a lot. and im 40 pounds overweight, just like most of my family on dads side. when someone who weighs a buck ten tells me that i would be fine eating papa ginos pizza "in moderation" i want to pick them up and toss them. – being Jul 10 2011 at 15:12
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I was 50 pounds overweight for the majority of my teen years and I lost it all on peanut butter and wheat bread sandwiches. Losing weight has a lot more factors then carbs or even any food intake. Correct exercise and stress free living are the biggest facotr imo and experience. – cliff Jul 10 2011 at 16:40
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The older you are and the more damage you have done the harder it seems to lose as well but then again I've seen some older folks lose extreme amounts of weight on just about every diet plan. – cliff Jul 10 2011 at 16:41
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Sorry, but one other thing of note Cliff - a diet designed around weight loss is simply "treating the symptom"... this is collectively what is wrong with the majority of nutritional and medical common wisdom. In my opinion (from my own experience), obesity is simply a symtom of a much larger illness. Treat the illness, not the symptom. – Joshua Jul 10 2011 at 18:10
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This is all very fascinating but also very complicated. I look forward to more discussions on the subject. I feel like we are talking a bit of apples and oranges here though. Epigenetics and transgenerational epigenetics are not the same thing yet we seem to be communicating as though they were.

Here's a great primer on epigenetics for those interested. I think it's a very easy to understand presentation.

Transgenerational epigenetics seems to be, for lack of a better description, a more complicated subset and I think something we know less about. I think this is a good article that makes it a bit easier to understand and also highlights some of the complexities involved in trying to understand how this all works.

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Thanks for the excellent links, Shari. – Rose Jul 10 2011 at 15:59
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biology is always complex when you get lost in the myopic details. There is a grand scheme. All based upon fractal geometry and cellular homeostasis. That is what I am attempting to slowly role out in the Quilt. I fully understand that some of this will make little sense to some. But the more pieces added you will soon see that life uses the same patterns over and over again no matter the biologic system. Its evolutionary mathematics at work. Most people dont understand things in math but in concepts. Ironically physicists get this more than any other group I speak too. – The Quilt Jul 10 2011 at 16:27
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Excellent point Shari. Sisson, in blueprint, went some way in concisely explaining epigenetkcs. Nothing new here in K's 3.0. Transgenerational is a completely different thing: apples and oranges for sure. – ben61820 Jul 10 2011 at 16:34
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Wow fractal geometry. That's hilarious. Thx for the constant barrage of goofiness, K! – ben61820 Jul 10 2011 at 16:36
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@Ben I said the same thing in my comment. The way sisson put it out there was much more measures considering that it's a relatively new area of study. – luckybastard Jul 10 2011 at 16:52
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Epigenetics is nice and all, but there is no way for us to rely on it unless we are a direct descendent of the Okinawans on both sides of our family. Our world is too fractured genetically for these types of conversations to be useful. What Quilt is getting at, basically, is N-1 self experimentation is good. I agree.

However, what should have been an answer in Jack Kronk's VAP thread is NOT what I would refer to as Paleo 3.0.

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And I do........there in lies the difference. – The Quilt Jul 10 2011 at 17:16
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Do you really think that epigenetics is useful outside of pure tribal groups? Do you really believe that N-1 self experimentation is new to paleo? Clearly, not a 3.0 moment. Contrarian, unqualified respones like this are a portion of why you aren't taken seriously here. – Arlokk Jul 10 2011 at 18:12
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@Arlokk -- one cannot "rely" on epigenetics/gene expression -- it happens. So one must attempt to have one's genome express in a healthful manner. Credit goes to Art De Vany for beating that drum for a long time. – Patrik Jul 10 2011 at 21:00
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I have always thought that epigenetics influences evolution. When I took some evolutionary biology courses in University (20 years back) we talked about the punctuate equilibrium theory of evolution (long periods of constant life followed by a short period of rapid change). Perhaps this is Nature's way of throwing anything against the wall and see what sticks. We are still evolving, it never stops. The way I look at it perhaps epigenetics is one of many causative factors that leads to the rapid mutation and change organisms can undergo.

Here is a link to a good article: http://epigenome.eu/en/1,3,0

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One advantage to being an old geezer (68) is that my mother and I were born before the perfect storm of agribusiness, junk food and misguided nutritional theories. My grandmother was born in the country in the 19th century. Her mother was no doubt eating too many grains but otherwise well. From my understanding, my grandmother came to stay with my mother when she was pregnant with me. (My father was in England with the Air Corps.)

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Not practical. There's not a damn thing the average person can do with epigenetics. Beyond general paleo guidelines of QUALITY food(max nutrients/min antinutrients), things like carb/fat/protein ratios and specific foods and supplements are all case sensitive and should be determined experimentally and by genetic analysis. It's not high protein or high fat, it's just food quality.

So if you want to become some intermediate in a developing familial line of people "adapted" to bread and Snickers bars, be my guest. But without genetic testing and experience most people are probably sh!t out of luck on knowing whether their ancestors consistently ate the same things. What if great grandma drifted into drastically different dietary habits then her lineage? What if it happened with each subsequent generation? What if the two parents are from completely different backgrounds?

There's no doubt that epigenetics is an occurring phenomenon. But on a practical level it's a wash. Show me a person who's gut can disable WGA, isolate the gene or bacterium, and then we can talk about epigenetics being useful. For now, it's just an area under the "needs more research" umbrella. Nothing more, nothing less.

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There is plenty to do if you invest the time to understand the science. If not you can mimic a lifestyle you think works best for you. We are at the point now where we can tell what turns on and off our switches. Art deVany has been pounding this drum longer than anyone in this community. And the more science that get uncovered the more his once unusual theories are beginning to make some serious sense. – The Quilt Jul 10 2011 at 19:38
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Quilt. Understanding the science is impractical because the science itself is very incomplete. Not to mention that we don't know enough specifics about our near ancestors' diet and health to make any definite conclusions. And even if we could, there are only so many foods and nutrients we have at our disposal. There's no magic combination that is all of a sudden going to heal everything(well, unless maybe a HG fecal transplant). What are you going to find out, that oranges are better than hazelnuts for you? Puh-lease – Kirill Jul 10 2011 at 20:29
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@Kirill -- you make multiple large errors here. 1) "The science" is ALWAYS incomplete. ALWAYS. In any field. 2) You are advocating for doing nothing in the face of incomplete knowledge and tremendous uncertainty. Silly and non-productive. 3) One can take existing (and yes, admittedly incomplete ideas/theory/science) and test them in the reality of the real world -- which is what The Quilt is doing with his patients. – Patrik Jul 10 2011 at 20:58
@Patrik Firstly, I'm talking about the average person, for whom there's not much to act upon. Secondly, of course if you're a professional who has access to data and lab tests then you can combine that to optimize one's diet and lifestyle. But guess what? Epigenetics will not play a great role in it unless extensive data on recent ancestors is present. And even so, tracking, logging, bloodwork analysis and genetic testing will pretty much carry 99% of the weight here. If epigenetics shaves off a little search time - great. But it's premature to dub it the new frontier or paleo 3.0. – Kirill Jul 10 2011 at 21:30
@Kirill - You are vastly and painfully incorrect. By simply eating Paleo, you are initiating positive epigenetic effects (per Art De Vany). It is a precisely a new frontier i.e. scary, risky, unknown, and yet full of potential. The reason this is a big deal b/c this, outside of the Paleo community, has had little impact on traditional views of nutrition. – Patrik Jul 11 2011 at 0:57
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