Joseph Finau: A Kiwi Tongan Being Like Daphnis

Australia’s Indigenous Health Woes

The official statistics I have quoted on indigenous health related to diabesity are appalling.  Anecdotally too, there are horrific case examples.

We looked at the nonsensical state of innovation in diabetes and diet. In a situation analogous to the slowness to accept the cure for scurvy, we have seen forces that appear to be holding back effective dietary solutions for indigenous health. Those solutions, based on a traditional diet, were demonstrated back in the 1980s.

The situation looks bleak, but the low-carbohydrate movement has always focussed on grassroots solutions. That is a good strategy. You see the stakeholders who have the most to gain are people whose health is improved. The problem with low carb is that almost everyone else has something to lose. That is particularly the case for the food and pharmaceutical industries who benefit from the status quo. If you are in government and reading this, I have a message. It is incredibly short-sighted not to openly understand whether there are the disempowered stakeholders you should put first. This is an ancient problem for bureaucracy. You need to be counter-intuitive and anthropological. But we are getting deep.  The efficient management of innovation by the government is a topic for another post.

Be Like Daphnis

Be Like Daphnis
Be Like Daphnis (C) Astrokatie

The good news is that change is happening at the grassroots. I came across this Internet meme about Daphnis.  It is one of the smaller moons of Saturn and the small ripples it makes in the rings of its much larger neighbour, and it seems appropriate to represent the change we can individually make. I think it is also very apt for this post.

We examined the success of Joy Aghogho in Nigeria. Dr Jay Wortman has done fantastic work with the First Nations peoples of Canada (see his comment in a previous post). Island nations like Vanuatu are going back to traditional foods although one wonders if they have the science completely right.

Joseph Finau: A Kiwi Tongan

I want to focus on the efforts of one individual in New Zealand who is making a difference. Joseph Finau commented on one of my posts, and I think it is worth considering his recent journey.

Joseph is a single dad from Auckland, New Zealand who has a remarkable story of battling diabesity and weathering personal tragedy.  Losing 100KG (220 lb) is something entirely amazing but moving beyond that I want to celebrate his success in innovating within his community. 

According to the 2013  NZ census, about 60,000 people of Tongan descent live in New Zealand.  Most live in the North Island in and around Auckland. Like many Pacific peoples, and in common with the Aboriginal and Torres Strait Islanders, Tongans have suffered from diabesity in the transition from a hunter-gatherer diet and lifestyle to a Western diet and lifestyle. For their diet, diabesity is commonly blamed on the eating of turkey tails, lamb flaps and corned beef.  Joseph has a different point of view- one born from the perspective of his success.

I believe that going back to the way our ancestors ate is the only way to cure ourselves from this western disease (Diabetes). for the last 3 years I’ve been eating Island foods mixed in with Western foods. example: Taro leaves & coconut cream & corned beef. Tongans loves corned beef but told it’s no good. the thing is? CORNBEEF has NO CARBOHYDRATES or SUGAR which means it’s low carb.

Joseph has adapted the Western foods Tongan’s love with some traditional food (less the starchy staples) to make Tongan and Pacific island dishes the low-carb way. That is also what the Nigerians have done and it is also what Western low-carbers have done. Corned beef cooked with cabbage in coconut cream and raw fish (AKA ceviche or kokoda) are but two dishes. Joseph has addressed one of the complaints, that low carb is too expensive, by also thinking about the economics for large families who need to be fed on a budget.

Is Low Carb Too Expensive?

The economics of low carb are an interesting topic perhaps for a future post. Let us just say here that the current criticism that low carb is expensive has some validity.  It is also true that economies of scale have not yet kicked into the food supply. For sure there will be winners and losers.  We only need to look at what has happened to the cost of solar power as economies of scale kicked in. A technology that was always a great idea but was uneconomic is now economic.

Data from the Solar Energy Industries Association and GTM Research show the inverse relationship between scale and cost. CREDIT: SEIA.org
Data from the Solar Energy Industries Association and GTM Research show the inverse relationship between scale and cost. CREDIT: SEIA.org

However, for the moment Joseph does have solutions that work for him and his community on a budget. As he shows, it doesn’t have to be about grass fed steak, tinned corned beef (which Tongans already eat) is fine.

LOW CARBZ 4 STARTERS & BIG FAMILIES. (Food is medicine)

Joseph has a Facebook group to reach out to people in his community and around the world.  He runs cooking workshops, and his group has a procession of recipes from the one thousand or so members.

Kiwi Tongan Cooking
Joseph Finau shows how to cook LCHF Tongan style

Now one thousand members may be small compared to the 340,000 now in the Ketogenic Lifestyle (Nigerian) group, but with 190,000,000 Nigerians and only 170,000 Tongans and Kiwi Tongans, it is actually quite significant.

What are the lessons for Australia?

Many people have long regarded Tongan diabesity as an intractable problem. Joseph is proving them wrong.

It seems that low-carb can be adapted to almost any cuisine and budget. By analysis of the Nyungar diet and by looking at the work of Prof. O’Dea and (most importantly) consulting with the communities, we should be able to adapt Western food to be closer to the macronutrients that Aboriginal and Torres Strait Islanders became metabolically used to for 30,000 to 50,000 years. It should be possible to make it affordable, available, and it should be more culturally appropriate than the food choices available today.

I am not saying it would be easy. I hesitate to suggest solutions for a people who have had plenty of ‘advice’ from my kind in the past. Social issues are always complex. Any solution must come from their grassroots. We need some champions like Joseph to lead the way to say eating needs to be different. Staple ‘modern’ bush tucker needs to be redefined and delineated from a preference for McDonalds or KFC. Awareness needs to be built about traditional diet and the reasons that fats and sugars are sought after, but need not be consumed in excess. That needs to be internalised. If it is hard for urban dwellers to avoid fast food, then the other side of the coin is poor access to healthy food in remote communities.

In the end, it will be a personal choice. However, if people and communities don’t have knowledge of this option, how can they choose a traditionally oriented diet for optimum health? 

‘Blind Freddy’ can see that the existing approach is not working.  It doesn’t work for the indigenous people of the world, and it isn’t working for us. We need different thinking.

Is a ‘Sugar Tax’ a Solution?

A sugar tax might provide revenue for some change while food supply economics normalise. If we are to have a sugar tax, why not apply it to tax the majority of unhealthy eating Australians to subsidise the food supply of those who may struggle to afford healthy food because of their socioeconomic or geographic disadvantage? Focus the funds on innovation to change ingrained food habits. This would be likely to normalise when the economics of the food supply and demand and supply settle down anyway.

No-one is arguing any more against sugar being unhealthy (apart from the food lobby). Before taxing other ‘unhealthy’ foods, the science needs to be settled.

It is in the nature of researchers to always call for more research funding. Frankly, when you see misguided research that appears to be being undertaken into diabesity, there are much better uses for the money. I am neither anti-research nor anti-academic, but funding should be judicious and focussed on settling the science for starters.

What are the lessons for NZ?

My Anzac cousins, you chose not to federate with us, and I get that. The last thing you need is some Aussie blogger telling you what to do!  Joseph is doing fine, and you have other fantastic people in the low-carb community, but I have to question:

Why on Earth do your bureaucrats and food policy people follow Australia when we think that our dietary guidelines and institutions are dumb and broken?

It perhaps says a lot about the power of trans-Tasman economics over trans-Tasman rivalry, and there is probably a PhD thesis somewhere in that.

I think it is time to assert some of that famous independent Kiwi thinking. Otherwise, pretty soon the change will be over in Australia, and we will claim that Prof. Grant (Schofield) was really an Aussie researcher- just like Split Enz was an Aussie rock band.

Keep Going Joseph

My message to Joseph is simple. You may not have 340,000 group members on facebook but you are like Daphnis, and you are making waves at the grass-roots and leading by example.

You are not half the man you used to be, but twice the man most of us will ever be.

“Kai mate”, my Kiwi Tongan friend, and may that eating be low carb for a long and healthy life.

Prof. Andrikopoulos: The Sir John Pringle of Australian Diabetes?

A Paleo Solution?

In our last post, we saw that Paleo dietary solutions were researched and shown useful for diabetes in Aboriginals in the 1980s. Diabetes and other chronic disease were obviously caused by a western diet and lifestyle, and yet the recommendation to Aboriginal and Torres Strait Islanders was to eat the very same Western diet that was making those chronic diseases prevalent in Western people like me.

Here are the healthy eating charts for Aboriginal and Torres Strait Islanders and the one for all Australians.

Indigenous Healthy Eating Chart not Paleo
Healthy Eating for Indigenous Australians
Australians Healthy Eating not Paleo
Healthy Eating for Australians

 

 

 

 

 

 

 

 

Prof. O’Dea’s work showed some forty years ago that we are metabolically different yet these nutrition charts treat us as metabolically equivalent. Prof. O’Dea also revealed that the traditional diet reversed chronic diseases for the First Australians however but for token changes, neither chart reflects a traditional diet. A traditional diet would be around two-thirds meat with few carbohydrates and seasonal fats. It would not have taken too much effort to look at the macro-nutrients of the Nyungar diet or Prof O’Dea’s data and devise a better-suited eating chart. Instead, I am sorry to say; this is like someone drew in a token lizard and kangaroo and substituted and moved some other pictures around. The emergency of diabetes and chronic disease among Aboriginal and Torres Strait Islanders deserves better than this. In fact, as Prof. O’Dea alluded to, we all might be better eating from the same chart reflecting an Australian ‘Paleo’ diet.

A Deeper Mess

When we examine what people diagnosed with diabetes should eat, the recommendation is that they still eat the same as in these charts. All Australians with diabetes should ask themselves something at this point.

If we have used those dietary guidelines as a nation and we have ended up getting fatter and sicker, why will continuing with that advice solve the situation?

The question is profound, but the answer is obvious. Of course, it won’t. Like this country’s obesity and diabetes statistics, your personal statistics will continue to get worse trying to follow that advice. Australia is chronically sick as a nation trying to eat that way, and you are also chronically sick trying to eat that way. Aboriginal and Torres Strait Islanders are even more unwell, and they point the way for all of us.

I must emphasize the word “trying”. You see some people try to explain away the problem by saying that people do not follow the guidelines. They imply that their technical perfection is the only effort needed as if their job was done. Population health demands actual outcomes not theoretically perfect guidelines that people cannot or will not follow.

Where is Innovation?

What has held Prof. O’Dea’s revelations of forty years from a possible practical application? It would be scandalous if this was deliberate as it really would by tantamount to a systematised dietary genocide of the First Australians. We can probably rule that conspiracy theory out though as it is killing us all. How could we arrive at this point where we are all getting sicker trying to follow this advice? This is not a problem of nutrition, and it is not an issue of the science. It is a problem of innovation.

We have already seen in past posts that dietetic organisations like the DAA appear preoccupied with things other than our health (including whole-grain breakfast cereals) and what seems to be dietary dogma. This contributes to the innovation problem.

What about the diabetes research community? While the problems are systemic, innovation can sometimes be held back by an individual at the top who holds views of the status quo. Usually, it is that the existing paradigm and way of thinking is a source of their power. Sometimes there are other reasons. It is instructive to look at the views of those who rule the roost on diabetes advice.

The Australian Diabetes Society

Prof. Sofianos Andrikopoulos is arguably the foremost Australian diabetes researcher being the current CEO and past president of the Australian Diabetes Society (ADS). The  ADS vision is: “To be the leading society for research, medical practice and education in diabetes”. They work with Diabetes Australia and the Australian Diabetes Educators Association (among others) who are on the front line to deliver diabetes management in practice. The ADS lists ‘innovation’ as a value.

Organisational Innovation

It takes a certain mindset for organisations and individuals to embrace innovation. In my analysis of companies, the innovative ones have CEO’s that can think differently and embrace with an open mind and build that capability in their organisation. Those organisations have the capability to think of the things that delight the ‘end user’ including things that even the end user never even thought of.  They also have the understanding to look for user trends. Users often ‘hack’ a product to make it work better. When they see that ‘hack’ they pick up on that and research it thoroughly to find out why their product or service is being hacked for insight. They don’t discount anecdote or exclaim “N=1!” because that is frequently how invention starts.

Innovation is often mistaken for invention. These are different words with different meanings. Invention is discovery, while the act of innovation is the process of introducing something new. One need not invent to innovate and ego, expertise and the need to be seen as infallible are often the enemies of innovation.

Innovating to Solve Scurvy

I am reminded of the health innovation to use citrus in the British Navy to cure scurvy. There is ample literature on this subject and I don’t propose to redo that work. Here is one reasonable account. My summary:

  1. In the 1700s, the British Navy was facing a battle with a chronic disease called scurvy. In some ‘battles’ it lost most sailors to scurvy than to the troublesome French with whom they were fighting. No matter what they seemed to try, the health of sailors degenerated until they died.
  2. Scurvy is of course due to vitamin C deficiency but this was unknown at the time. Scurvy was seen as a complex problem that was multifactorial and even James Lind (who eventually solved it) “saw scurvy as having many causes, including poor hygiene and discipline“. Most believed that diet was a factor.
  3. Lind undertook ‘medical trials’ to determine the root cause and pioneered the use of citrus juice to prevent scurvy as early as 1753, however authorities did not endorse it.
  4. In the meantime, while citrus juice was still not official policy, “some naval surgeons, however, looked on it as a medicament that they might occasionally provide from their own purse“. No doubt their lack of scurvy was just an anecdote.
  5. Historians attribute a big part of the delay to accept Lind’s work to the personal beliefs of the very eminent Sir John Pringle, who held a differing theory on the cure for scurvy.
  6. It took Pringle’s retirement and death  (in 1782) and the appointment of Gilbert Blane as the commissioner of the Sick and Hurt Board, for this simple treatment protocol to be agreed by the Admiralty. That was not until 1795.

The Analogy

What does this have to do with diet and diabetes?

  1. We are facing an epic battle with diabetes as a chronic disease- just like scurvy.
  2. Diabetes is seen to be a complex and multifactorial problem with diet being a major factor- just like scurvy.
  3. O’Dea’s work in the 1980s showed that a Paleo diet, high protein but lower in carbohydrate and fat was a solution for the most sensitive people to this problem (Australian Aboriginals)- just like Lind.
  4. Many of us who have effectively cured our diabetes with that kind of diet are like those lemon juice drinking ship’s surgeons. Some of us are indeed doctors.
  5. So what are the ‘beliefs’ of Prof. Andrikopoulos about the paleo (low carbohydrate) diets and are they holding up acceptance? We can point to two major pieces of work.

The Paleo Mouse Study 

In early 2016, Prof. Andrikopoulos published a study of the effect of a paleo diet on mice. His own university wrote a summary of it here. A perusal of his publications shows an extensive list of endocrine-related papers but, unless I am mistaken, no more mainstream diet and nutrition studies until this one.

This study really hit the headlines and caused a media frenzy. I lost count of the news and blog articles that it caused and I spied articles in China, India, Canada and the United Kingdom.

I am not going to analyse this paper in any detail however, many others have found issues with it.

Primarily those issues are:

  1. Mice are not representative of people for dietary research (although they may make good models for endocrine research).
  2. There are plenty of RCTs in humans that show the opposite effect to this study.
  3. This was not a human Paleo diet anyway. Neither by type of food nor by macro composition.
  4. It was not the ancestral (Paleo) diet for a mouse so no wonder it caused health issues.

Mouse Study Fallout

Many critics in the paleo and low-carb high fat (LCHF) community were annoyed by what they saw as a biased attempt to discredit their way of eating and some disparagingly tagged the professor with the nickname “Dr Mouse”.

It certainly left other academics scratching their heads. Prof. Aaron Blaisdell wrote:

Why would the lead author, a scientist of reputable standing in the Australian academe, have been so misled?

Cambridge scholar, Nathan Cofnas, wrote back to the journal the paper was published in to say (among other things):

Mice in the experimental condition were fed something loosely based on a version of the human Paleo diet, which for mice is not Paleo.

An academic peer from New Zealand, Prof. Grant Schofield, seemed annoyed when he wrote:

We think that the way Prof Andrikopoulos presented his results in the media was disgraceful. He can’t be unaware of the human research into LCHF for diabetes and the problems with mouse models. He could easily learn, if he wanted to, about relevant research into the Paleo diet too. Absolutely none of this research supports the claims that he’s making on the basis of his 9 mice.

His claims, despite being based on minimal evidence having very limited relevance. seem designed to disrupt the efforts of those of his colleagues who are using LCHF diets to benefit people suffering from obesity or diabetes.

He and three peers G Henderson, C Crofts, and S Thornley also wrote in their letter to the Journal of Nutrition and Diabetes:

The unfounded conclusions of Lamont et al., and the widespread publicity given to their criticisms of LCHF diets, amount to ‘an unjustifiable interference with a method that is working well’.

It is unclear how this research fits into a systematic endocrinal research program as may be seen in Prof. Andrikopoluos’ other work. Instead, this sudden foray into dietetic research appears to support assertions of interference and a disruptive agenda. I note that at the time that this research was being contemplated and undertaken, Chef Pete Evans and the Paleo diet was very topical. It is possible that Pete Evan’s popular message had somehow upset the Prof. Andrikopoulos and motivated this study to be undertaken. While I applaud academics who involve themselves in topics of controversy (we need more of it), I question the use of these research resources when diabetes is in crisis if that was the motivation. That is, unless the NHMRC is counting media articles instead of citations these days as a KPI.

The MJA Paleo Article

Prof. Andrikopoulos doubled down with a second foray into nutrition when he wrote a journal article for the Medical Journal of Australia that was also not supportive of Paleo diets (low carb) for diabetes in August 2016.

It was also reported widely in the medical media and it was also criticised again– although not as resoundingly as the mouse study. I think it should have been due more criticism.

In the Shadow of CSIRO

It is surprising to realise that when the journal article was written, the CSIRO had already done considerable work on its low carb diet with 93 participants for 24 weeks for diabetes and published in mid-2014 yet that is mentioned nowhere. With his profile in the ADS, that work must have been known to him. About six months after that ‘warning’ that went to doctors through the journal, the CSIRO has published a popular book on the subject on sale to the public. Imagine when patients begin talking about the CSIRO diet and their doctors lack information.

It is all the more surprising when you realise that the mouse study itself was undertaken in the shadow of the CSIRO work. While the diet composition was different (58% vs 80% fat for example) they are similar enough to question why the mouse trial was done at all.

Diabetes Research Leadership?

Prof. Andrikopoulos concluded in his mouse study:

The potential effect of popular weight loss diets needs to be carefully considered with the help of sound evidence before they are recommended for type 2 diabetes.

… and his journal letter:

…. clearly more randomised controlled studies with more patients and for a longer period of time are required to determine whether it has any beneficial effect over other dietary advice.

Prof. Andrikopoulos, as a diabetes research leader through the ADS should be and should have been the driving force to solve these questions. Leadership is not owned, it is given. Unless he has been very busy in the last months solving these important questions of potential dietary diabetes therapies, his leadership position looks diminished.

If indeed, it is as it seems (that these research questions have already been answered) then it would instead appear that his beliefs have been killing the innovation efforts of others.

Back to Our Historical Analogy

What I curiously discovered in writing this blog is that Prof. Andrikopoulos refers to one of Prof. O’Dea’s papers from the 1980s when writing his journal article. Was that reference by Prof. Andrikopoulos to Prof. O’Dea similar to how Pringle may have referred to Lind’s work?

History is indeed repeated by those who do not heed its lessons. If O’Dea is Lind, and Andrikopoulos is Pringle. One speculates who will be the Gilbert Blane who now shows the leadership to bring change and when?

Whether a low-carb paleo diet is 80% fat as in the mouse study or low-fat high protein as in O’Dea’s work, the ADS cannot ignore the low-carb issue any longer. People are getting sicker and dying waiting for innovation. Chronic disease in Aboriginal health is a national shame. It is time for change.

In my next post, I will examine how other indigenous people and groups are tackling their diabesity challenge at the grass roots.

Nyungar Diabetes: Australian Dietary Genocide?

NOTICE

Aboriginal and Torres Strait Islanders to should use caution viewing this post, as it contains images of dead persons. Nothing in this post should be taken as criticising or diminishing the efforts of the Nyungar or Aboriginal and Torres Strait Islander communities in pursuing their health or be construed as criticism of them for an unfortunate situation.   The Nyungar have a deep and rich oral culture of which I am not a part. Therefore, I hope to be excused for any error due to the interpretation of things via the written words of mainly white historians. It is worth the risk to be wrong because this issue deserves highlighting and, as always, my comments are open to people to improve the information on this blog.

Nigerian Musings

In my last post, I talked about the phenomenal success of the ketogenic diet in Nigeria where hundreds of thousands of Nigerians were using a Facebook group to solve their obesity, diabetes and PCOS health problems with a ketogenic diet. Then I saw an article on Siberian health problems from carbohydrate consumption and other lifestyle change in Russia. It got me to thinking, how are Aboriginal and Torres Strait Island Australians faring?

A Diabetes Emergency in Aboriginal Australia

It is, unfortunately, no secret that diabetes is out of control for them and this crisis was seen as that many years ago. Even when compared to lower socio-economic Australians the statistics are horrifying. Whereas among other Australians, type 2 diabetes is virtually unknown in people under 25, the rate for Aboriginal Australians is 1.5% for people aged 15 to 24, and 0.5% for children aged 2 to 14! After that, the rates are about four to five times other Australians until age 55+ where 40% have diabetes.  In general, Australian Aborigines develop diabetes twenty years earlier than other Australians and are about twice more likely to be hospitalised.

Why is it so bad?

Indigenous peoples in other places like the Arctic and the Pacific Islands experience similar problems with obesity and diabetes. This was blamed on ‘thrifty genetics’ that predisposes them to weight gain.

While the existence of a thrifty gene is now disputed, the common thread is that their hunter-gatherer lifestyle has changed to a Western diet. As concluded from this study, that change results in health problems linked to insulin resistance. The fat deposition is very noticeable in aboriginal people. They tend to put on weight around the middle yet can remain quite lean elsewhere, and this is backed up by the cited study. 

There is a predominantly central pattern of fat deposition in both men and women, which is associated with greater insulin resistance and cardiovascular risk than is peripheral fat deposition.

Past Research into Diet

Prof. Kerin O’Dea undertook pioneering work into traditional aboriginal diets, obesity, diabetes and heart disease. In her study from 1988, it was noted that even in underweight subjects still adhering to a more traditional way of life; there was higher fasting insulin and elevated triglycerides (signs of insulin resistance) even though their diet was low fat and comprised of lean meat. 

In a book chapter from 1988 “The hunter-gatherer lifestyle of Australian Aborigines: implications for health.” Prof. O’Dea looked precisely at what we could learn from a ‘Paleo’ type diet of aborigines. In summary:

  1. Aboriginals become obese and develop diabetes (along with high blood pressure and heart disease) when they stop eating traditional food.
  2. Before European contact, they were lean and physically fit, and there was no evidence of chronic disease. They were ‘underweight’ with low BMI (13.4 to 19.8 kg/m²) without having signs of malnutrition.
  3. There was a lack of literature and nutritional data on an entirely traditional diet, and so she studied people living mostly traditionally.
  4. One group she studied had “a traditionally oriented diet” with a BMI of ~17kg/m² and exhibited low fasting glucose (3.8±0.4 mmol/L) but still showed other diagnostic signs of insulin resistance.
  5. Referred to her previous seven-week study of a traditionally oriented diet (about 1200 calories). It had two-thirds of calories from meat, 13% from fat, 54% from protein and 33% from carbohydrates when the group were inland where tubers and honey were more plentiful. The carbohydrate quantity dropped to a level estimated at less than 5% when on the coast with protein at about 80% and fat at about 20%. The trial showed a normalisation or improvement of the metabolic factors associated with diabetes. 
  6. She concluded that a traditional aboriginal (Paleo) diet could reduce primary diabetes and cardiovascular risk factors in the general population but noted it was unlikely to be popular with nutritionists.

This type of diet is also unusually rich in animal protein and high in cholesterol- characteristics not generally favoured by nutritionists in making recommendations for better health.

Other Research

Prof. O’Dea performed other ground-breaking research regarding diet, diabetes and Australian aboriginals.  These included:

  • A 1980 three-month cross-over study that compared an aboriginal urban diet and traditionally oriented diet (50% protein, <20% carbohydrates, >30% fat) with a Caucasian control group that showed aboriginal people exhibit a stronger insulin response to glucose than Caucasians which was less pronounced after a traditional diet. This was likely to be a major factor in their predisposition to diabetes.
  • A study in 1982 on the effect of a high protein, seafood based, very low carbohydrate ketogenic diet for two week period. This showed a significant but small improvement. Most other trials of ketogenic diets have proceeded for longer periods as two weeks is about the time required for initial ‘fat adaptation’. It can be wondered what might have been the result had this trial been longer. 

The Nyungar

My armchair research is not as ground-breaking, but I do want to add. I decided that I would like to focus this blog on one particular group.  The Nyungar (or Noongar) whose lands I dwell upon in South Western Australia. Why? The Nyungar were lean and healthy eating a traditional diet until relatively recently, and much of that diet is well recorded.

It is unknown exactly when the Nyungar came to these lands, but there is evidence dating to at least 30,000 years- or greater than 1,500 generations ago.  History records that Europeans did not first settle here until 1826. Along with European settlement came new foodstuffs, disease and farming practices previously unknown to the Nyungar. Flour became especially attractive to them as they had nothing as starchy in their traditional diet. Some of the trouble with settlers was for stealing flour however despite new found foods, the traditional way of eating is said to have existed until the 1960s. Allowing some leeway, it was only three to five generations ago that the Nyungar changed their diet.  

Many things changed with the coming of settlers, but I will focus on their food. It is common sense to do so as obesity is roughly 80% metabolism and diet and only 20% exercise and other lifestyle factors. The Nyungar did not run marathons for fun. Like other hunter-gatherers, their activity was low level for long periods and aimed at surviving. If you doubt that common sense, remember that it takes a 6.8km run to burn off a serve of coca cola and takes little effort to drink a few serves.  I do not know why people confound themselves with other factors and think that we are obese because people just aren’t moving as they used to. It is a factor, but you cannot outrun a bad diet- contrary to the favoured myth of the fitness industry.

Nyungar Diet Today

So what was their diet like then and what is it like now? Some of the information I am about to present comes from this paper from 2010.  It suggests that the current diet is high in fat, sugar, fast food and carbohydrates and that it is given to infants at an early age. 

The majority of infants had received ‘fast foods’ by 12 months of age with 56.2% had been given coca cola, 68% lemonade and 78% fried chips.

Unsurprisingly, many are on the same poor Western diet that causes diabesity all around the world. The same one that results from giving advice to the populous to minimise salt, fat, sugar, avoid saturated fat and to eat 45 to 65% of dietary intake from carbs (Australian Dietary Guidelines) and the food industry adjusts its products to match. The diet exacerbated by the fast food industry with its fattening mix of carbohydrates and polyunsaturated seed oils.

Traditional Diet

What was their diet? Well, the account of foods is quite detailed in this paper too. It was a meat based diet rich in meat, offal, but low in green vegetables with some tubers with limited grains, fruit and sugars. The effect of that diet is apparent below.  

Traditional aboriginals
Obesity and diabetes were unheard of on a traditional diet. Courtesy Wikimedia Commons

Respectfully, I have not put any pictures here of today’s Aboriginals and Torres Strait Islanders following (as best as they can) the Australian Dietary Guidelines but you can do your own google search. You are likely to find that, along with all Australians, people are not as lean. It is important to remember however that research showed that even lean Aboriginal and Torres Strait Islanders were predisposed to diabetes.

I think it is important that a reader gets some context of the ‘bush tucker’ food available here- especially the carbohydrates. The exceptional skill that the Nyungar had to live on this land is hard to appreciate unless you have spent time here. We do not have natural forests of edible nut trees with an undergrowth of berries. There was no farming, and everything was taken in season leaving enough to replenish naturally. Surviving on meat and fish here is one thing, determining the edible plants among the majority that are toxic belongs to Nyungar knowledge won over millennia that is foreign to me. Let us look more closely at the carbohydrates in their diet. These were said to be from the zamia palm, seeds and nuts (primarily wattle seed), fruits, nectar, honey and tubers.

Sugars: Nectar, Honey and Fruits

Banksia Nyungar Food
Banksia nectar was a Nyungar treat

Nectar from plants like the Banksia was seasonal at the flowering time. The nectar would obviously form a seasonal treat or snack in their diet- much like when Europeans suck on a honeysuckle.

 

There was no organised cultivation or production of snack products. As you might imagine too, just like these available for all Australians at my local supermarket, such snack treats would not form the mainstay of their diet.

Honey

Honey is a product of the concentration of nectar by bees. Unlike the European bees that arrived with settlers, most Southwest Australian bees are solitary and small.  You just don’t get the same prodigious quantities of honey from them. Australia’s honey producing stingless native ‘sugarbag’ bees are not native to South Western Australia.

Fruit

Native peach is of scant flesh

The fruit the Nyungar ate is typified by the native peach or ‘Quandong’. It is the size of an oversized grape and has limited meat. In fact, the ones in this picture are quite luscious compared to ones I have found in the wild. The ones I have seen have very thin flesh and a large nut with an oily kernel eaten roasted. It is a bit like a macadamia with a root beer flavour.

The Quandong has a short season of about a month over Summer in each locale ripening progressively from North to South in range over four months. It is also a small parasitic tree depending on specific compatible host trees, so both the fruit and the tree are not plentiful. The quandong is high in vitamin C but not overly sweet. If you can gather a sufficient quantity (an undertaking of some effort) and then combine with sugar, it makes a pleasant jam. Eaten fresh, the Nyungar would have had a tart treat.

While sugars were undoubtedly sought after, you would defy credibility if you were to maintain that the traditional Nyungar diet had any substantial sugar. It is recorded that the Nyungar collected nectar mixed with water for a sweet drink and also fermented it into an alcoholic drink (called Gep). Without bees to do the work, you can be assured that even when such seasonal pursuits were possible, they were well below the WHO stretch target of 5% of calories from sugar. You can be fairly sure that due to local availability and seasonality, most days would have no sugar intake at all.

Starches: Wattle, Tubers and Zamia

Wattle seed was probably the dominant seed that was eaten. In season it was ground and made into cakes cooked on an open fire and qualifies as the primary Nyungar grain. It would have been typical of the seeds that the Nyungar ate. Nutritionally, it was very high fibre (54%), and with a net carbohydrate content of 10.5%, 20% protein and about 6% fat, it is a very low carbohydrate grain compared to wheat (~70% carbohydrate).

Tubers were the last and probably most significant of the starches, and the Nyungar diet had a varied number. While I can find no nutritional analysis for these plants, it is important to remember that they were opportunistically collected, seasonal and never farmed or selected to improve the size and nutritional content. It is also a factor that tuberous plants tend to be found inland in the forests, and not on the coast.

Zamia: Carbohydrates or Fat?

Unlike other groups in Australia, the zamia palm is said not to have been eaten by the Nyungar for its more starchy seed, but instead for the poisonous oily macrocarpam which was specially treated to make it safe to eat. Contrary to what may have been assumed, to the Nyungar this was valued as a fat and not a carbohydrate source- much like the oil palms of the tropics.

Nyungars were not Vegans

The major part of the Nyungar diet, as written in many sources, was animals, eggs, birds, fish and grubs. As previously linked:

Traditional foods from this region varied but included emu, kangaroo, possum, goanna, fresh water crustaceans (maron and gilgies), bardi grubs from under the bark of eucalyptus trees or in the roots of mallee trees, wild duck, mallee hen eggs taken from the mound where multiple eggs were found and fish for people who lived on the coast permanently or in different seasons. Everything edible on an animal carcass was consumed, including organs such as the liver, kidney, brain and intestines.

It is evident through their preference for eating the oily zamia palm and other accounts of meat eating that they did seek fat although it was also not a high-fat diet. Fat would have been mostly from animal sources, and most wild sources from meat are not as high in fat as the domesticated ones that we now eat.

A Paleo Diet?

Putting this diet into modern terms, it would be pretty close to what people call a ‘Paleo Diet’.  No dairy, but with eggs, meat and fish as available with limited vegetable content as could be foraged. Looking at the descriptions of Prof. O’Dea’s work and the descriptions above, most Nyungar would probably be on a high protein (say 75%) low fat (say 15%) and low carbohydrate (say 10%) diet with inland Nyungar probably eating more tubers for some more carbohydrates.

The actual composition would be subject to the seasonal and local availability of the carbohydrate sources like tubers; it would have been at times, a ketogenic diet- particularly if the hunt and forage were insufficient.

With so few carbohydrate and fat rich foods, there is no doubt that the Nyungar would have prized fat and carbohydrate foods as high energy sources.  This is likely to be why they took the time and trouble to detoxify oily zamia palm fruits. 

The Cause is Apparent

We have looked at some of the past research and taken a look at the likely composition of the Nyungar diet. It should be fairly obvious why the Nyungar would suffer from insulin resistance, obesity and diabetes when fed a Western diet. Even if you disregard the similar opportunistic diet that they ate while migrating to Southwest Australia they have had more than 1,500 generations to adapt to the low carbohydrate, low-fat food in their country. We have given them three to five generations to adjust to a high carbohydrate, high-fat Western diet. The effect of our dietary advice has tripled obesity since the 1970s for all Australia. It even gives us the diabetes epidemic that Australia now faces. No wonder the Nyungar have been so severely affected by it.

I am of Northern European descent. My ancestors have had over one hundred generations to adapt to a higher carbohydrate diet made possible through agriculture, but even that is not long enough. No wonder I developed diabetes in my forties while some Nyungar get it in their twenties. Doesn’t that make perfect sense?

The Australian Dietary Guidelines

Even if the diet that Australians ate was exactly to the Australian Dietary Guidelines (essentially low-fat with 45 to 65% of energy from carbohydrates with multiple meals spread throughout the day), it still is far from their traditional diet of one main meal, low in carbohydrates, after the hunting and foraging were completed.

Now we hit the great conceit. You see with all of our science and technology we have worked out that the ‘perfect’ diet for Australian humanity is expressed in the Australian Dietary Guidelines. The Nyungar and other groups should eat our perfect diet born of science because to do otherwise would be to deny them health. It would be discriminatory to have them follow a different diet.

If I were to espouse their original low-carb, low-fat, high protein diet, people would say: “Yes but in their primitive way of life they died young”. To that, I would say: “That is why we have modern medicine including antibiotics, sterile surgery, vaccinations, pre and ante-natal care, effective drug therapies and more”. Further, as obesity and diabetes were completely unheard of on their traditional diet, no-one would likely die of diabetic complications, suffer diabetic induced cardiovascular disease, diabetic blindness, kidney failure and amputation. Isn’t that what we are seeking to fix?

No one is suggesting that the Nyungar must go back exactly to their traditional diet and lifestyle. There is no reason though why healthy eating of similar composition to their traditional diet cannot be recommended.  It is not, though. In fact, the diet that I am on is denied as an option for the Nyungar by Diabetes Australia and Diabetes WA. My diabetes effective low carb healthy fat diet would be pretty close to their traditional diet. It is safe, maintainable and gives me normal blood glucose that means I will avoid diabetic complications.

Most importantly, it has reversed my diabetes.

Calling it Out

No Facebook groups are helping the Nyungar, or other groups achieve low carb weight loss and curing their diabetes as the Nigerian ladies have achieved through self-organisation. Our First Australians are depending on not-for-profits who are failing them. 

Advice from Diabetes Australia for Aboriginal and Torres Strait Islander’s with diabetes may include the call to eat more bush tucker, but it is otherwise much the same as for all Australians. In particular, it does not suggest limiting, total carbohydrate. The CSIRO has recently proven this to be effective, and actually, Prof. O’Dea’s studies also showed its efficacy some forty years ago. It seems unfortunate that it was not a favoured message of the nutritionists either now or then.

This issue has to be called out, and so I am doing so. To continue pushing the Australian Dietary Guidelines for people with diabetes, and in particular for the First Australians like the Nyungar, is tantamount to Australian Dietary Genocide. It is making us all, white fella and black fella, very very sick.

My next post will examine this issue further.