18

votes

What if health has little to do with diet?

Answered on August 19, 2014
Created July 13, 2011 at 9:20 PM

I recently discovered the town of Roseta, PA in the course of reading a book unrelated to diet. The claim was made that the people of Roseta lived longer and healthier lives than those in surrounding towns. Expecting some dietary explanation, I was somewhat surprised to see all the normal mechanistic explanations (diet, genetics, exercise etc) debunked. Their diet sucks by all standards (paleo and SAD), yet they just don't have as many disease markers as other populations. Simply living in Roseto appears to convey a health benefit.

This is called the "Roseta Effect", and googling can provide more background and pubmed a few studies. Essentially, the conclusion is that this is a product of their community structure, which, by strongly supporting inviduals, reduces their stress and makes them more likely to be healthy and more likely to live long lives.

This got me thinking about the "paleo" diet. One of my major pet peeves is the romantic notion of re-enactment; I despise "Grok" as a concept, teaching tool and implied guide through diet. Yet this particular example challenges my general, reductive conception of health and fitness, and so maybe some paleo-speculation is in order.

One feature of paleo life which is largely ignored by our current gestalt is the fact that it was necessarily far more tribal/familial than what we experience today in America (and most western countries). I'm currently thousands of miles away from my parents, sharing my house with my wife. My nearest friend is at least thirty miles away. My nearest relative, fifty. What if all my strict avoidance of this and that boils down to a minor health advantage largely negated by my fairly high-stress, low community lifestyle?

I can never eat another gram of refined sugar, but maybe that's a lot less relevant than being surrounded constantly by a group of friends and family which can help me get through the things in life that diet has nothing to do with. Not a comforting thought.

I freely admit I have no basis in fact or evidence to suggest that my musings here are true. I'm merely curious as to how the community would explain the example posed, and what people here think about the importance of a close social structure when it comes to health.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 27, 2011
at 11:50 PM

Pfw, just triggering your orange envelope alarm to make sure you see this: http://paleohacks.com/questions/54319/21-year-old-treating-crohns-and-gastroparesis-with-paleo-too-much-stress-on-b

1d9af5db8833413037be3ac48964714f

(3789)

on July 16, 2011
at 01:03 AM

In graduate statistics, one of the first errors we were warned about was taking a bunch of measurements of, say, census data and generating a giant list of variables correlate with with which others. If you do that, you will find all sorts of spurious "statistically significant" relationships that in reality have nothing to do with each other. I still see many news reports of bad research of this type. Assuming that there must be a "cause" for the good health of one town is very similar.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on July 16, 2011
at 12:21 AM

It's more likely because of environmental or group behavior patterns. We're talking about the town's overall longevity, not individual longevity. At the collective level, any single person's statitiscal anomaly would disappear rather quickly.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 03:53 PM

I can't say. Best to do all of them, they all help.

4145b36f1488224964edac6258b75aff

(7821)

on July 14, 2011
at 01:17 PM

Given a large random distribution of people, you'd expect to find clusters of healthy people geographically, yes. However, to suggest that probability "caused" their good health is absurd. Their health is a product of physical factors, not a mathematical abstraction. Or are you suggesting that human health is completely random, and that all of this is merely grasping at false patterns in the mist?

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 14, 2011
at 05:20 AM

I can back up the Kendrick thing, although I'm also going from memory. He thinks there's good evidence connecting high heart disease rates to immigrant populations. So, it's about the stress that comes from losing one's "real" environment. I also heard him talk about this with Jimmy Moore.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 14, 2011
at 05:17 AM

So your hunch is that if one of the two -- nutrition/exercise or love/happiness -- is in excellent shape then you'll probably be OK if the other is not.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 03:56 AM

sally - Robbie talks about the fact that 95% of our DNA is "junk DNA" which acts like the instructions on how to use the actual gene - Environment is huge according to him....

957a563c7e4a165663fd3c71207c39da

on July 14, 2011
at 03:45 AM

this conversation reminds me of how brain plasticity is now recognised rather than ridiculed, rather than the view that the brain is "fixed" after childhood. i see a similarity with genetic determinism vs a more well-rounded view that we have genetic pre-dispositions, but they do not become activated until something environmental switches them on.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 01:44 AM

due to a good ability to turn off the inflammatory cascade cleanly. Although I bet that all of that impacts more than just blood markers. Telomeres? Gut integrity? We're kind of in the twilight realm here with our super awesome paleo diets, it is hard to say what randomized trials or epidemiology could have to say about us. Copious fornication is always a good bet, though.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 01:42 AM

I can't say, but subjective assessment of "feeling good" certainly would. It's a wild speculation but I think that the body is built to withstand all sorts of emotions good or bad all of the time and it is only when normal functioning becomes dysregulated does that stuff make a big impact. For example stress is always inflammatory, but how dire inflammation is depends upon how well the systems that we use to suppress it work. High nutrient density and lack of toxins accomplishes this and someone who frequently feels stressed, lonely or angry might end up with rock bottom inflammatory markers

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:36 AM

Seriously Kamal, when I was at a point when grown up movies were possible, I loved - majorly.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 14, 2011
at 01:32 AM

Meredith-- I haven't seen Breaking the Waves! Time to put the newly expensive Netflix to work...

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:30 AM

Ha! Quilt you tickle me! I loved the part of Robbie's book where he talks about "Junk DNA". I need to know more! I was an English major and my Darwinism in Literature prof (rest his nicotine soaked sole) loved Lamarck! Junk DNA = instructions for how the DNA should act is killing me! Be on my podcast with TMS - it's in the works :)

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:20 AM

Robbie has it right. Genetic determism has been dealt a fatal blow in the last ten yrs. Darwin is sick to his stomach and Lamarck is laughing now.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:19 AM

I have a large population in my practice. Most are not healthy. But they do live long because of their other lifestyle factors

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:18 AM

they eat more grains than one can imagine

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:11 AM

Kamal - I love those two - Emily Watson (swoons) Did you see Breaking the Waves? I love.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 14, 2011
at 01:01 AM

So as soon as you get a significant other your markers will be right up to perfect?

3c6b4eed18dc57f746755b698426e7c8

(5152)

on July 14, 2011
at 12:51 AM

One up Dr. K, but those from the other side point out vegetarianism and healthy lifestyle resulting in these people's longevity. Early light dinner and no snacking. No alcohol, smoking or even caffeine. Those factors alone trump whether you're eating vegan or Paleo. Lifestyle factors trump whether you're eating meat or not.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 14, 2011
at 12:10 AM

Oh yes, I'm sure stress and community plays a humongous role in longetivity and happiness. We had a thread on here a while back about that. I read an article about supercentenarians where the common thread was that they didn't stress out about little things. But never, ever, will I pass up an opportunity to poke fun at Malcolm Gladwell.

4145b36f1488224964edac6258b75aff

(7821)

on July 14, 2011
at 12:08 AM

@sarah-ann: Diet was controlled for and was similar or identical to that of surrounding towns. There was no dietary explanation available.

4145b36f1488224964edac6258b75aff

(7821)

on July 14, 2011
at 12:03 AM

I'd appreciate it if you all would go a little further than ad hominem and thought-stopping cliche. Gladwell merely *reported* these results; he had nothing to do with generating them and was merely using them as an example to make a totally unrelated point. The question at hand is whether or not society plays a significant role in health, not whether or not Gladwell is right about diet or a reliable source. I've edited the question to get rid of the offending irrelevancy and hopefully we can now focus on the actual content.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 13, 2011
at 11:57 PM

Malcolm Gladwell should write an ironic autobiography called "Hasty Generalizations" or "Spurious Thought-Provokers". Here is a cool website...http://www.malcolmgladwellbookgenerator.com/

A727956fa3f943057c4edb08ad9e864e

(4183)

on July 13, 2011
at 11:47 PM

I've read that book, Gladwell mentioned how much artery clogging saturated fat they eat, nothing to see here. I'm gonna guess you don't get too much processed food in a remote town in the mountains either.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 13, 2011
at 11:39 PM

Ha! That reminds me of Punch Drunk Love...Barry Egan: "You are so beautiful. I love you so much I want to smash your face in with a sledgehammer." Lena Leonard: "I love you so much I want to scoop your eyeballs out of their sockets and chew and suck on them."

32123f4f25bdf6a7b70c9c2a719386ed

(396)

on July 13, 2011
at 11:31 PM

Perhaps the water is high in minerals.... that always helps.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:31 PM

I was going to mention the Blue Zones as well - Around here those Adventists run a Bible Camp that revolves around planting a garden and harvesting fresh foods. As far as I can tell, many of them are really slim - I don't know how healthy they are, but compared to the rest of my neighbors, they are sticks and everyone else resembles marshmallows - camp fire time!

4145b36f1488224964edac6258b75aff

(7821)

on July 13, 2011
at 11:30 PM

@Patrik: Gladwell didn't do the debunking. He merely reported someone else's work.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 13, 2011
at 11:22 PM

I think tribal behavior lowers stress hormones to confer longevity

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:20 PM

@ Shari - have you seen him speak - he's all over YouTube and stuff. I want to put him in my pocket, wear him like a wig, eat him for breakfast!

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:16 PM

No dude - bammers - you get yourself to the library and get his books - also he is all over YouTube, he did a Ted Talk - immerse yourself before that old codger tries brainwashing you :)

226b10cbb6b1d3530b00d2d84a2dc86e

(3313)

on July 13, 2011
at 11:03 PM

Sounds like an interesting read. Let me know how it turns out. +1 from me. I'm taking a genetics course in the fall with a professor I suspect leans towards the "Genes determine behavior (health)" descriptor. He's just old-school. He's got like 27 years of school under his belt but genetics as a field is very skewed towards genetic heritage trumping genetic expression.

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 13, 2011
at 11:03 PM

+1 for "Robbie (I love him) cause it made me giggle.

41dfb1a4fecb38d24075ff52f13ccb28

on July 13, 2011
at 10:27 PM

I'm pretty sure Malcolm Kendrick discussed something similar to this in The Great Cholesterol Con. IIRC, the group he was discussing was Asian immigrants. I would provide a more accurate reference, but my copy of the book is currently packed in a box somewhere (moving).

93f44e8673d3ea2294cce085ebc96e13

(10502)

on July 13, 2011
at 10:15 PM

Malcolm Gladwell hasnt debunked anything. My advice is stop reading him. That said, of course!, good family/tribe/community structure is good for health!

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9 Answers

6
0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 09:38 PM

I am reading "Monkeyluv" by Robert Sapolsky right now. I have a crush on him, but that's besides the point.

He does a bang up job in describing how genetic coding works - how genes basically mean nothing without environmental input. "Genes modulate how one responds to the environment" is a better descriptor than "Genes determine behavior (or health)."

So, if environment is everything from food, to relationships, to weather, to sleep , to exercise, to work, to EVERYTHING - who is to say whether diet alone is the key to health and happiness.

Robbie (I love him) describes three different rat experiments in three different labs in three different geographical areas testing for the same thing: how the rats respond to cocaine. Two labs had nearly identical results, one lab's results were something like 500 x stronger than the other two. These were painstakingly maintained environments, yet dramatically different results. My takeaway is that there are environmental factors we don't even know about (very cool things probably) that can have dramatic impact.

In my view, diet may play a small role in health when considering all of the environmental factors. Community, love, companionship, laughing, partying, these things surely have positive impact - whether it's larger than diet, I just don't know - but Ive just started Robbie's book, so maybe I'll have a better idea in a few days.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:16 PM

No dude - bammers - you get yourself to the library and get his books - also he is all over YouTube, he did a Ted Talk - immerse yourself before that old codger tries brainwashing you :)

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:20 AM

Robbie has it right. Genetic determism has been dealt a fatal blow in the last ten yrs. Darwin is sick to his stomach and Lamarck is laughing now.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 14, 2011
at 01:32 AM

Meredith-- I haven't seen Breaking the Waves! Time to put the newly expensive Netflix to work...

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 13, 2011
at 11:03 PM

+1 for "Robbie (I love him) cause it made me giggle.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 13, 2011
at 11:39 PM

Ha! That reminds me of Punch Drunk Love...Barry Egan: "You are so beautiful. I love you so much I want to smash your face in with a sledgehammer." Lena Leonard: "I love you so much I want to scoop your eyeballs out of their sockets and chew and suck on them."

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:11 AM

Kamal - I love those two - Emily Watson (swoons) Did you see Breaking the Waves? I love.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:36 AM

Seriously Kamal, when I was at a point when grown up movies were possible, I loved - majorly.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:20 PM

@ Shari - have you seen him speak - he's all over YouTube and stuff. I want to put him in my pocket, wear him like a wig, eat him for breakfast!

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 01:30 AM

Ha! Quilt you tickle me! I loved the part of Robbie's book where he talks about "Junk DNA". I need to know more! I was an English major and my Darwinism in Literature prof (rest his nicotine soaked sole) loved Lamarck! Junk DNA = instructions for how the DNA should act is killing me! Be on my podcast with TMS - it's in the works :)

0dbd7154d909b97fe774d1655754f195

(16131)

on July 14, 2011
at 03:56 AM

sally - Robbie talks about the fact that 95% of our DNA is "junk DNA" which acts like the instructions on how to use the actual gene - Environment is huge according to him....

226b10cbb6b1d3530b00d2d84a2dc86e

(3313)

on July 13, 2011
at 11:03 PM

Sounds like an interesting read. Let me know how it turns out. +1 from me. I'm taking a genetics course in the fall with a professor I suspect leans towards the "Genes determine behavior (health)" descriptor. He's just old-school. He's got like 27 years of school under his belt but genetics as a field is very skewed towards genetic heritage trumping genetic expression.

957a563c7e4a165663fd3c71207c39da

on July 14, 2011
at 03:45 AM

this conversation reminds me of how brain plasticity is now recognised rather than ridiculed, rather than the view that the brain is "fixed" after childhood. i see a similarity with genetic determinism vs a more well-rounded view that we have genetic pre-dispositions, but they do not become activated until something environmental switches them on.

4
Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 13, 2011
at 09:45 PM

If you wanted to be able to make a claim that diet has nothing to do with health based upon these people you would have to put them on a great paleo diet and then demonstrate that they didn't improve. My markers are nearly perfect and I REALLY need to get laid :P. If your title had been "what if there is more to health than diet/exercise" then I would have agreed completely.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 01:44 AM

due to a good ability to turn off the inflammatory cascade cleanly. Although I bet that all of that impacts more than just blood markers. Telomeres? Gut integrity? We're kind of in the twilight realm here with our super awesome paleo diets, it is hard to say what randomized trials or epidemiology could have to say about us. Copious fornication is always a good bet, though.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 01:42 AM

I can't say, but subjective assessment of "feeling good" certainly would. It's a wild speculation but I think that the body is built to withstand all sorts of emotions good or bad all of the time and it is only when normal functioning becomes dysregulated does that stuff make a big impact. For example stress is always inflammatory, but how dire inflammation is depends upon how well the systems that we use to suppress it work. High nutrient density and lack of toxins accomplishes this and someone who frequently feels stressed, lonely or angry might end up with rock bottom inflammatory markers

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 14, 2011
at 05:17 AM

So your hunch is that if one of the two -- nutrition/exercise or love/happiness -- is in excellent shape then you'll probably be OK if the other is not.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 14, 2011
at 01:01 AM

So as soon as you get a significant other your markers will be right up to perfect?

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 14, 2011
at 03:53 PM

I can't say. Best to do all of them, they all help.

2
3c6b4eed18dc57f746755b698426e7c8

on July 14, 2011
at 12:56 AM

From the Loma Linda study, the biggest factors that contribute to their longevity and health seem to be these lifestyle factors:

  • avoidance of smoking, drinking and even drinking beverages with caffeine.

  • early light dinner and no post-dinner snacking

  • going to bed early rising early.

Seriously, whether you eat vegan or Paleo ... these are the factors that will make you healthy, especially when compared to the average american on the SAD.

Nevermind that these people eat breakfast cereals by galore -- Kellogg was apparently a 7th Day Adventist.

Notice though that somple poeple frequenly cite vegetarianism as the main reason for their health. I contend, it's your lifestyle.

After all, Ancel Keys lived to 100.

1
Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 13, 2011
at 11:15 PM

This is the basis of the blue zone of the seventh day Adventist of Loma Linda as well who have a horrendous diet

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:19 AM

I have a large population in my practice. Most are not healthy. But they do live long because of their other lifestyle factors

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 13, 2011
at 11:22 PM

I think tribal behavior lowers stress hormones to confer longevity

3c6b4eed18dc57f746755b698426e7c8

(5152)

on July 14, 2011
at 12:51 AM

One up Dr. K, but those from the other side point out vegetarianism and healthy lifestyle resulting in these people's longevity. Early light dinner and no snacking. No alcohol, smoking or even caffeine. Those factors alone trump whether you're eating vegan or Paleo. Lifestyle factors trump whether you're eating meat or not.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 14, 2011
at 01:18 AM

they eat more grains than one can imagine

0dbd7154d909b97fe774d1655754f195

(16131)

on July 13, 2011
at 11:31 PM

I was going to mention the Blue Zones as well - Around here those Adventists run a Bible Camp that revolves around planting a garden and harvesting fresh foods. As far as I can tell, many of them are really slim - I don't know how healthy they are, but compared to the rest of my neighbors, they are sticks and everyone else resembles marshmallows - camp fire time!

0
70132f605eb16448c9827aac59fe6d27

on October 14, 2011
at 03:43 PM

No matter where you look in nature, everything is affected by multiple factors. I really believe in the paleo/primal way of life, and that diet is a huge factor in health (your body can't function or repair itself if it's lacking the proper parts) but no single factor is ever a cure all. Eating healthy will improve your health and allow your body to function at optimal levels, but that can only do so much to offset other negative factors. You can't simply look at what they ate, you have to look at their genetic seed stock, where they live, how they live, even cultural/learned perceptions and mechanisms for handling stressors, community structure, personal support networking, risk taking behaviors....so many different factors are involved.

It's always going to be a matter of both genetics and environment blending in ways the human mind isn't capable of comprehending -- the big picture is just too damned big. In cases like the Roseta effect, you can't say "oh look, they ate crap and they're even more healthy than the rest of us!". There are just too many other factors in place. Rather imagine what life would be like for them if they ate well too!

0
B9cc28905ec54389c47cde031d709703

on October 14, 2011
at 10:04 AM

There is a old documentary on National Geographic called Stress: Portrait of a Killer, pay attention to the part when they discuss the monkeys on the same diet; some of them had atherosclerosis and some of them didn't. Which ones didn't? And then the seemingly paradoxical situation of the pathogen infested trash eating.

0
1d9af5db8833413037be3ac48964714f

on July 14, 2011
at 01:43 AM

If you survey health data for enough towns, you will find a few where the overall health of inhabitants is far better than average (and others where everyone seems to be dying young for no apparent reason). That doesn't mean there is a cause other than probability. I would be bizarre if such towns didn't exist.

Humans are wired to find causality, regardless of whether there is any. That tendency has taken us a long way, but it also leads us down some blind alleys.

4145b36f1488224964edac6258b75aff

(7821)

on July 14, 2011
at 01:17 PM

Given a large random distribution of people, you'd expect to find clusters of healthy people geographically, yes. However, to suggest that probability "caused" their good health is absurd. Their health is a product of physical factors, not a mathematical abstraction. Or are you suggesting that human health is completely random, and that all of this is merely grasping at false patterns in the mist?

1d9af5db8833413037be3ac48964714f

(3789)

on July 16, 2011
at 01:03 AM

In graduate statistics, one of the first errors we were warned about was taking a bunch of measurements of, say, census data and generating a giant list of variables correlate with with which others. If you do that, you will find all sorts of spurious "statistically significant" relationships that in reality have nothing to do with each other. I still see many news reports of bad research of this type. Assuming that there must be a "cause" for the good health of one town is very similar.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on July 16, 2011
at 12:21 AM

It's more likely because of environmental or group behavior patterns. We're talking about the town's overall longevity, not individual longevity. At the collective level, any single person's statitiscal anomaly would disappear rather quickly.

0
Ac1e55cf06c2180f4008ff01953d10dd

on July 13, 2011
at 10:57 PM

While I totally agree that factors other than diet do have a strong impact on health, I still believe that it is wrong to say that "diet has little impact on health". Other factors, such as stress, family and social environment and of course, Physical activity are important, but still, diet is very important for your health!. In fact I once asked a related question on group and tribe support in paleo times http://paleohacks.com/questions/20306/socializing-and-group-support-for-optimal-health#axzz1S1kW50db Also I am sure that other stress producing factors, like spending two or three hours a day to commute to your workplace also have a negative impact on modern people life´s. Perhaps part of the emphasis on diet comes from it being one of those factors that we may be empowered to change, individually, while other factors, such as group support or house to work transportation often depend on many other people. For instance the Dutch and Scandinavians, who are biking to work almost every day, have shown great improvements in their health standards, and also have much lower rates of obesity than Americans do.

0
776bb678d88f7194b0fa0e5146df14f0

on July 13, 2011
at 09:58 PM

I totally agree that more attention needs to be paid to socialization and reduction of stress in line with our evolved and/or traditional past. As far as child-rearing and sex goes, two books that I've found really mind-blowing in terms of evo-bio are "The Continuum Concept" and "Sex at Dawn" respectively... although if you are married you might find Sex at Dawn to be a little racy.

Concerning physical health though, I think that for most obese or sick individuals diet IS the most important thing. When it comes to someone generally healthy who is trying to optimise then yes, reducing stress may have the most benefits. But for someone whose metabolism is utterly broken, I don't think it follows that trying to reduce stress by having a great community will produce the most effective outcome. Having this external stress from loneliness, poverty in our strictly hierarchical system and so on may be one of the cultural things that drive people to eat in such a way that leads to obesity or disease - that doesn't mean that loneliness or poverty in itself caused the obesity or disease.

As far as trends go though, it would be hard to really tease out the influence of diet versus the breakdown of extended family bonds. Both started to disintegrate around the middle of the 20th century. So sad.

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