 This is not going to be a very scientific talk. This is going to be a much more personal talk. But in a sense, it might be important for you all because, well, people are interested in their health right at the moment and their appearance right at the moment. They also are interested in what things are going to be like as time goes on. And as far as I know, I'm one of the first people to have been doing this for as long as I have. This is what we're all interested in now or what most of you are interested in now, personal appearance, personal health at the moment. But you have to think about the future and we want to avoid this sort of thing. What we do want is to have something like this, not only the way we look on the outside but the way we are put together on the inside. And that's what all of you should have is a long-term goal, I hope. As I say, this is not a scientific presentation. Once and for all, it's a very personal story and it is an example of somebody who has followed this particular train of or approach to health and well-being for probably longer than anyone else. I haven't heard very much about this particular subject, this particular topic. But if you can do any one thing for your health that is in line with the paleo program, not smoking is it. Now I assume there's almost no one in this room who smokes but there's still 20% of Americans and more in European countries and other parts of the world who are smoking but it is totally out of keeping with anyone whose ancestor is not an Australian aborigine or a Native American. I'm a big fan of the nutrition as it occurred in the African savanna and particularly East Africa. Those of you who saw Spencer's movie last night saw the length of time that our ancestors were Northeast Africans or at least Africans and consequently I think we are primarily designed, our metabolism biochemistry is designed for nutrition as it occurred in that location and people who say there are many paleo diets, I would like to discuss that with them. I think this is the basic paleo approach to nutrition. Well what does that mean? The best we have been able to come up with is that our ancestors on the average, of course there are variations from place to place within Africa and variations from time to time within the different seasons, are consuming roughly 30% of their energy in the form of protein, carbohydrate as much as 35% but it came from fruits and vegetables, nuts, they did have simple carbohydrate which was in the form of honey which you were very fond of but they had very little other simple carbohydrate and they did get about perhaps a third or 35% of their energy in the form of fat but it had more polyunsaturated fat and less saturated fat than we consume with our fat at the present time. I've heard some discussion of fiber, they had a tremendous amount of fiber, you cannot eat the proportion of natural fruits and vegetables that our ancestors ate and not get a lot of fiber because wild fruits and vegetables have far more fiber than do the cultivars that we consume today. So up to 100 grams of fiber, of course they did that from childhood on, if you wanted to do that now you'd have to go at it very slowly and incrementally. They were getting, as far as we can tell, far more vitamins and minerals, varied from the different one. A very important consideration is that they had substantially more potassium than sodium. They got as little as 1,000 milligrams of sodium which is way below any of the recommendations that are made by various authorities today. One thing we can be sure of is that all of us can eat more potassium than sodium. That's, even if we can't get down to 1,000 milligrams a day, at the very least we can eat substantially more potassium than sodium. The acid-base considerations haven't been discussed very much here but Linda Fressetto can deal with that and tell you more about it in a very authoritative way but their intake was somewhat more basic, ours is somewhat more acidic compared to what they were consuming. And lastly, for antioxidants, we've had a discussion about whether those are good, bad, or indifferent, whatever they are, our ancestors were getting far more of them than we are now. So that is something to be considered. I consume, as a good deal of antioxidants, either through the foods I consume or by supplements, beans are a factor that people can argue about. They do have a very high level of antioxidants and they also have good soluble fiber. So while there are some negatives associated with legumes and so forth, there are also some positives that whether you consume them or not depends a bit on your own personal situation. So for nutrition, I think you can look at it in two ways, either in the weak form, which is what I personally follow because I do not have any longstanding or chronic health problems and because my biomarkers are acceptable, at least to me anyway, so that in this situation, most of what you see there, the recommendations in point, I think practically everybody here would agree with, poultry, fish, shellfish, plant foods, vegetables and fruits and so forth. What we would not agree with would be whole grains or dairy. Many people here would disagree with that, but I think for the person who has biomarkers, they consider desirable and who has no particular longstanding health problems that this is perfectly acceptable in moderation or in a relatively minor contribution to the diet, much less than most Americans consume. Alcohol is something to consider, I think fiber, I think is particularly important. I was a personal friend of Dennis Burkett's for a long time and consequently, I believe in many of the things that he originally promoted. So these would be some of the foods that I am particularly fond of. We are about to leave from here to go up to Maine and we will indulge our shellfish craving up there for sure. Fruits, vegetables, a big part of our diet at home and should be for everyone else, I think. How anyone could argue against carbohydrate in this form is hard for me to understand. I think that as opposed to what some people here believe that in the weak form, certain kinds of whole grains are okay. If you have shredded wheat here, there's no salt and no sugar. That's not a bad food. Skim milk, I think, is an acceptable food. Personally, I'm a big fan of red wine, but moderation is necessary, I must say it in some cases, my moderation is less than it should be, perhaps. And these are some of the supplements that I think are worthwhile. I do take vitamins and minerals. I take extra EPA and DHA and I take extra fiber, particularly soluble fiber, which I think we are particularly deficient in our diets at the present. Now, here's the diet that most everybody here can buy into. This is the strong form of the paleo nutritional approach. And this is appropriate, in my opinion, for individuals who do have resistant health problems that have intestinal problems, that have coronary disease, that have high blood pressure, that have any number of things that are not responding to treatment and who need a dietary approach that is going to be more effective, in my opinion, than the weak form, which works for me, but wouldn't work for a lot of people. And another group that would be very, would be worthwhile, at least, considering this approach to their nutritional intake would be the competitive athlete who wants to try to improve his or her performance. So, the big difference here, most everything is the same as the weak form. What you do is you cut out the grains and you cut out the dairy altogether. Alcohol, I think you could experiment to find out if you're achieving what you want to achieve as you consume alcohol. And if you are, fine. If you're not, cut that out as well because our ancestors didn't have alcohol until long after agriculture began. So, in the strong form, no dairy, no grain foods. There's been less discussion at this meeting about physical activity than I would have expected there were to be. And I think that high-level physical activity or let me rephrase that. More physical activity than the ordinary American obtains is an essential aspect of the Paleolithic approach to health. And we have every archeological evidence and we also have evidence from observing hundreds and gatherers and so forth that their levels of activity are high despite the recent paper about the Hadza which I disagree with. And for myself, what I do is three days a week of alternate days a week of endurance or aerobic activity and four days a week of resistance or strength training and that with the resistance training I do lower body two days a week and I do upper body two days a week. And I think this sort of varies things around in a pattern that fits to a certain extent what our ancestors were doing. Hunters wouldn't usually go out every day and hunt. They would go out alternate a couple days a week. Similarly for women they would go out to gather not every day most of the time but alternate days or every third day or whatever was necessary but it was an alternate kind of thing not every single day. As far as endurance activity is concerned I personally am restricted because I have very bad osteoarthritis in my left knee. So I can't really jog which I would greatly prefer to stationary biking which is hideously boring. But if you watch the TV or if you read a book or something it's fine. And that's what I do for three days a week. I love to swim which is another form of aerobic activity. I do that in our own pool. It's not a heated pool so it's limited to summertime. And when I'm in Maine I swim in our lake which is very pleasant I must say. This is certainly more, this is TMI for sure but it is just to show you that when I am doing lower body exercises I do quite a number of them because I think conditioning your lower body to my mind is more important than conditioning your upper body. But these would be some of the ones I would do as far as upper body is concerned these would be one and you see there's a smaller number of those. I don't ordinarily do a chest press but I'll show you in a minute that for the couple of months prior to this meeting I did work with the chest press just to see how things would go. After every session I do some stretching and some work for abdominal musculature and lower back and I do that this is seven days a week which goes against my philosophy to a certain extent but it is what I do. When we wrote the Paleolithic prescription in 1988 I suggested that we make a standard for, we have standards for males and females. What we put out for the male standard was that whatever, however old you are you should be able to do your body weight as a bench press. You should be able to do one and a half times your body weight as a leg press. So earlier this year I tried to see if I could do this. That's why I was doing those chest presses and was happy to find that I could do 200 pounds in the chest press which is not as hard as a bench press for sure but it's sort of like it. Five times and similarly I could do 300 pounds with the leg press five times. So the prediction that we made in 1988, at least up to this point has been confirmed. Now here's the biochemistry. I haven't done nearly the extensive or sophisticated biochemical analyses that have been done. I was a little unhappy with this but it is certainly much better than an average person for my age, average male for my age. Similarly my percentage of body fat, I wish it were lower but the last time I had this done was about 10 years ago, it was about 14.5%. Now it's 16.5% but it's still better than males of my age on average. Blood pressure, I was reasonably satisfied with that. My insulin is, serum insulin is okay. Fasting glucose is not down to the average if we're 100% gathers but it's within the range and substantially below what you ordinarily see for males and American males in my age category. My serum cholesterol really annoyed me. The lowest I've ever been able to get it was 138. Right now it's 171 as opposed to the 70 year old average American who is close to 190. However, you have to keep in mind for males in my age category in the United States, 40% of them are on statins. If males in my category who have any indication of existing corny heart disease, 80% of them are on statins. So this figure is artificial to some extent because it's heavily influenced by statin medication. Again, I wish I had a lower LDL than I have but I was quite pleased with the HDL compared to 100 gathers and certainly compared to American males of my age. I was very pleased with the triglycerides which shows that the relatively low level of triglycerides you can achieve if you have very little simple carbohydrate sugar and refined carbohydrate coming in. This is a measurement I've only had done once just a couple of months ago and I've been interested to talk with people here. A number of people here, far more sophisticated than myself have had this done for years. But anyway, there are no data on 100 gather figures here. Whatever that is. Anyway, but as far as people males in my age category in the Framingham study, I'm about at the halfway point as far as they're concerned. There have been some criticisms about our original paper, Stone Agers in the Fastlane, that we did not provide the references for 100 gatherer total cholesterol levels. The reason for that was we originally submitted the paper with over 200 references. They said this is, we like your paper but you gotta cut the references in half and that's what happened to these references. So if there is anyone who wants to know where we got these figures, this is where. This is the take home message here for heart disease. As a radiologist, I am fortunate that I can get this kind of study for free. This is, the one in the left is me and I really cannot see where my pointer is pointing but let me see if I can prove it. This is the main left main coronary and this is the left anterior descending coronary artery. And you can see that they are free of plaque as opposed to this person who has quite a bit of calcified plaque in the corresponding artery. I'm sure everyone here is very familiar with the difference between median and mean. Median would be the score for people in my age category that has half the people above that level, half the people below that level. So the median score is 188. Mean score is taking all the people adding up their total score and averaging that. So that my score of zero is substantially better than the median and a hell of a lot better than the mean. I'm getting to the end of my talk now and I wanna point out some things about the paleo approach to living that is over and beyond mere considerations of your biochemistry or your physiologic physiology. We expect that this approach is going to provide more vitality, it's going to make us look and feel better. We expect that it's going to give desirable health checkups. Those are things you might ordinarily expect from a health program and it's appropriate that one does so. But speaking as somebody who some people have called the grandfather of this program, I'll give you some grandfatherly advice. It's human to want some degree of material success. I suspect there are some very altruistic people here who don't feel that way, but I bet you the majority of people here would like to have some degree of material success. That's perfectly fine. I think myself that to achieve material success requires talent, which is unfortunately something that you are primarily given but you can improve on. It requires a lot of hard work and in my opinion it requires a lot of good luck. Good physical health and a positive self-image enhances whatever talent you've been given by your genes. It enables you to work hard. And I personally think it greatly increases your chance of good luck. So material achievement, material success is something that's very important. However, more important, I think almost everyone here would agree, probably everyone would agree, is your relationships. And they too are improved by health, good health and a positive self-image. So my take home message is following the Paleolithic Health Protocol has enhanced my own personal life for 30 years and I believe that it can do exactly the same thing for everyone in this room and for everyone who follows it across the world. Thank you.