 Well, good morning. It's a pleasure to be back here at Ancestral Health. I was dressed this morning as Dr. Phil, and I'm the original. I was Dr. Phil before McGraw was in grad school. I'm the one with the hair. He's the one with the money. Well, as members of this society know, stone ages did not have a miserable disease ridden existence. I mean, if they did, we wouldn't be here. And as Boyd Eaton and Marjorie Shostack and Melvin Conner have pointed out, generations ago, they were taller and stronger and healthier than most of us are today. So what were the kids like? It's really an interesting story. There are a few surprises in there. This is a condensed version of a two-hour presentation. So if you'd like more information, I have a list of references about 35 or so. And if you contact me through my website, I'd be happy to mail it to you. So what was the frame of reference? Well, we're looking at about 50,000 to 100,000 years ago. And the fact is that the human genome hasn't changed very much in those 50,000 years. There are some changes. One is some of us have become resistant to malaria, for instance. Because of changes in red cell physiology. Some of us are tolerant to gluten. Some are not. Many of us are lactose intolerant, especially in those areas where dairy production has never been very common. So what did a stone age family look like? And that's what most people think of when they think of stone ages. But this is what they really look like. And what's the one thing you notice about this family group? Nobody is overweight. Nobody is obese. I mean, if you were obese back in the Stone Age, you'd be some animal's lunch. So it's important to know that child health begins before conception. Because a pregnant stone age was healthier than a modern pregnant woman, which seems at first blush to seem kind of odd. But when we look at modern women, we find that 90% of women these days of child-bearing age are deficient in at least one major nutrient. And the examples are these calcium and iron and folic acid, for instance. And that has spanned generations. Studies continue to show that that is true. When we look at the pregnant stone age, we find that she was an excellent physical health. I mean, she had to survive to child-bearing age. She had a normal percentage of body fat. She didn't use tobacco or alcohol or drugs. And she had no sexually transmitted diseases, because in those small groups, sexually transmitted diseases simply didn't spread. Epidemics certainly couldn't spread. And she was immune to most local infections because of growing up where she was exposed to germs and she was essentially getting vaccinated by the germs that she took in her environment. Well, when it comes to a healthy pregnancy, she had fewer maternal complications because she was healthy and therefore fewer infant complications. For one thing, she didn't have gestational diabetes, which ranges from different population groups from maybe 4% to about 10%. And in fact, it's increasing by about 50% every 10 years or so. There were no elective C-sections, obviously, and she had fewer children with congenital defects because she had a healthy pregnancy. If we look at some of the modern hazards that we see among our child-bearing population, we find that overweight and obesity are linked to an increased rate of birth defects involving the heart, the eye, the GI tract, the kidneys, etc. And when we look at women who are overweight or obese, they have an increased risk of having a child with cerebral palsy. Simply being overweight increases their risk by about 22%. Having severe obesity doubles the risk. And these are things that simply did not happen back in the Stone Age. There was no tobacco back then, and what we know now is that smoking during pregnancy is linked to tumors of the eye in the brain and to leukemia. That mothers who smoke have infants who will have thinner retinas and therefore they have a greater risk of glaucoma later in life. Also, mothers who smoke are less likely to breastfeed than we all know what the advantages of breastfeeding are. There was probably no marijuana back then, you can't be sure of that, but we do know that marijuana used during pregnancy is associated with increased risk of childhood leukemia and brain tumors and a particular kind of tumor called Arabidomaesarcoma, which is a tumor of muscle. Both regular smokers and marijuana smokers have kids who have lower birth weight and more likely to be premature. When it comes to strength of the skeleton system, we find that a mother who has a low bone mass is going to have children who are themselves bone deficient. And one of the major reasons is because of a lack of physical activity and as a matter of fact, if we look at adolescents these days, only about 20% of adolescent females get as much as an hour a day of moderately intense exercise. It's important to note that calcium is only one of the many bone building nutrients. Calcium is important, but there are many other things that are as well. We also find that mothers who smoke will deliver kids who have a weaker skeleton and we know that from studies of eight-year-olds. Eight-year-olds are kind of the markers of bone fragility in children. We find that among eight-year-olds, the risk of forearm fracture today compared to 1970 is about double. And so we're clearly having babies whose skeletons are not as strong. What does that tell us about what osteoporosis is going to be like when these kids reach middle age? One of the challenges that we find now is that about 67% of modern women have had some sort of eating disorder, bulimia, anorexia nervosa, et cetera, and that occurs during a particular age span when they are building a strong skeleton and therefore they are not taking the nutrients that they need to do that. Looking at the very first moments of life, we find that there's a big difference between natural birth and C-section. For one thing, the birth canal obviously is very narrow and the baby gets really squeezed coming through so the chest gets squeezed, the lungs get squeezed, fluid in the lungs gets squeezed out, which is a reason why babies born by natural childbirth are less likely to have breathing problems afterwards compared to C-section babies. Well, the birth canal is a pretty messy place and so they end up swallowing a lot of the probiotics that will be so important to them later on. Generally speaking, the cord was either cut or beaten through and this really still grosses me out as a physician, but they had no instruments obviously back then. There's something called the Vernix Casioza, the Latin word for cheesy varnish, and when a baby is born in most places today, things are changing, but in the past generally, the baby was taken away and washed off and then give it back to the mother. They give the baby back to the mother because they know that in those first moments that contact is very important and so the baby ends up with that cheesy varnish. Now, this Vernix has a lubricating factor and an antibacterial factor and this is what it looks like. Only a mother could love something like that. Yes. Breastfeeding back then obviously was the only choice because there were no substitutes for breast milk back in those days and we didn't begin domesticating animals until about 10, 12,000 years ago. It's pretty hard to milk a mammoth and so that just didn't get done and it's interesting now we are so certain that there is a very close relationship between the breastfeeding mother and her baby. We call that the mother-infant dyad because the milk changes every day. The milk that the mother produces in the first week is different from what she produces in the second week and the second month and the second year and it varies with the gender of the infant because the milk that a mother produces for boy babies is different than the milk she produces for girl babies and the obvious question is what if it's a boy and girl twin? We still are not sure except that there is some research to show that same-sex twins when they mature are taller than opposite-sex twins and it may be something to do because of the breast milk that's formed for them. Well, one thing that is nice to know is that breastfed babies usually, not always, but usually sleep better through the night. One of the reasons is that there is a variation between day and night milk and that there is some more melatonin present in nighttime milk than there is during the day and so the baby obviously is going to sleep better. Another really fascinating factor is that the milk changes whether or not the baby is born prematurely or full-term. As an example, omega-3 fats are transmitted through the placenta during the last six or eight weeks of the pregnancy so what happens to the poor kid who is delivered early? Well, it turns out that if the baby is born prematurely the mother's milk changes and she then begins to produce more omega-3s in her milk to make up for what the baby didn't get during her last six or eight weeks of fetal life. The breast of course is a wonderful defense mechanism because there is an enormous variety of immune factors in breast milk and we now know, talking about probiotics, that those favorable bacteria are present in breast milk even before labor begins we used to think that breast milk was sterile now we know that it is not. What does that tell you about the priority that nature gives to the importance of probiotics in our environment? Well, there are live cells in breast milk there are no live cells in formula and if there are, the guys in quality control are going to be out of a job because formula is not only always the same but there can't be any live cells but breast milk contains at least five different kinds of live cells and if the baby takes cow's milk with live cells and say fresh cow's milk those cells will be digested but the cells that come from the mother's breast are not digested they pass through the intestinal tract and they migrate to the immune tissues of that baby where they can persist for years we know that they persist for at least seven years and it's a possibility that some of those cells persist for a lifetime to add to the immune capability of the baby it's certainly true from many studies that breast milk affects the brain and the eye development not to a huge amount but there are measurable differences no one has ever shown that that kids who are breastfed only have a lower IQ or whose vision is less good than those who are fed formula there are some other breastfeeding benefits one of the major ones is that they have fewer infections this is really important in the third world in developing countries because as you know we have been promoting infant formula in developing countries for decades and the problem is if that formula has to be reconstituted with water because it's either a powder form or a concentrated form the sources of water in those countries are not safe so that increases the risk of gastrointestinal diseases among children until early in the 20th century gastroenteritis was a major the leading cause of death among children is in developing countries and that's one reason as I mentioned breastfed babies tend to have a consistently but slightly higher IQ we used to say that breastfed babies were less likely to be obese when they became older that is not as true now as it used to be because there are so many other factors during childhood that contribute to childhood obesity so the breastfeeding factor tends to be diminished somewhat one of the important things about the baby who is born prematurely is that they are at risk of something called necrotizing enterocolitis and the younger, the smaller the baby the more likely necrotizing enterocolitis is a condition where a section of the intestine simply dies and we now know that by feeding the baby's mother's breast milk it lowers the risk of necrotizing enterocolitis possibly by as much as 40% it is now standard practice in many hospitals in the NICU to give babies their own mother's breast milk there is some maternal benefits of breastfeeding and one of those is that immediately after birth if the baby is put to the breast the uterus begins to contract as a reaction to that suckling and therefore it contracts the blood vessels lowering the risk of bleeding well in a developing country or back in the stone age that was a big deal because the major cause of death among mothers is breastfeeding they also have a faster return to pre-pregnancy weight when a mother produces breast milk for her baby every day she's putting out about 500 calories well 500 calories a day for a week it's 3500 calories that amounts to a pound of fat so mothers who breastfeed return to their pre-pregnancy weight faster than those who form the feed and we now know that that's for the mothers who breastfeed that's a complicated issue part of the fact may be because they tend to have less adipose tissue and as you know adipose tissue produces estrogen estrogen is a driver of some cancers and that may be one factor there may be other factors involved too that we're not yet sure of but one thing that we are aware of is that the immature breast is more susceptible to cancer-crossing agents if a mother has not gone through pregnancy those cells in her breast never completely mature and that lack of maturity means that those cells are more susceptible to carcinogens especially those that are present in tobacco smoke mothers who breastfeed worry about getting something called mastitis mastitis occurs when the breast either becomes very engorged or becomes actually infected there are two kinds of mastitis and when the swelling occurs some of those ducts begin to rupture break down send certain tissue into the mother's bloodstream and there seems to be some sort of immunologic phenomenon that lowers the risk of ovarian cancer there is a lower risk of later cardiovascular and liver disease in mothers who breastfeed again because they are less likely to be obese and less likely to have those drivers of cardiovascular disease and this really cute little kid has been riding around on the mother's back like that since the first day or so after he or she was born and that's the way hunter-gatherers carry their babies and probably they did back in the stone age so the baby was always around the mother which meant if the baby was carried in the front and was hungry he or she was simply reached up and grabbed the breast that's right there and for that reason the breastfeeding is done on a very frequent basis when we looked at the first baby foods we find that generally speaking weaning occurs in hunter-gatherers societies between 2 and 4 years or so and there is something called pre-mastication where the mother chews the food puts it back into the spoon and feeds it to the baby I was 10 years old when my brother was born and this really grossed me out when I saw my mother doing this still kind of grosses me out except nature is not stupid nature provides that kind of mechanism for feeding babies because there are salivary enzymes that the mother provides in that pre-masticated food that begin the digestive process makes it easier for the baby to digest that food it also has probiotics to the baby's system because the mother of course has these normal flora in her mouth as well and she gives that to the baby also there is something called IgA secretory IgA which is formed in the upper part of the mouth the respiratory tract and this is also protective so it's one more level of protection that the mother gives to her baby when it comes to combating infection when it comes to nutrition there are still nature has an enormous variety of plant and animal foods certainly they had 100 or more different kind of plant foods different kinds of animal foods and what they found was everything was organic and food was always fresh because they had no way of preserving food plant foods of course are low in sodium the high in potassium and we have reversed those ratios we now have taken twice as much potassium in our diet as we do twice as much sodium as we do potassium and that's not the way we are designed there was minimal contamination because nowadays you've heard about outbreaks of E. coli in terms of things like sprouts or ground beef and that's because of our ways of producing and disseminating food well back then that didn't happen because all the food they had was produced locally and there was no transshipment there was no storage there was no time for organisms to grow and reproduce in that food well there are some diseases that kids did not have they didn't have what we call the usual childhood diseases things like measles, mumps, chicken pox and one of the reasons was there was no epidemic diseases I mean they lived in groups of 25, 50 maybe 100 people and that made it impossible for epidemics to occur also at the time of the agriculture revolution we began to develop diseases that came from animals first how many have ever traveled to Switzerland have you ever noticed some of those houses of families on the second floor the animals live on the first floor do you wonder whether some germs are spread back and forth absolutely and that's been happening since the start of the agriculture revolution back then there was no such thing as type 2 diabetes because overweight drives type 2 diabetes and they didn't become overweight and certainly never became obese I was in pediatric practice for 35 years and it's been 25 years since I've left practice but during those 35 years I never once saw a child with type 2 diabetes if you go to any metropolitan pediatric diabetic clinic these days you'll find nearly half of those kids have type 2 diabetes which simply did not exist a couple of generations ago they of course had no obesity related problems because they were not obese and now we're seeing obese kids in the first couple of years of life 22 or 23% of first graders are obese not just overweight but obese they didn't have rickets and they wandered around all day with no clothes on in the sunshine and Stone Age of the Course didn't live in the far north they lived in a few hundred miles north of the equator where they had sunshine all the time they got plenty of vitamin D and therefore no rickets excuse me for just a moment so there was no one who was vitamin D deficient and they didn't have acne hunter-gatherers don't have acne when they go through adolescence and Lauren Corden was someone who published one of the seminal papers on this issue and indicated that there's something about the hunter-gatherer lifestyle that keeps that from happening well there were no epidemics in this Stone Age however they did have parasites in or out of their body part of my career was spent in Puerto Rico and I was visiting with the head of parasitology at hospital San Juan and I said this was of course over 60 years ago and I said what percentage of people who live in Puerto Rico have parasites and she's this doctor if we do a stool examination and we don't find parasites we think we've made a mistake so we do it again we've had a lot of change in the last 60 years in even places like Puerto Rico but they were part of the normal flora, the beneficial organisms back in the Stone Age what happened was that we co-evolved with parasites we need them and they need us and parasitic worms and bacteria as you know are becoming part of mainstream medical treatment we joke about poop transplants but that's happening both for bacteria and parasites when it comes to elimination there were no diapers in the Stone Age and so how did mothers handle that well you saw how that baby was carried in the sling hunter gather mothers learned to sense when the baby needs to void and they hold the child away from them pointing away of course and therefore the baby eliminates right there now when I was a pediatrician I got to be pretty good at telling when a little boy was about to unload not always but most of the time I could guess when I was going to be a target well so toilet training began in the very few months of age when it comes to crying babies you may have heard that apache babies don't cry and I have verified this by reading information from Native Americans and they point out that among the apaches raiding of other tribes was common so the mothers and the kids would go and they try to escape to it a royal or a canyon army or hide someplace and if the baby cried it was a giveaway that the raiding party would find them so from the very first days of life mothers began to pinch the baby's nose shut when they began to cry because babies are obligate nose breathers because if they're suckling they can't breathe through their mouths they can only breathe through their nose that doesn't change for several months and very quickly those babies learned that if I whimper mom's going to do this and the fact is that they didn't cry and some hunter gather babies never cry maybe for different reasons but one is that they're carried by the mom all the time they're always close to the mother's body no reason to cry because the breast is always there the tension is always there babies are meant to be carried until they can walk and keep up I know that's pretty hard to do these days we have six kids my wife never carried anyone around in a sling other things to do with the other five kids obviously but the fact is among hunter gather populations that's exactly what they do if we look at the way primates behave we find that gorillas and monkeys and other primates carry the babies on their backs for weeks at a time among hunter gather societies crying babies reflect badly on the parents in those societies so there's some social pressure to keep babies from crying I wonder if there are any moms in the audience who had a kid who was a picky eater yeah well picky eaters live longer I mean think about this you have an 18 month old who wanders away from mom and he or she begins to eat any kind of berries whatever they can find and if they're the wrong kind of berries they don't grow up to reproduce and so that trait is hard to wireness and some kids will only accept the new food when it's been offered 20 times very few parents are going to give kids peas more than two or three times if the kid says no but if they just persisted they would eat it because they saw mom eating it and siblings eating it and that pre-mastication tends to minimize the fact is that breastfed babies accept foods more easily but there's some behaviors that never change kids forever are falling and I'm sure that back in the stone some kids say hey guys watch this as he tumble off a tree branch or fell off a rock they fought with each other they certainly were subject to things like snake bites when I was in practice every spring I see a kid almost always a 10 year old boy who was sure he was faster than that rattled snake but he wasn't so it was always bites on the arms and hands there were animal bites and then of course there's something like this now he's obviously not a stone-ager but one of the things that you may be aware of is that toads and frogs have toxins in their skin some of them are really dangerous but some are hallucinogenic and it may be that that behavior happened back then as well there was of course a daily egg hunt kids were the best egg finders and the best that they had back in the stone age turtles, snakes, alligators did they all taste the same? no and of course you know who this is that's pigpen the pigpen theory is known as hygiene hypothesis and we are hosts as you have heard this week to about a thousand different species of bacteria and they boost our immune system they form barriers against harmful bacteria they lower cholesterol and they provide nutrients that are not present in food and we're exploring yeast and fungi and viruses also in terms of beneficial microorganisms and the fact is our kids are too clean because we know that kids who grew up on farms are less likely to have allergies like eczema and asthma than kids who are city-born and are not raised with kids their first vaccines came from dirt and feces because they acquired the germs that would protect them if a related species were a dangerous one they were already somewhat protected because they had ingested the more benign form you all know the 3 second rule when food falls on the floor if you pick it up within 3 seconds it's okay to eat well I have the 10 second rule 1, 2, 3 because I want to get some bacteria that might be on the floor well not really but the fact is that clean food is not normal for humans back in the stone age they didn't wash their food they didn't wash their hands they ate whenever they could going barefoot is something of course we are becoming aware of it because for 2 million years nobody wore shoes does it name Ababy Bikila Ringabel? yeah he won the marathon in Rome in 1960 and he was barefoot so what was the risk in the stone age well there was no glass and metal to get involved to stab your feet and barefoot running is coming back yeah this is known as co-sleeping because babies and mothers are evolved to sleep together and this idea of over lying and infant death as a result is something that only began to occur about 2 or 3 thousand years ago because back then there were no mattresses there were no pillows there were no blankets baby bumpers this is why babies suffocate in a study from Australia of sudden unexplained infant death that there were no unexplained infant deaths they all had a reason I'm going to go through this quickly but the reasons they found obesity, drugs, alcohol, bed covers etc we find toys and games among children's graves and before the agricultural revolution we didn't have any evidence of that but we find fingerprints of children on miniature bowls from the 9th century and miniatures found in children's graves boys are buried with weapons with kitchen utensils why do children fight with their parents because they're learning how to do that in a safe environment if a 12 year old has a terrible argument with his dad the dad will knock the snot out of him but he's not going to kill him but if he argues with some other guys his dad he might end up dead they learn how to hunt together from an early age hunting gatherers, boys learn how to track from the age of 8 stone age children in a similar pattern when it comes to puberty girls begin to menstruate at about 18 in hunter gatherers societies and they may be married by that time now girls married at the age of about 12 and because of that they may accumulate more body fat because body fat then produces estrogen etc and they have what's called incessant ovulation and ovarian cancer and the other side is that for millions of years children were discarded or sacrificed at many points in human history and the 10th plague of Egypt in fact may be this kind of problem it may be that the reason for the 10th plague the first born child the first born domestic animal dying was not because it all happened at once like in the Cecil B. DeMille movie but because it was a practice not to be sacrificed when I heard the story about Abraham and Isaac I wondered how is that Abraham didn't complain to God when he said you have to kill your child and it's because in that period prior to 2000 BC or so when Abraham lived child or infant sacrifice was a common practice and that's why Abraham didn't put up a fuss you know why Isaac was only 12 years old and Abraham was told to sacrifice him if he were a teenager wouldn't have been a sacrifice my wife hates it when I tell that one we know that the Aztecs sacrificed children for various reasons and modern hunter-gatherers sometimes do as well and finally when it comes to technology there is the old man with the arrow through his nose and the kids are saying that just can't get the hang of this new technology thank you very much I appreciate your attention if you have any questions we have about 8 minutes for questions if you have any questions right now these are very useful for people watching the presentation because they'll be recorded so maybe someone has a question they want to pick his brain great presentation thank you my question is around breast milk and we understand how important it is for a child I talked to some female friends of mine that say I just don't produce enough breast milk to feed my baby day and night the baby is too hungry so I have to start mixing in the powder milk what would your response be how do we handle that that's a tough question I wrote an article called breastfeeding inadequacy but I've never submitted any place because I don't know where to send it because it's such an emotional issue but it is that our culture for generations certainly during the mid 20th century downplayed or actually abhorred breastfeeding and so today's grandmothers many of them never breastfed because it was looked down upon so they can't pass down that lore to their daughters and so we have lost that entire body of experience of breastfeeding mothers who could teach their children and they had their own there's a study done on this issue that showed that if mothers who had this breastfeeding inadequacy problem were counseled and given some instruction that that so called inadequacy was resolved about 80% of the time and even a woman who has very small breast has plenty of breast milk breast forming glands that form adequate milk and I have had babies in my practice who are twins and they, I mean these were like the Michelin kids and the mother was exclusively breastfeeding for both of them and the interesting thing about breastfeeding is that when there are twins or three the breast actually produces more milk in response to that again nature isn't stupid nature wouldn't waste the child and so this breastfeeding inadequacy is relatively uncommon in breastfeeding skills and I think that's a major problem I'm curious about complications and death during childbirth in hunter-gatherers modern medicine is lauded for how much it's helped reduce that and there must be some bell curve over time where it has improved something that got bad but it maybe was better in the deep past well we really obviously don't know because we don't have any way of really identifying what the causes of death were during childbirth we know that during the 18th and 19th century infection was very common and if you've ever heard a story of Ignace Simmelweis and the Strep infection childbirth fever is a tragic story that was very common probably less likely that they died of infection but that was possible but certainly if there was what's called cephalopilvic disproportion the skull was just too big to come through the birth canal both the mom and the baby died and we see that still in developing countries my guess is that probably most of the causes of death in mothers at that period were either because of the cephalopilvic disproportion or from bleeding and I can't really make a good case for infection because again the kinds of germs that devastate populations didn't get transmitted from one group to another because of the distance involved so that's my best guess the encephalopilvic disproportion may have been less for nutritional and just lifestyle reasons I don't know I think it may be because the human pelvic anatomy is not quite perfectly developed yet the pelvic structures in some women are such that that canal is so narrow that obstetricians can tell by sonograms before delivery this baby ain't going to come through that way and when I was in practice I saw I was in the military for 20 years and I saw a lot of Filipino women who are Asian women who were very small and they had were married to guys that were a pretty good size I wonder how was that baby ever going to get through but most of the time they did not require a C-section and so there are all those individual variations and there's no way to predict that without a sonogram and they didn't have that back then so good question well thank you all for being here and enjoyed it hope to see you again next time thanks