 Thank you all so much for being here. I've been thinking a lot about this question, and I'm very excited to share my thoughts with you all. So just a quick run-through of the learning objectives that were published. So we're going to review the concept of evolutionary mismatch and what it means for the human diet. And we're going to look at the perspective from three different fields. We're going to look at it from the anthropological perspective, evolutionary biology perspective, and also the nutrition and dietetics perspective. And then we're going to look at the clinical literature about mismatch from diet, from three different dietary perspectives, from the food group perspective, the macronutrient perspective, and the diet quality perspective. And then we're going to determine if the evolutionary theory fully supports the use of the paleo diet today and discuss how an updated stance on diet can hopefully help the ancestral health movement move forward. So many of you in the room are familiar with evolutionary mismatch. This is just when you have an organism that has evolved and is better adapted to one environment, and the environment changes, promoting a state of disease. Evolutionary discordance hypothesis takes the evolutionary mismatch perspective and applies it directly to humans, thinking about how changes in from a hunter-gatherer and sexual times to modern times today promotes diseases of civilization. And when I tell people that I study evolution and diet, one of the first things that comes out of their mouth is, oh, you're talking about the paleo diet. And the paleo diet is really interesting. It's highly debated because it's one of the many fad diets out there, but it's also debated because it's based on the central keystone of biology, evolution. And since it's based on the central keystone of biology, we're going to look at it from the three different disciplines that I mentioned earlier and look through and see what the literature has to say about the paleo diet or evolutionary mismatch and what it means for the human diet today. So first will be the anthropological perspective. Chang and Noel in 2016, great title, How to Make Stone Soup, is the paleo diet and missed opportunity for anthropologists. So in here, they basically are excited about the paleo movement and think that, you know, they say, shouldn't we be happy that consumers are searching for evolutionary guidance about how to best live their lives? And in the paper, they recognize that prior efforts of anthropologists to engage the paleo community have primarily failed. And they basically say moving forward that anthropologists should take advantage of the paleo movement to educate people about their discipline and about human evolution. So this is a recent 2016 paper, so it's a pretty promising start. Another paper here, before and prepared to, they talk about in the paper how the natural human diet is a product of human evolution, and there really is no one set human diet. So the idea of having something like an optimal diet or a diet made up of certain food groups or not certain food groups is really incorrect and they emphasize in the paper that diversity and flexibility of a diet is really crucial to the human diet. Turner and Thompson, they start the paper off by talking about the evolutionary discordance hypothesis that I mentioned already and they recognize that it's sustainable and they support the use of it. They say, but it's focused on a single model of the ancestral diet and the assumption that cultural evolution outpaces genetic evolution and that this is a cause of diseases of the modern world has really resulted in an incomplete view of the flexibility and variability that is the human diet today and in the past. And they say that returning to a more true human nature is inconsistent with how human metabolism and eating has evolved throughout time. Critidine and Schnorr, they also go ahead and say that, you know, the true human diet is tremendously variable based on things like ecology, seasonality, seasonality, and the available resources. But they also talk about in the paper that there's recently been a strong public interest in evolutionary health that's effectively forcing this interdisciplinary response by health researchers and policymakers. They say things that like evolutionary medicine, the paleo diet, and just people seeking alternative medicine has led to this realization that human health is immutably dictated by human evolution. So again, promising. To summarize, there is no one human diet and you know, variation and flexibility is key. But overall the anthropological perspective doesn't support the use of really any one diet or the paleo diet. Moving on, evolutionary biology. Eaton, Cordain and Lindberg outlined some common counter-arguments to the evolutionary health promotion and thinking about evolutionary mismatch in diet. They specifically talk about the potential for genetic changes since agriculture, the heterogeneity of the ancestral environment, and then just human adaptability. And while they discuss these in detail in the paper, you know, there's still some reserve bio-evolutionary biologists and Marlene Zook in a paleo-fantasy book has pretty much talked about all those counter-arguments and says that it's still open for debate. Basically, argues against every justification for the use of the paleo diet today. A great book review titled Throwing Out the Mismatch Baby with the Paleo Bathwater. This was written in response to paleo-fantasy. And they basically, these two authors say that Zook is basically failing to acknowledge the success of the mismatch perspective. So she thinks that she's attacking it a little too much. And they still argue that it is still useful to use while I may not fully support the use of a paleo diet. And one last paper. Ville argues that the paleo trend has led to a widespread misconception regarding the true nature of human evolution. And this narrow conceptual model romanticizes the hunter-gatherer lifestyle while simultaneously relegating it to the distant past. And they say that this romantic and simplified evolutionary model has major limitations of understanding global variation in human health and nutrition. So to summarize, you know, evolution doesn't stop the idea that we are best adapted to one point in time versus now doesn't really make make sense and when you think about evolutionary biology and they give examples. So overall the evolutionary perspective doesn't fully support the use of the paleo diet today. Nutrition and dietetics perspective. So this is a systematic review that incorporated many randomized controlled trials. And we see that, you know, the adoption of a paleolithic diet is associated with some physiological benefits, specifically weight loss, BMI, waist circumference. But they continue to go on and say that we need larger, better trials to really get at this question of is the paleo diet effective. This is a 2019 systematic review. Another 2019 systematic review, so very recent. Studied a lot more. The paleolithic diet associated with a decrease in weight, BMI, waist circumference, body fat, lower blood pressure, improved lipid profiles, and a decreased circulating CRP, so inflammation. But again, go ahead and say that we need larger, well-designed clinical trials to really get at this question. Another 2019 systematic review of paleolithic diet randomized controlled trials. This one found no effect in improving glycemic markers compared to the controls. So in 2016 here, Pitt wrote a response to some of the randomized controlled trials that were coming out at the time. Cutting through the paleo hype, the evidence for the paleolithic diet. And he concludes that the paleolithic diet is overhyped and understudied. Overhyped because it's one of the many fat diets that are just buzzing in the media. And underresearch because the level of evidence that we have to fully support its use is minimal. And then of course it continues on to say that further research is warranted. A review of various weight loss techniques created a list of pros and cons for the paleo diet based on the evidence that's available. So there is a number of physiological benefits associated with adopting it. Rapid weight loss, improved lipid profiles, improved glucose, but overall it's expensive. And there's concern about whether or not the benefits that are seen in the diet is not just from the caloric restriction that's produced, but from the actual food groups that make it up. There's also a number of studies that have reported side effects with its adoption of headache, diarrhea or weakness or fatigue. And then also there's concern about calcium intake on the diet that's been reported. So to summarize it's effective at promoting health and improving physiology, but it's overhyped and understudied. It's concerned for micronutrient intake, cost, and of course side effects. And there's just a general lack of evidence to support the paleo diet over another diet and more research is needed. And yes, while the Paleolithic diet and evolutionary mismatches based around the central keystone of biology, evolution, we don't see support across disciplines that use evolution in their discipline or not so much dietetics, but the other ones. So there really isn't a consensus across the disciplines for the use of the paleo diet today. And I think the reason that there's not a clear answer in the literature is really just a matter of perspective. And where is the mismatch in our diet? So when we're talking about how our diet has changed over time and looking at evolution and mismatch, what has actually changed in our diet? And I really think it's a matter of perspective with how we're defining or thinking about diet. Excuse me for a second. I'm sure many of you have seen this here. Depending on how you're looking at something you can come up with a completely different answer. This is the same thing that's happening in nutrition. You can have somebody who looks at a diet or a plate of food or an individual piece of food and say, oh, this is a food. This is a fruit. You can have somebody come along and say, oh no, this is carbohydrates. And then you can have somebody else just come along and say, it's a nutrient dense whole food. So you have these three different perspectives all looking at the same thing. So what I'm going to do today is take these three different dietary perspectives, look at how they align with the evolutionary mismatch perspective. So we're going to look at the literature and basically look at these different perspectives and how well they can improve health and improve physiology via diet. And then come look at the dietary prescriptions that come out of them. So the first one, the food group perspective. This is one many of you are familiar with. You have ancestral food groups and non-ancestral food groups that came after the adoption of agriculture. Food groups on the left here and their ancestral would be considered on the paleo diet. And everything that's not on the paleo diet would be the non-ancestral food groups. And we know that today this represents roughly 70% of the calories that we take today. So this brings us back here for the paleo diet. So let's take a look at the clinical evidence. This is a large cohort study at about 20,000 people in it. And I basically scored them on their diet and looked at how paleo-like is this diet or how Mediterranean life is this diet. So again, the paleo diet being a diet that's only made up of ancestral food groups and the Mediterranean diet which includes non-ancestral food groups and ancestral food groups. So it scored them on their diets and looked at mortality. And we see the conclusion of the paper is that the more paleolithic your diet is and the more Mediterranean life your diet is, they're both equally associated with lower risk for various types of mortality. Another study looking at biomarkers of inflammation and oxidative stress. Again, just scoring on their diet and looking at inflammation and oxidative balance. And we see the same conclusion for both diets being equally associated with lower levels of systemic inflammation and oxidative stress. Another study here, this time looking at colorectal cancer. Same type of study design. And we see the same relationship. The more paleolithic your diet is and equally more Mediterranean life your diet is inversely associated with colorectal cancer. Another study here, this is a large cohort of 35,000 people. An evolutionary recorded diet, paleo diet and Mediterranean diet. And we see the same exact relationship. Inversely associated with all cause and cardiovascular and cancer mortality. Another study here, comparing the Mediterranean diet to the paleo diet and its effects to lower hemoglobin A1c, which is a long term marker for blood glucose concentration, used to diagnose diabetes. And we see that both based on the evidence Mediterranean diet and paleolithic diet were both associated with a significant reduction in hemoglobin A1c. No difference across the literature. So if it was truly better to have a diet just solely made up of ancestral food groups, we would see in comparisons that it would just be ringing true to be better than any other diet if it had, if it was only made up of ancestral food groups. So we're not seeing this in these comparisons here. So it may not be fully necessary to restrict a diet to just ancestral food groups to have a healthy diet. So we're going to move on to the macronutrient perspective. And this is the percent of calories based off the average ancestral intake compared to the 2011, 2014 and HENZ data. And we see that overall there is today more carbohydrates being eaten, roughly an equal amount of fat being eaten and a lower quantity of protein being eaten. But before we even continue to look at the prescription that comes out of this, there is really just tremendous variation in what our hunter-gatherers, what hunter-gatherers that we study today consume. And again we use them as a model to try to understand what our ancestors ate. Tremendous variation in specifically carbohydrate quantity that's being eaten. So even just looking at this perspective and just using the averages to move forward and make a recommendation doesn't really, it's not exactly true because the averages is just an average. But from that perspective you come up with this idea that a low-carb diet is what we're going to need to address the evolutionary mismatch in our diet. There's been a ton of research on this. I'm not sure many of you are familiar with it. The never-ending macronutrient debates that's circling around low-carb versus low-fat. I've seen, there really isn't a clear answer. I've seen all sorts of randomized controlled trials and even at the RCT level and the systematic review level, I've seen some mixed information as to whether or not it's better to restrict low-carb or low-fat. But there's two studies here that I want to present to you that have done low-carb versus low-fat. So this is a 2009 paper. It's a weight loss goal and varying diets in macronutrient content, but the diets were matched for a few things. So they had 8% or less saturated fat, recommendation for 20 grams of dietary fiber, recommendation for cholesterol as well, and also with a caloric deficit. But across all the diets, regardless of the macronutrient content, all of the carbohydrates were going to come from low-glycemic index carbohydrates. These are going to be your minimally-processed carbohydrate-rich foods. And again, specifically looking at weight loss, all the diets were equally successful at promoting a clinically meaningful weight loss. And satiety, hunger, and satisfaction with one's diet and attendance to the group sessions were similar for all the diets. So it looks like there's something else going on above the macronutrient level. And the next study here really does a better job of driving home that there's something else important to consider other than macronutrient. So this is the diet fits study. And two groups, low-carb versus low-fat, and they educated them to have the lowest possible fat intake and the lowest possible carbohydrate intake. But again, the diets were matched for a few different things. Both groups were educated to maximize vegetable intake, minimize intake of added sugars, refined flours, and trans fats. But most importantly, they were educated to consume whole foods that were minimally-processed and nutrient-dense. And no significant difference was found in the change in weight between the healthy low-fat and the healthy low-carbohydrate diet. On top of that, there was an equal decrease in the prevalence, or I should say non-statistical, difference between the two groups and a decrease in the prevalence of metabolic syndrome. They basically equally improved a number of physiological markers that were studied throughout the study. So again, it just kind of, there seems to be something else above the macronutrient level that really needs to be considered. So next we're going to move on to quality and look at diet quality. So diet quality is a very interesting thing. People will use it in the literature to mean whatever they want it to mean at the time that they want to use it. But when you just search diet quality, you see that there's a clear positive relationship between whatever diet quality is and health. It's going to be beneficial. And there's a number of different ways to use diet quality in the literature, but most of the time it's used in terms of just an adherence to a certain dietary recommendation or to eating certain food groups or not. So based off of one of these scores, if you don't eat a certain food group or you don't have access to a certain food group, you would have a low diet quality score. So we really need to come up with a diet quality measurement that isn't dependent on a food group or a dietary prescription that also doesn't bother to think about macronutrient intake. So thinking about just the differences in how our food has changed, I'm going to go ahead and use this definition of diet quality and talk about just the degree of processing, the nutrient density of the food and also the variety of the food. And this is the definition that I'm going to use moving forward when I say diet quality. So looking at how, by that definition, how diet quality has changed over time, we can see that our diet was minimally processed in the past, nutrient dense and had a ton of variety, and today that is not seen. So the mismatched perspective here would be the answer, the high quality diet. So I'm going to present to you a nutrient density score. It's called the NDS 23. 23 because it includes 23 micronutrients into the score. It looks a little something like this, but basically it's a mean of the micronutrients, how it meets the recommended dietary allowance for the micronutrients, all controlled for the amount of calories in the food. And we see here, so on the left-hand side is just the various food groups and some of the sub-food groups so you get an idea of what they look like. But in Figure B here, we're mainly looking at the dotted bars. And we see that fruits and vegetables are the most nutrient dense food group there is, then drops down to meat, and then the next highest is dairy, and then mixed foods, and then we see sweet starches and added fats. Importantly, the starch group, fruits and vegetables four times more nutrient dense compared to the starch. And then the starch group is reds, potatoes, grains, and legumes. So we see that ancestral food groups on the left-hand side, fruits and vegetables and meat, are way more nutrient dense in comparison to the other ones when we lump them all together and look at nutrient density based on their food group assignments. This analysis was with over 600 different foods. Now we're going to look at a way to think about food processing. Has anybody heard of the NOVA classification system? It's pretty hot in the nutrition field right now. So this breaks up foods into four different groups. You have your unprocessed or minimally processed foods. These are all your whole foods then, your fruits, your vegetables, legumes, they include milk here, eggs, meat, etc. They also include some grains in this categorization. Then we have processed culinary ingredients. So these are basically energy dense foods that we're going to use in the cooking process. Sugar, honey, oils, butter, they include salt in here as well. Then we have processed foods, condensed milk, cream milk, cheeses, beer, wine, etc. Then you have your ultra processed foods, the very delicious things. This is your pizza, your donuts, you name it, it's on there. So looking at both the nutrient density score that I presented and the NOVA classification system, we can see that, so this was a large database of foods, over 600 foods also. They scored them for their nutrient density score. They're calling it the NRF here. They scored them and they ranked them all and they cut them in the tertials. And we see that the largest, the most nutrient dense foods are in the green and they are mainly found in the unprocessed food group. And then when we move down to the processed food groups, there's less and then ultra processed, there's less. And in terms of culinary ingredients, again most of these are just energy dense, very nutrient poor, they don't have any of the first or second tertials. And when we look at the means, we see that overall unprocessed foods, 108, then we drop down for processed foods, lower for ultra processed foods and then culinary ingredients are negative. So if you wanted to have a nutrient dense, minimally processed diet, you would want to eat typically as much of this category as you can, but you could also, it allows for some wiggle room because you can have nutrient dense foods here, nutrient dense foods here, and I don't know what's in this category. I'd be very interested in seeing that. So this type of thinking about nutrition and diet from a larger perspective, looking at dietary patterns and whole dietary classifications is relatively new for nutrition science. I mean, you go back even 30 years ago, people are just again focused on macronutrients and prior to that they were just thinking about vitamins and certain mineral intakes. So this is a relatively new way of thinking about food. But there's really an abundance of literature that basically shows you that the more processed your diet is, you have more associated with a larger intake of problematic nutrients, mainly salt, sugar, and fat, and also a greater risk of disease. Again, this new perspective, thinking about processed foods only, has really only recently did we have the first randomized controlled trial that looked at the effect of processing on improving physiology. So this was two groups, people with obesity. There was two diets, one diet made up of ultra-processed foods, the other diet made up of unprocessed foods, and the diets were presented in random order to the participants over a two-week period. But the diets were matched for the calories provided, even though it was ad lividum, they could eat as much as they want. They were matched for sugar, fat, fiber, and even macronutrient content. And over the two-week period, what we saw is that those eating the ultra-processed food diet on average significantly ate 500 calories more per day, just starting even on the first day of the diet. And what that translated to was basically a significant weight gain of two pounds over the course of two weeks, or a weight gain if you ate the ultra-processed food diet, and a weight loss if you ate the unprocessed food diet, in as little as two weeks. So I'm hoping that they do a lot more studies like this to really get at this. This was an in-hospital metabolic ward. They weighed and measured everything that went in and out of the body to see the effect of the diet. And the researcher, Kevin Hall, he didn't think he was going to see an effect at all, but he proved himself wrong. So Katzenmeller wrote a review paper, Can We Say What Diet is Best for Health? And in this, they run through a number of different dietary recommendations that are used. We see low carb, low fat, low glycemic Mediterranean, even the paleo diet. And they look across all the diets to see what's compatible with all of them. And they say that in one shape or another, the diets limit refined starches, added sugar, processed foods, limit intake of certain fats, and they all emphasize whole plant foods, whether without meat, depending on your recommendation. And they conclude that all of these diets are potentially consistent with the famous Michael Pollan quote, eat food not too much, mostly plants. But what I see here, thinking about evolutionary mismatch, is that all of these diets in one way or another is addressing the change in diet quality that we have through evolutionary mismatch. So pretty much any diet you follow is better than the westernized diet, regardless of what it's made up of. And this is why in the literature we see that dietary adherence is really the best predictor of success with any diet. You look at any clinical study, those who follow it more have the most physiological benefits produced from eating their diet. And any diet is going to work to increase diet quality per the definition we're using, yet they all vary in the macronutrient intake and the food groups that they do include or restrict in the diet. And what's going on here is that, you know, yes, our diets are made up of foods from various food groups, and they contain their nutrients, but it's really the quality of the diet that determines how a diet interacts with our physiology to produce either a state of health or disease. So here we are. And overall, across all of these, a high-quality diet really has the most evidence behind it through the evolutionary mismatch perspective. And one thing that I really like about thinking about diet quality like this is that this diet quality prescription of just consuming a minimally processed nutrient-dense and varied diet really allows for the variation in flexibility that's an essential aspect of the human diet. So in terms of adherence, having a dietary recommendation that allows people to have some wiggle room in terms of what they eat and how their diet can change throughout their, as their taste change or food accessibility, this prescription also would hopefully satisfy everybody within anthropology and evolutionary biology as really because it'll allow for the variation that they talk about throughout human evolution. And, you know, we're here at the Ancestral Health Symposium, and I've spent a lot of time thinking about diet, and we all know that evolutionary medicine is valuable. Thinking about our health and disease from an evolutionary perspective produces all sorts of new things and new hypotheses that we can test. And hopefully if we alter our diet recommendations via evolution mismatch away from the paleo diet to one that just focuses on diet quality, hopefully this would decrease some of the pushback that I have definitely experienced and probably some of you have with the Ancestral Health Movement when people just think about the paleo diet. And again, you know, the paleo diet has a lot in common with other diets. We're just in one way or another working to make people healthier and making diet quality. And the other thing that we have going, Connor and Ian say in 2010, most people respond to the notion of a diet and lifestyle that's natural. And the Hunter-Gatherer model is the first and only scientific model that we have for this idea. And yes, we can use it as a model, but we need to look at the diet from the diet quality perspective instead of the food group perspective. So to conclude, paleo diet has enough full support across academic disciplines. If it was truly the answer to the dietary mismatch, we would see support for it in every comparison. And really it's this change in diet quality that's responsible for the diseases of civilization that we see today. And just thank you all for coming here. The Center for Evolution and Medicine paid for my travel fees. We have some time for questions. Thank you. Okay, so thank you very much. I have to ask, is this your thesis project? It's the background for one of my chapters. Erin? Very nice talk, Anthony. The only thing I'm a little confused on is I thought the paleolithic diet was based on the principles of level of processing in the sense that paleolithic technologies can do a certain amount of processing and then agricultural, you know, iron age and later ages produced more technologies that can do higher levels of processing. So I thought the paleo diet was really couched in terms of the level of processing. I have never heard that. When people tell me the paleo diet, they just say I've heard and read that food groups of our ancestors versus not food groups of our ancestors. Oh, really? That's funny. That's the most common thing that I've heard. Anybody want to help me out here? I saw like one person over there. Dovetailing behind Erin. I was like totally confused. Who gave you the... I mean, who's the definition? Sorry, that sounded aggressive. I didn't mean it that way. But was it Lauren Cordain's definition of the paleo diet? Where is your definition of the paleo diet? Because what you said about nutrient density and high quality has always been my definition of the paleo diet from hanging out with these guys. I think more when I think about it, when you look at clinical trials that use it, they only use it in terms of the food groups. Okay, so is there a predisposition against the scientific work that we're doing with the ancestral method and the paleo diet that they don't look at what we're talking about and only just like what somebody wrote in a grocery store or something? I mean, don't get me wrong. I'm not saying that paleo diet isn't a healthy diet. I'm just saying the mechanism at which it is a healthy diet is that it's working to increase diet quality. Yeah. And there are multiple ways to do that. And I actually have experience with your department. I went to one of the meetings at ASU at the Center for Evolution and Medicine. And I ran into a gal who just ripped me a new one because I told her that I was in the ancestral and paleo movement. And I think she might have been vegetarian slanted. So I wrote one of your directors and just said that was just totally unfair. I just came there and just happened to mention. I had always thought we look at evolutionary mismatch and a number of people right here in this room have done some beautiful work in regards to evolutionary mismatch. But thank you for clarifying, but you don't have any definition that's more than... I mean, did you analyze who is promoting the concept paleo diet? I mean, I've read all sorts of stuff on the paleo diet. And when most people talk about it, they just think about it only from the foods that you do or do not eat. That you wouldn't eat? That you do or do not eat, yeah. Yeah, that you would and then also wouldn't eat. So, well, it's just confounding because the concept of being close to nature is anti-processed. And whole foods and everything you said about the good diet was my definition of the paleo diet. So I'm out of here. Thank you. It was actually, it was a great talk. Thank you so much. I'm also more than happy to talk to you. Yes. I'm a certified primal health coach and I think a lot of the points that you brought up about the word paleo, what the mainstream interprets paleo to be and how they can possibly study paleo are really important for all of us to accept because if you can't fit it in a column of what you do eat and what you don't eat, then they're not going to be testing it and researching it and the mainstream isn't going to be able to get ahold of it. And so now we have to think if that message doesn't translate with the paleo diet and it's too late now, everybody just thinks it's the caveman diet and it's the meat eating diet, then we need to imagine, can we support a trend like the primal diet? Will that be accepting? Because I don't know if you know any of the nuances, but the primal diet is very similar. It's just a little more open to legumes and dairy and things that have been forbidden like peanut butter. And so I'm just bringing this to the conversation because maybe we lost our chance with the paleo diet. You know, maybe it's too late and like Mark Sisson reformulated his dietary pyramid because he had meat on the bottom because that would be the bulk of the calories. But he changed it so that plants are on the bottom now because the way that we understand it when we look at a food pyramid is that the bottom is what we should eat most of. And so plant-based paleo is something also trending which is something we can all consider and primal. So it sounds to me like that's a lot of what you are promoting. Yeah, thank you so much. You raise a great point. And no, we think about ancestral health and where are we drawing the line when we say ancestral? Is that just several hundred years ago? I mean the Mediterranean diet could be considered an ancestral diet. So yeah, you raise a great point. Yeah, and too bad we can't call it the ancestral diet because most of the population won't be able to pronounce ancestral so there goes that idea. Thank you so much. Terrific presentation. Thank you so much. I wish I had a good question for you, but I have a couple of comments. One, I think it is a very interesting conversation about what is paleo. We just released a how-to guide and we created a distinction between authentic paleo and popular paleo. A lot of people are introduced to paleo through products in the grocery store, of which there are many now. A lot of those are basically the standard Americanification of approved products, right? They're basically refined and processed. And so should you reject all of those? Well to the degree that you can perhaps stay within a range that helps you comply with the paleo ideology but still lets you create a birthday cake for your five-year-old's birthday versus serving grilled sardines. Maybe that helps you stick with it more easily. One comment. The second one was on the Kevin Hall study. Stephen Keeney and I created a weight loss program a couple of years ago and it created a saying that highly processed foods make you eat more calories before you're full and more calories after. So they're acting upon different mechanisms, both of which lead to the consumption of more calories before you're like, I'm done and that was a great illustration of that. Awesome talk. Thank you. Thank you so much. I've got mainly a comment and an illustration about food study. And I'd like to start off by plugging a conference called Acres USA which is all about nutrient-dense growing of food that's a worldwide leading organization, Acres USA, on how to grow nutrient-dense food. All these studies are considering carrots are carrots are carrots. And like meat is meat is meat. K-fo meat versus grass-fed meat, organic versus conventional but grown in soil that has nutrients in it. To me, the fact that none of this is taken in consideration in these studies invalidates practically the whole result because carrots are not all carrots. Industrial carrots versus grown in nutrient-dense almost virgin soil is a world of difference in nutrient density and also how it affects the body, the enzymes and all. There's a world of difference between those things. So this metadata study and trying to draw conclusions without any understanding of what the actual food was consumed where it came from, what is nutrient density. There's a term in food density, this called BRICS, which is actually from the wine industry. Those little prismatic devices, if you take a garlic press and squeeze a carrot onto the BRICS meter and you measure across a range of carrots, the density of nutrient density that varies from almost nothing in industrial carrots to a nice juicy sweet carrot can be measured. So my advocation is that you go to Acres USA as long as all of us here as well and we learn how to grow nutrient-dense food. That'll be even more nutrient-dense than what we have in the database. Excuse me, it's four o'clock so anybody who wants to talk to Anthony can do that. We have a 10-minute break and we'll start again at 4.10. Thank you all so much.