Gabor Szendi:
Diseases of civilisation and the Industrial Revolution
The history of mankind is often represented as a victory march. A part of this is that we live ever longer and healthier. This is usually put down to the victory of medicine since we have defeated the majority of diseases and are working hard on beating the rest. We are inches from the goal: the immortal man who will be able to renew his ruined organs from stem cells.
I don't want to be a spoilsport but it could be rather sobering to have a look instead at the statistics. More than 50% of the western population now dies from cardiovascular diseases, 30% from cancer, 8% from an autoimmune disease, and 10-20% suffer in the second half of their lives from diabetes or prediabetes. Looking at the death rates I am forced to think of the word defeatrather than victory. Of course you could argue that these diseases have always existed, and the development of medicine first radically confined infectious diseases, lengthening our lives, and is now working on eliminating chronic disease. The truth is a lot more disappointing than this: it was not medicine that combated infectious diseases, our lives really are not lengthened, and medicine is losing against diseases of modern civilisation.
The Duration of Life
There is a common myth that cavemen only lived for 15-20 years1. I understand that it is good to believe this because we can contentedly look forward to our own 70-80 years lifespan. Of course it doesn't hurt to deduct some years from this because the life expectancy of Hungarian men is actually 69, and of women 76. But even this seems two to three times longer than our ancestors. Demographers Jim Oeppen and James Vaupel showed that since 1840 the life expectancy of western people grew by 3 months every year2. Excellent, our confidence has received scientific support. But the engine of this growth seems to be running out. In 2005 Jay Olshansky et al. showed that from 1980 every time they tried to predict the growth of life expectancy from the previous trend, they were wrong by a long way3. Because the extension of the expected lifespan stopped in the last 20 years, compared to earlier prognoses there is a bigger and bigger gap between the predicted and actual lifespan. In 1980 for instance, according to calculations, the expected lifespan of American women in 2010 would have been 86.5 years, but it turned out to be only 81. According to the data of Olshansky et al. the reason for this break is that the entire Western world is becoming more and more ill. But is this only the result of the last few decades? Or are there a lot of older processes that were veiled from us by medical propaganda flaunting its own success?
In this propaganda, the notion of life expectancy (an estimated lifespan that we will live) came in very handy. Life expectancy, however is largely influenced by infant and child mortality, because if many children die the average life span will be shorter. Since infant and child mortality in the West dropped to a minimal level in the 20th century, for mathematical reasons the expected lifespan cannot increase any more. It could only grow further if people indeed lived ever-longer. For this reason another marker, describing the modal or most common age of death, is much more telling. (The modal age at death is an alternative measure of longevity that is particularly useful if the interest is on death distributions and concentrations. Since around the mode is where the vast majority of deaths are concentrated 4). For instance the graph below demonstrates that in Denmark over 160 years the most common age of death only grew by 15 years. If we compared that to the life expectancy it would be 34 years more, which sounds a lot better but covers something completely different. 4
Let's jump back by 160 years and examine the life expectancy of British workers, who worked 16-hour days and lived in dark accommodation. Because of high child mortality life expectancy was about 35-40 years. In those days half the children under 10 died of some kind of illness. If, however, we look at the life expectancy of those who lived to be young adults, we can see that in 1850 British male workers lived on average 75 years, and females 73 years5. Comparing this with the Danish data from1840, there is nothing surprising about this. If we compare it with the life expectancy of Hungarian people today (which is no longer seriously reduced by infant and child mortality), then we can see that compared to the British workers and the Danish population in 1840, during 160 years the life span of Hungarian people reaching adulthood did not really grow, in spite of immense general development.
We will begin thinking even more differently about development if we compare the lifespans of modern Western people with natural people living in Stone Age conditions. Michael Gurven and Hillard Kaplan published a thorough study in 2007 in which they analysed several hunter-gatherer tribes, living untouched by modern civilisation. 1
Their results showed that in these people the most common mean age of death is 72 years6. The Hadza people for instance die most commonly in their 76th year. 24% of Hadza die at this age or later. The most common age of death in the Ache tribe is 71 years, and 24% of them live to this age and longer. The most common age of death of the !kung people is 74 years, and 35% of them live at least that long. In other words the lifespan of people living in primitive circumstances are the same as the European average of 1840-50. If we examine the age of death in Hungarian people, then we see that 12% of the population live until at least 70-74 years of age. It might seem like a bold idea, but the data proves that natural people, if they outlive their childhood, have a longer lifespan than contemporary Hungarian people.
Gurven and Kaplan point out that the natural people examined in their study are a model of the Paleolithic man, in other words it is reasonable to assume that cavemen lived a similar lifespan. This is also supported by modern methods of fossil analysis. According to Gurven and Kaplan as well as other scientists7, one of the reasons for the success of the human race is long life that made it possible for people - especially women - even after the reproductive age to look after their offspring as grandparents.
How is it possible that compared to the extremely primitive living conditions in the Paleolithic age, or in the lives of contemporary natural people, in the unbelievably well-developed Western world people only live 10-15 years longer? Or, in the case of Hungarians, we only manage to live as long as cavemen did?
The Causes of Death
We know what Western people die of: cardiovascular diseases, cancer, and autoimmune and degenerative diseases. In their last years many people are kept alive artificially by medical tools, surgery, and medication. Perhaps we are less aware that diseases of civilisation are unknown in natural people. In the 19th to 20th centuries quite a few isolated tribes untouched by civilisation were explored by doctors, anthropologists and explorers. The unanimous view of these experts was that there were no natural people with heart disease, atopic (asthma, allergies, eczema) or autoimmune diseases. Diabetes, hypertension and obesity were unknown, and cancer was a very rare occurrence.
The most common causes of death in natural people are gastrointestinal infections, accidents (such as snakebites or falls), or violence. Since natural people - if they live beyond 15-20 years of age - live nearly as long as Western people, the often proclaimed argument that the reason they don't have any heart disease, diabetes or cancer is because they don't live long enough to develop it, can be refuted. These chronic diseases have several medically measurable warning signs before they manifest. In his 2010 book "Food and Western Disease" Staffan Lindeberg shared his own field studies and summarised earlier studies by others. The various lab results and measurements unequivocally proved that the typical warning signs of western diseases cannot be detected in natural people of any age8. On the basis of observations of contemporary natural people, and archaeological finds, the same can be stated about Paleolithic man as well.
The only explanation for adult life expectancy to have hardly grown compared to Stone Age people is that what development gave with one hand, it took back with the other. So can we detect at which point in the development of civilisation things went wrong?
Farming: A Time bomb in the History of Mankind
Farming started 5,000-8,000 years ago in Europe. People started cultivating and eating grains, raising animals, drinking milk and eating dairy products. According to the archaeological finds from these times, people on average shrunk 5-10 cm compared to the height of Paleolithic people. Their remains show signs of osteoporosis and various deficiencies (for example iron-deficient anaemia), as well as traces of infectious diseases. Because of under-nourishment, the previous first occurrence of menstruation at the age of 12-13 became postponed until 16-18 years of age9. This is what we suffer the consequences of now, because in times of plenty, sexual maturity starts early, but there is a wide gap between psycho-social and biological maturity.
The diet change caused by agriculture thoroughly damaged the health of the human race. For 2 million years the human body adapted to a diet that did not contain highly refined carbohydrates, and did not learn to handle grain proteins, gluten (more exactly alpha-gliadin), or the proteins in milk. These characteristics of the new diet, however, somehow remained hidden all the way until the beginning of the 19th century, but were ticking away like a time bomb. This is partly because the effects of grains, then after Columbus, potatoes, corn, and later rice, were balanced by the large amounts of plant food and meat that was consumed. Also, because of the primitive milling technology, carbohydrates from coarse grains got absorbed only partially and more slowly. Another important point is that people, out of necessity, ate little but worked hard. In other words all the way up to the New Age the average person had a negative energy balance. The two dominant causes of death in the Middle Ages were infection and under nourishment, and also many women died in childbirth complications.
The Effects of the Industrial Revolution
The Industrial Revolution fundamentally changed the life of western man. The increasingly fast changes started somewhere at the end of the 18th century to the beginning of the 19th century, or at least we can conclude this from the occurrence of the diseases of civilisation. The Industrial Revolution caused several changes in the lifestyle of western people, the significance of which we can only begin to recognise now. The direction of this change can be captured in the fact that the lifestyle of western man is increasingly distanced from its well-adapted, evolutionary ways. Genetically we are optimized for the Stone Age, as we will later see, down to the last detail, such as spending a lot of time outdoors, or the nature of our bowel flora.
One of the effects of the Industrial Revolution creating serious problems was urbanisation. Cities existed earlier but even only 50 years ago 10-20% of the population lived in cities, and the rest in the countryside. Now this ratio is the opposite way around. The extremely fast population concentration caused by the Industrial Revolution resulted directly in epidemiological and public health problems. The reason for the devastating epidemics of the Middle Ages were also the increasingly dense populations, but the developments of cities with several hundreds of thousands, and later millions of inhabitants, forced a revolution in hygiene. As Thomas McKeown proved, it was primarily the resolution of drainage, clean drinking water, transportation of garbage, maintenance of cleanliness in cities and the development of personal hygiene which helped push down death rates from contagious diseases. 10
The diminishing of TB clearly demonstrates the effect of increasing sterility. Neither the discoveries of the TB bacterium, or of antibiotics influenced the diminishing rate of TB deaths. Naturally, antibiotics saved the lives of many people but at a population level we can consider heightened hygiene as the victor over contagious illnesses.
The Unexpected Consequences of Increased Hygiene
The cleanliness mania of Western people reached such a point somewhere in the 1950s that it started a wave of illnesses in the population. One of the consequences of the increasing sterility that can be clearly seen today is the widespread prevalence of atopic illnesses (allergies, asthma, and eczema).
For an illness to become common, or for there to be a revolutionary recognition in the pathological mechanism of an illness, there is always an indication that decades prior to the discovery a new era started, in one way or other. This is because when an illness becomes an increasing burden on society, research into that illness also becomes more intensive. SGO Johansson described in 1967 that in atopic illnesses the high IgE level (Immunoglobulin E) is in a causal relationship with the various atopic symptoms11. In 1968 Johansson had already pointed out a paradox that many studies have since proved: that natural people have 50-100 times higher IgE levels than atopic-free Western people12. In spite of this, atopic illnesses are unknown among natural people. Research shed light on the fact that the incredibly high level of IgE in natural people is caused by an immune response to various intestinal worms and parasites. Being infested by intestinal worms activates another type of cell in the immune system that in turn is capable of suppressing the activity of cells creating an allergic reaction13. When a health campaign was begun against intestinal parasites in various natural people, children started showing signs of allergies14. Research proved that in atopic illnesses the "uncontrolled" immune response is related to the lack of, or the changed composition, of microbes and parasites in the bowel. This was also proved by a completely different study which compared the bowel flora of children who later became atopic, with children who were free of atopic illness. It became clear that there are significant differences15.
Epidemiologist David Strachan introduced the so-called hygiene hypothesis in 198916. According to this, allergies increase in proportion to the level of hygiene. The better life circumstances are, the more likely is atopic illness. In other words, the less pathogens and parasites the bodies of infants and children are exposed to, the more likely they will become atopic later. Humans in their evolution have learnt to live together with microbes and parasites so well that these have become the conditions for normal immunity. This notion is summarized in the "old friends" theory. Because antibiotics kill all kinds of microbes without selection, antibiotic therapy for children below the age of two, and atopic illness later in life show a very strong connection17. Naturally, these "old friends" have adapted to the same natural food that people consumed during millions of years. The changed diet of modern Western people also has a significantly negative effect on the composition of bowel flora.
The spread of atopic illnesses is a model of how civilisation has disturbed the symbiosis between man and microbes.
The Effect of the Food Industry Revolution
A new challenge arose to provide food for big cities. Large populations had to be catered for with storable, transportable, non-tainted food with a long shelf life. One of the major determinants in the development of the food industry was the explosive expansion of the sugar and milling industries. Today sugar consumption is a hundred times more than in the 1800s. Grain food also became cheap, and in the nutrition of city people there is a major detectable change from the1870s onwards because more advanced milling technology and cheap American grains became widely available. Food provisions stabilized, intermittent periods of abundance and famine no longer existed. People's nutrition became more and more dominated by high-glycemic (GI), refined carbohydrates at the expense of vegetables. So the nutrition of the average person of today consists of 50-60% refined carbohydrates. In other words grains, potatoes, rice, corn, sugar and fructose make up the larger part of the daily diet. This process is well demonstrated by the fact that at the end of the 19th century 3-4% of the population was obese, whereas today 50-60% of the Western population is overweight or obese18. The tendency to gain weight is an evolutionary inheritance that formulated over millions of years. We have developed an ability to store surplus food in the form of fat. Since foods made out of high GI carbs have high calorie density, if someone is fulfilled with these, it is certain that they consume more calories than they use up. The human race, during evolution all the way up until the development of agriculture, never regularly consumed high GI carbs, so our bodies are not really suited to dealing with them. This is well demonstrated by the fate of those natural people who, during the 20th century suddenly switched to a Western diet: 30-70% of them became severely obese and diabetic19. It's most likely that in the history of Western man, after the Neolithic revolution something similar took place, so today's people can tolerate high glycemic foods relatively well, and these health problems only develop slowly with aging20. The new foods introduced by agricultural practices did not cause obvious problems for a long time because people were still physically very active.
A not well enough appreciated effect of urbanization is inactive lifestyle. City life and work requiring less and less physical effort have resulted in a lack of exercise for the majority of the population. During human evolution man adapted to walking 15-20 kilometres a day. In the last ten years it has come to light that movement has an anti-inflammatory effect21. Therefore, a lifestyle that lacks movement has the same effect as if modern man dropped taking that effective anti-inflammatory "pill" that he has been "taking" for millions of years. Inflammation has a defining role in the development and sustenance of diseases of civilisation. The recognition of the role of inflammation - among other things - was delayed because the cholesterol hypothesis that became dominant in the 1950s lead medical research completely astray. The fundamentally false cholesterol hypothesis had a major role in that official nutritional guidelines put the emphasis more and more on carbs, and the reduction of animal protein.
Gerald Reaven described the metabolic syndrome22 only quite late, in the 1980s. The essence of this condition is that consuming a lot of high GI carbs causes insulin resistance which results in faster weight gain. The so-called visceral fat that deposits around the internal organs is particularly dangerous because it acts as a sort of hormonal organ constantly giving out inflammation promoting substances. The metabolic syndrome is also the basis of cardiovascular diseases. In other words, the epidemic of heart disease is not caused by the growing consumption of fat and cholesterol, but by the high GI carbohydrates gaining more and more ground in the Western diet. This is one of the reasons why fat phobia further exacerbated the health problems of Western people, because while it tried to offer a solution for the explosive spread of cardiovascular diseases and deaths, in actual fact it caused the situation to worsen by recommending a change of fats to carbs, and by propagating inflammation-promoting industrial seed oils. Heart attacks and heart disease are illnesses of the modern Western man. Among natural people atherosclerosis, hypertension and heart disease are unknown. However heart attacks were also unknown in the West all the way until 1872 when the first medical description of death by heart attack came to light31. Nevertheless it still remained a rarity. The first thorough theoretical analysis of a heart attack was published only in 1900. Because of its rarity doctors did not even recognise if their patient had suffered a heart attack until the end of the 1920s. On the other hand, a mere 20-30 years later it became the dreaded death of middle aged men. The situation is further worsened by the fact that vitamin K2 disappeared from our diet. Dentist Weston Price, considered an eccentric by many, in actual fact a genius, had already stated in the 1920s that a deficiency of a substance he then named Activator X (later identified as vitamin K2) causes heart disease23. It has come to light in the last 20 years that atherosclerosis is not an alteration accompanying aging but simply a deficiency of vitamin K224.
Type 2 diabetes was also a complete rarity until the end of the 1800s, then, during the 20th century, as carbohydrate consumption grew and physical activity diminished, it became increasingly common, until it reached a frequency of 10% in the Western population25.
There is a similar situation with cancer. At the turn of the 19th-20th centuries many natural people were examined but hardly any cancer was found. French scientist Stanislas Tanchou had already stated in 1843 what many other scientists later confirmed: that cancer is a disease of civilisation. However, the survival time of cancer patients in the 19th century was many times longer than that of today's patients. The reason for this is likely to be the lower insulin and blood sugar levels at the time. Otto Warburg had proved already at the end of the 1920s that cancer cells are dependent on sugar26. The growth and proliferation of cancer cells is promoted by high insulin and blood sugar levels typical in metabolic syndrome. Obesity is one of the most serious risk factors for cancer. The other risk factor is the chronic inflammation characteristic of metabolic syndrome. The high inflammation level measured by C-reactive protein is a sign of bad prognosis in case of cancer27.
For the large scale needs of the food supply created by urbanization, the food industry reacted - for technological reasons - by providing high GI carb foods. This, combined with a lack of physical activity, caused the widespread illnesses related to metabolic syndrome, such as cardiovascular diseases, diabetes and cancer. We could also mention polycystic ovarium syndrome (PCOS) which affects 15-20% of women.
Lack of Light
Another factor accompanying urbanization is that people from early childhood started living in covered places. It was especially prevalent in the 19th century when people worked in dark factories all day and went to bed in dark hovels at night. In natural people who spend a lot of time in sunshine, the blood level of vitamin D is 80-100 ng/ml, while modern urban citizens typically have 10-20 ng/ml. For a long time it was a mystery why the prevalence of certain illnesses grows from South to North. Such illnesses include schizophrenia, type I diabetes, sclerosis multiplex and other autoimmune diseases, as well as cancer. According to the latest research, low levels of vitamin D play a role in the development of heart disease, as well as autism. The multiple effects of vitamin D are explained by the fact that it is a hormone which influences brain development in the embryo, the workings of the immune system, and the regulation of inflammatory processes and cell division.
As I mentioned previously, it is always an important sign when researchers begin to describe an illness, independent of each other. Before 1800 for instance there was not even one known true description of the course of schizophrenia in medical literature. However around 1810 one after another recordings started, and the number of schizophrenic patients began to rise by leaps and bounds28. The same thing happened with descriptions of sclerosis multiplex at the beginning of the 19th century. Rheumatoid arthritis was first described in 1800 and received its current name in 185929. It is clear that the quickly developing industrial environment and urban lifestyle led to a severe vitamin D deficiency in the population.
It is important to point out that vitamin D deficiency has become a pathogenic factor in interaction with other dietary factors. In the case of cancer, vitamin D deficiency, together with over-nutrition represents an extremely serious risk factor. This is indicated by the fact that on the same diet, in Southern countries only a third of people die from breast or colon cancer.
In the case of autoimmune diseases a particular interaction can be detected. In almost every autoimmune disease vitamin D deficiency is a risk factor for the development of the illness, and conversely high levels of vitamin D is a protective factor. At the same time, convincing evidence is available that the so-called "foreign proteins", which our human body has not met with in millions of years, can also cause autoimmune diseases. Such foreign proteins are gluten and casein, lectins found in pulses, and DING proteins found in corn, tobacco, potatoes, and tomatoes30. A good model of autoimmune diseases is type I diabetes. Gluten and dairy-free nutrition in early childhood, and high levels of vitamin D are both powerful protective factors. The average baby, however, receives gluten-containing food very early, and in general has low levels of vitamin D. In this way the incidence of type I diabetes, similar to other autoimmune diseases, showed a steady increase in the 20th century.
The Curse of Civilisation
If we analyse the last ten thousand years of human history, we can see that the "decline of the West" was already encoded from the beginning. Starting agricultural practices was a necessity because of increasing numbers of the population. The new foods that appeared with agriculture on the one hand allowed the population to grow even more and this became the engine of civilisation, because it was necessary to overcome more and more technical difficulties. On the other hand these new foods ticked like a time bomb until the 18th-19th century. The abrupt industrialisation and urbanisation that started at that time let the genie of Western diseases out of the bottle. Today's common and insurmountable problems with cardiovascular diseases, diabetes, cancer, autoimmune diseases, atopic illnesses, and functional disturbances called mental illness have all developed from the conjunction of urbanisation and a change in nutrition.
Another way to put it would be that the extent of Western civilisation today means a complete distancing from the optimal lifestyle and environment coded into the human genome. The main factors where we have violated the laws of natural life are: a diet based on high GI carbs, consuming foreign proteins, abandoning physical activity, and lack of natural light. This is all also exaggerated by hygiene, and the betrayal of "our old friends."
References
[1] Gurven, M; Kaplan, H: Longevity among hunter- gatherers: a cross-cultural examination. Population and Development Review, 2007, 33:321-365.↩
[2] Oeppen, J; Vaupel, JW: Broken Limits to Life Expectancy. Science, 2002, 296(5570):1029-1031.↩
[3] Olshansky, S. J.; Passaro, D. J.; Hershow, R. C.; Layden, J.; Carnes, B. A.; Brody, J.; Hayflick, L.; Butler, R. N.; Allison, D. B.; Ludwig, D. S.: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med, 2005, 352(11):1138-45. ↩
[4] Canudas-Romo, V: The modal age at death as an alternative measure of longevity: an appraisal of current research. Lecture at University of Copenhagen on the 7th of June 2010. Web: http://www.demografi.dk/andet/ku7june.pdf↩
[5] Clayton, P.; Rowbotham, J.: An unsuitable and degraded diet? Part two: realities of the mid-Victorian diet. J R Soc Med, 2008, 101(7):350-7.↩
[6] Gurven, M; Kaplan, H: Longevity among hunter- gatherers: a cross-cultural examination. Population and Development Review, 2007, 33:321-365.↩
[7] Hawkes, K; Jones, NB: Human age structures, paleodemography, and the grandmother hypothesis. In: Grandmotherhood: The Evolutionary Significance of the Second Half of Female Life. Chasiotis, A; Voland, E; Schiefenhovel, W (eds.): Rutgers University Press, New Brunswick ,2005. pp. 118-140. ↩
[8] Lindeberg, S: Food and Western Disease: Health and nutrition from an evolutionary perspective. Wiley-Blackwell, 2010.↩
[9] Pollard, TM: Western diseases. An evolutionary perspective. Cambridge Univ Press, Cambridge, UK, 2008. ↩
[10] McKeown, T: The role of medicine. Dream, mirage, or nemesis? Princeton Legacy Library, Princeton Univ. Press, 2014/1979. ↩
[11] Johansson, SG: Discovery and development of IgE assays. Clin Exp Allergy, 1997, 27 Suppl 1:60-3.↩
[12] Johansson, SG; Mellbin, T; Vahlquist, B: Immunoglobulin levels in Ethiopian preschool children with special reference to high concentrations of immunoglobulin E (IgND). Lancet, 1968, 1(7552):1118-21.↩
[13] Hurtado, A. M.; Hurtado, I.; Sapien, R.; Hill, K.: The evolutionary ecology of childhood asthma. In: Trevathan, W. R.; Smith, E. O.; McKenna, J. J. (eds): Evolutionary Medicine. Oxford University Press, New York, 1999, pp. 101-134↩
[14] Matricardi, PM; Hamelmann, E: The hygiene hypothesis and allergic disorders. In: Rook, GAW (ed): The hygiene hypothesis and darwinian medicine. Birkhäuser, Basel, 2009. pp:117-134↩
[15] Matricardi, PM; Hamelmann, E: The hygiene hypothesis and allergic disorders. In: Rook, GAW (ed): The hygiene hypothesis and darwinian medicine. Birkhäuser, Basel, 2009. pp:117-134↩
[16] Strachan, DP: Hay fever, hygiene and household size. BMJ, 1989, 299:1259-60.↩
[17] Bloomfield, SF; Stanwell-Smith, R; Crevel, RW; Pickup, J: Too clean, or not too clean: the hygiene hypothesis and home hygiene. Clin Exp Allergy, 2006, 36(4):402-25.↩
[18] Helmchen LA, Henderson RM. Changes in the distribution of body mass index of white US men, 1890-2000. Ann Hum Biol. 2004, 31(2):174-81.↩
[19] Szendi G: Paleolit táplálkozás. A nyugati életmód és a civilizációs betegségek (Paleolithic Nutrition. Western Lifestyle and Diseases of Civilisation). Jaffa, Budapest, 2009.↩
[20] Diamond, J: The double puzzle of diabetes. Nature, 2003, 423(6940):599-602.↩
[21] Szendi G: Boldogtalanság és evolúció (Unhappiness and Evolution). Jaffa, Budapest, 2010.↩
[22] Mendelson, SD: Metabolic syndrome and psychiatric illness: interactions, pathophysiology, assessment & treatment. Elsevier, Amsterdam, 2008.↩
[23] Price, W.A.: Nutrition and Physical Degeneration. Price Pottenger Nutrition, 1939/2006.↩
[24] Szendi G: Új vitaminforradalom (The New Vitamin Revolution). Jaffa, Budapest, 2013.↩
[25] Taubes, G: Good calories, bad calories: challenging the conventional wisdom on diet, weight control, and disease. Knopf, 2007.↩
[26] Warburg O, Wind F, Negelein E: The metabolism of tumors in the body. J Gen Physiol. 1927 Mar 7;8(6):519-30.↩
[27] Marsik C, Kazemi-Shirazi L, Schickbauer T, Winkler S, Joukhadar C, Wagner OF, Endler G. C-reactive protein and all-cause mortality in a large hospital-based cohort. Clin Chem. 2008 Feb;54(2):343-9↩
[28] Torrey EF. Schizophrenia and civilization. Jason Aronson, 1980, New York.↩
[29] Szendi, G: Paleolit táplálkozás és korunk betegségei (Paleolithic Nutrition and the Diseases of Our Age). Jaffa, Budapest, 2011.↩
[30] Berna, A; Bernier, F; Scott, K; Stuhlmüller, B: Ring up the curtain on DING proteins. FEBS Lett, 2002, 524(1-3):6-10. ↩
[31] Hammer, A: Ein Fall von thrombotischem Verschlusse einer der Kranzarterien des Herzens. (trans. Ludwig, J) Am J Cardiol, 1978, 42:849-852. Translated from Wien med Wchnschr, 1878, 28:97-102.↩