A lone doctor put the pieces of the leaky gut/autoimmunity story together almost 50 years ago. He saw the connections between intestinal permeability and diseases such as rheumatoid arthritis and multiple sclerosis. He published his findings, he helped the people in his care...and his amazing insights eventually died, were buried and nearly lost to time. Loren Cordain shot me the following two papers from Dr. R. Shatin. [...] Dr. Shatin had pieced together the connection between gut permeability, celiac disease rheumatoid arthritis and multiple sclerosis.

In the early 1960's.

Time of the great freeze
I love reading science fiction. I know, shocker, right? The geek who loves sci-fi. My obsession with sci-fi goes back as long as I can remember and has been a source of enormous joy and has certainly stimulated my imagination and influenced my scientific tinkering. One of the earliest novels I remember reading was The Time of the Great Freeze by Robert Silverberg.

The story is set 600 years in the future when the earth has been ensconced in a sheet of ice, virtually from pole to pole. People live huddled in underground cities, preferring authoritarian rule to being cast out in the sub-zero wasteland that lies above. This story really captured my childhood imagination and although the book is not well regarded in the sci-fi world, it really had an impact on me. It's interesting to note that the book was first published in the 1960's and reflects the then scientific consensus that the world was heading towards another ice age. This notion held sway through all of the 1970's and on into the 1980's. Then, seemingly overnight, the perspective changed, no ice age for us! Pull out the water wings. Hmm.

I've always enjoyed stories about cultures lost, of Forerunner species who spread far and wide through the cosmos, building civilizations of staggering complexity...only to wither and succumb to the onslaught of time. Andre Norton was my favorite childhood author in this genre, while Jack Mcdevitt has written a number of phenomenal books in this theme. I'm not sure why, but it's so fascinating thinking about these far away cultures that reached amazing levels of sophistication...and then simply ceased to exist. Why? The authors rarely offer specific details, that's part of the mystery, but it makes for good reading and even better pondering.

Now, this line of reasoning...that cultures grow, evolve and then die will likely strike many folks as "wrong" or counter intuitive. That there have been a number of highly advanced civilizations that have come and gone over the past 10,000 years or so is unfortunately, a shock (shrug?) for most people. Few realize the remarkable sophistication of the pre-Columbian, Central and South American civilizations, nor do people realize that the ancient Greek & Roman civilizations had most of the trappings necessary to enter the Industrial Revolution, which would not occur for nearly a thousand years after Rome's collapse.

When in Rome

I'm by no means a historian, but I am a fan of certain time periods other than the Paleolithic. One of my favorite areas of study is the dissolution of the Roman civilization and the rise of the Dark Ages (I know most modern historians dislike the term "dark ages"...like I said, I'm NOT a historian!). The technology and knowledge base of the ancients is nothing short of amazing. Take the ancient Greek Antikythera mechanism. This contraption was built over 2,000 years ago and appears to have been a complex analog computer that could precisely calculate the positions of celestial bodies. The level of craftsmanship necessary to produce the gears was not seen again until the 19th century. It's fairly reasonable to assume this was in fact not the first machine of its kind and that precursors were likely in development for several hundred years, which pushes the technology back even further. Then we have the Roman Aeolipile, a steam engine precursor which predated the Industrial Revolution by nearly 2,000 years. Now, this topic has actually been the subject of some very good alternate history sci-fi. "What if" the Roman Empire had NOT collapsed? They were just starting to exploit coal reserves instead of wood and water, they had advanced mathematics, the ability to use mechanical calculation tools and although iron was not yet on their list of technologies, that would obviously just be a matter of time. Some speculate that if Rome had not collapsed we'd be terra-forming Mars right now. Or the Earth would be a crispy radioactive cinder. Interesting stories either way. What is crystal clear however is these early civilizations reached far across the globe, had enormous influence, possessed remarkable levels of technology and culture...and eventually collapsed and were consumed by time. It took almost 2,000 years to reach similar levels of civilization and technology. Unlike the sci-fi novels which leave the demise of Forerunner species largely to the imagination of the reader, we know why civilizations tend collapse:
  1. Getting over extended militarily
  2. Producing a large and ever growing entitlement class
  3. Falling prey to professional politicians who keep the wheels spinning on the above two issues until the wheels fall off the whole damn system.
For the folks who get your panties bunched about my Libertarian leanings, don't worry, this is not politics, just history :0P

So, you may be asking yourself "What the hell does this history survey have to do with nutrition, medicine and health?" Well, quite a bit when we consider the following story. A lone doctor put the pieces of the leaky gut/autoimmunity story together almost 50 years ago. He saw the connections between intestinal permeability and diseases such as rheumatoid arthritis and multiple sclerosis. He published his findings, he helped the people in his care...and his amazing insights eventually died, were buried and nearly lost to time. Loren Cordain shot me the following two papers from Dr. R. Shatin:

Shatin Paleo Diet 1964

Shatin Paleo Diet 1967

When I read those papers, particularly the first one, all I could do was think "WOW!!"

Dr. Shatin had pieced together the connection between gut permeability, celiac disease rheumatoid arthritis and multiple sclerosis.

In the early 1960's.

He also had a clear grasp of the influence of evolution in health and disease. I'd wager it was using the evolutionary template that lead to his subsequent observations regarding intestinal permeability and autoimmunity, but we have precious little information about Dr. Shatin. Dr. Ben Balzer did some digging and at present this is what we have:
Dear Dr Balzer

Thanks for your email enquiry of 13 April 2012 seeking information about Dr R Shatin a prominent doctor from The Alfred hospital who published some significant papers regarding diet and disease in the 1960′s which are of continuing interest to doctors and scientists who study the Paleolithic Diet and its relevance to modern health. It is pleasing to note your observation that Dr Shatin's studies are prescient indicating he is one of the many leading doctors and nurses who have made The Alfred a world class treating and teaching hospital.

I have checked The Alfred hospital's archives and found that Roman Shatin graduated as M. B. B. S. (Melb.) in 1935 and worked at The Alfred from 1947 to his retirement on 1 July 1977. His main role was Medical Clinical Assistant (1947 - 1955), Senior Medical Clinical Assistant (1956 - 1976) and Honorary Clinical Assistant (1976-77).

I am aware of one of Dr R Shatin's publications namely Man and His Cultigens - R Shatin (Scientific Australian March 1964).

I regret not having more information on Dr R Shatin and would appreciate your forwarding me any more information you come across. Although there have been a number of publications covering The Alfred's history (The Hospital South of the Yarra, A history of Alfred Hospital Melbourne from foundation to the nineteen-forties, Ann M Mitchell, the Griffin Press SA 1977 and Alfred Hospital Faces and Places Volume I, II, III & IV Published by The Alfred Heritage Committee between 1996 and 2010), I am surprised there is no mention of Dr Shatin who served the hospital for 30 years.

Thanks again for this enquiry.

Peter Frawley
The Alfred Hospital & Caulfield Hospital
16 April 2012
You folks in Australia should be damn proud. One of the biggest thinkers in the Paleo/Ancestral health scene is one of your own, and he was fighting the good fight a half century ago.

I want to look at some specific observations from the two papers and talk a little about how significant and prescient that material is/was. Let's look at the first paper first starting with an observation about the field of autoimmunity:
In the field of rheumatic disorders the currently prevailing theory of autoimmunity has failed to establish causes or promote cures. An alternative concept has been advanced by the present author (1963)6. This concept is based on the postulate of man's maladaptation to biologically new food. Evidence for the presence of this maladaptaton; considered in this concept to be the genetic (inherited) susceptibility to rheumatic diseases, is based on: (a) clinical observation; (b) a pilot trial of treatment, 19646; and (c) recent advances in biochemistry, genetics and gastroenterology including the study of the small intestine on the one hand and clues from paleopathology on the other.
It's interesting, one must look very hard at the current models to see the connection between intestinal permeability and autoimmunity. Hygiene hypothesis is about as close to it gets. But one does not ever see commentary about evolutionary/genetic discord. That Dr. Shatin connected these dots so long ago is remarkable. Then this:
Briefly, in the concept advanced here, it is suggested that the cereals wheat and rye, the biologically new food (hitherto probably only avian food), were not universally suited to human metabolism because of their protein component, gluten.
Celiac disease had only reached prominence in the medical community a few decades earlier. That Dr. Shatin was able to piece all this together is remarkable. I'll leave you to peruse those two papers, but I think it's worth asking: Why did this information almost disappear from history? Dr. Shatin performed clinical trials showing a paleo diet to be beneficial for RA. He knew a remarkable amount of what we know today with regards to intestinal permeability and autoimmunity, but like the Aeolipile this technology and understanding has largely been lost to a Dark Age of reductionist medicine. I think it's pretty clear what happened here: This man's ideas were counter to the CONSENSUS (I have a piece brewing on scientific consensus) and so the ideas were ignored, likely ridiculed (nearly) out of existence. The changes that are afoot today are NOT happening from consensus and are certainly not coming from the scientific and academic mainstream. Yet. The change we are benefiting from today is happening because with social networks we can effectively step outside the "consensus" and do things that actually "work." We are seeing N=1 experiments with the Paleo/Ancestral Health template performed millions of times per day. If it did not work, if this way of doing things did not benefit autoimmunity and a host of other issues, the concept would wither and die. It appears to be doing anything but that.

Don't get too smug though, any good sci-fi novel will remind you that decay and entropy are the norm, not the exception. So too apparently are totalitarian power grabs, especially when the dominant paradigm is being eroded. Case in point:

The North Carolina Board of Dietetics and Nutrition (NCBDN) is threatening to sue, shut down and SEND TO JAIL a type1 diabetic man who has found a way out of the system of managed death. It's worth noting that the ADA reviewers do NOT see recommending a vegetarian diet as being problematic...

The NCBDN will apparently forcibly confine and silence those people who do not stay within certain "Party" guidelines. This on the heels of the Forbes piece implicating the ADA for forming what is essentially a monopoly on nutrition advice. Which created some seriously bunched britches on the part of the ADA. I find it hilarious that I need to sit through a Sugar Free Coffee Mate ad on the Food Management site before being allowed to proceed to the response. THESE people are in charge of our food policy?

That the Internet and social media have allowed the concept of Ancestral Health to be broadcast to the masses is undeniable. It is also not surprising that we are witnessing an attempt by the government and academic institutions to silence our attempts at self determination. If we are not sick, fat and dying from the subsidized foods the government and ADA wants to feed us, what NEED is there for the ADA?

I don't know about you, but I will not allow another Dark Ages to hamstring medicine and be set back 50 years. Again.

The ADA has a serious problem if it chooses to try to wrest control of our ability to TALK about food and it can be proven in court. They do not practice their craft from a legitimate scientific position. Don't worry my New Earth Creationist pals, I'm not even talking about the fact the ADA is not on a firm epistemological footing with regards to Evolution, what I'm talking about is the scientific method MUST follow this process:
Scientific method
"Nutritional science" largely stops at hypothesis generation, yet they are allowed to dictate public nutrition policy. They use epidemiological studies to try to support their case, but this is correlation, not causation. When it comes down to actual, randomized controlled trials we consistently see low-carb interventions trumping the grain centric recommendations of the government. The ADA is not practicing science, this can be proven in a court of law and it could eviscerate the Clergy masquerading as scientists.

Now as much as I might like a good fight (and we may need to roll up a newspaper and paddle the ADA's backside a bit legally) there is likely a better way to win this battle. Instead of fighting a legal (or even ideological) war with the leaders of these organisations, why not change the culture from the bottom, with the people who will be the leaders tomorrow? Maybe we start offering scholarships for undergrad and graduate nutrition majors who choose to conduct research in the Ancestral Health/Paleo/evolutionary biology realm? Best essays and research proposals win the cash. For the cost of one hard fought court battle we could have scholarships in EVERY nutritional science program in the world.

Markets, incentives and innovation might just win the day. Shocker.

It's interesting, when I started writing this piece my only intent was to pay homage to a great physician and scientist who saw remarkable connections between ecology and health over 50 years ago. In the midst of this process the Reason Magazine piece was released and it gave me significant pause. As far as we've come, as much as we've gained... it could all go away. SOPA was a terrifying prospect, which we managed to put down. This time. Now this.

I can assure you most of the folks living at the end of the Roman era did not see the problems surrounding them. They had indoor plumbing, heated floors, arts, entertainment...what could possibly go wrong?