Turns out Cleave is a very interesting guy. Born in 1906, he was a doctor in the Royal Navy who was convinced of the negative effects of refined carbs in the Western diet. While not paleo/primal wrt avoiding grains as a prescription, he identified the problems Westerners faced as a result of eating a diet we’re not yet adapted to.
It turns out that the full text of his book, The Saccharine Disease, is available online. It’s quite an interesting read in the context of the discussions many of us are having now!
I encourage you to read the whole thing, but to give you a taste (no pun intended :), here are some highlights I found interesting.
On nature versus nurture (or genes versus environment), emphasis mine:
[The] struggle for existence has prevented the rate of any hereditary defect exceeding 5 per 1000 live births … If the incidence is many times as great as that of any known hereditary defect, then, quite apart from other considerations, such a cause for the ailment becomes extraordinarily improbable. … This approach by incidence-figures is thus of great value in deciding whether a disease is due to a hereditary defect, or to a new factor in the environment to which no adaptation is yet possible — in short, to use a commonplace expression redeemed by its clarity, in deciding whether the body is built wrongly or is being used wrongly.
[Note: That said, just because it’s not your genes doesn’t mean the answer is eat less, move more!]
On when refined carbs became a problem:
Of all the foods that exhibit an alteration from the natural state, the refined carbohydrates — represented in this country chiefly by sugar and white flour — exhibit the greatest. …
Furthermore, it is to be noted that these alterations are so recent by evolutionary standards of time as to date but from yesterday. It is true that, apart from earlier evidence from Egypt, white flour was being produced in Greece at least as early as 500 B.C., and Hippocrates himself recommended white bread for diarrhoea, which shows that it was already realized as passing through the gut at reduced speed. … However, at the end of the eighteenth century practically all the poor were eating white bread, and so the turn of that century — i.e. around the year 1800 — is an approximate baseline, as it were, for the dating of general white flour consumption in this country.
Cleave was not an fan of the lipid hypothesis (emphasis his):
To sum up, then, there is no doubt, from an evolutionary point of view, that, in any disease in man due to alterations in his food from the natural state, the refined carbohydrates, both on account of the magnitude and the recentness of the alterations, are always the foods most likely to be at fault, and not the fats.
On his disagreement with his contemporary, John Yudkin, author of Pure, White and Deadly:
The conception set out above, of mankind not being adapted to the consumption of refined carbohydrates, must be carefully distinguished from that advanced by J. Yudkin, that the human body is not properly adapted to the consumption of unrefined (i.e. natural) carbohydrates either, because ‘with the discovery of cereals some ten thousand years ago, man for the first time became a food producer and ceased to rely on gathering and hunting his foods’.
The present author cannot accept this view, for three separate reasons.
Firstly, he does not hold that man until ten thousand years ago was primarily a carnivore. …
Secondly, Yudkin’s conception implies that man cannot rely on his sense of taste when eating foods in their natural state — i.e., that his sense of taste may be evolved out of harmony with the rest of his body, so that he may like eating whole cereals or other natural carbohydrates without being able properly to metabolize them. But logic dictates that the body is evolved harmoniously, as a whole; and so does the evidence, too, for a herbivore, like a horse, will die of starvation rather than eat meat or other animal foods, which it cannot metabolize; whilst a carnivore, like a lion, will die of starvation, too, rather than eat grass or other plant foods, which it likewise cannot metabolize.
Thirdly, and most important of all, it will be the endeavour of this work to show that all the manifestations of the saccharine disease discussed are strikingly absent in those races still subsisting almost exclusively on just these unrefined carbohydrates.
[Note: This is where I have an issue with Taubes. But that’s another post.]
Cleaves on exercise and obesity:
The view that obesity is due to insufficient exercise is just as vulnerable. … People are blamed for using lifts in office buildings and for not walking when they leave their offices. Yet this is what their natural inclinations often tell them to do. … Throughout the whole animal kingdom, in fact, no living creature, unless forced to do so in order to get food, ever takes any more exercise than it wants to take. Nature obviously likes to conserve the heart — and certainly never inflicts on any organism the penalty of obesity for ‘laziness’. …
It is perfectly true that restraint of appetite or enforcement of exercise will reduce obesity, but as long as the true cause continues to operate — the consumption of refined carbohydrates — the use of either is an example of two wrongs not making a right. To be sure, these two factors are valuable in the removal of surplus weight already in existence, but in the basic matter of prevention the mind should be riveted on the essential cause and not confused by irrelevancies.
Cleaves on another kind of over-consumption:
Although the taking of refined carbohydrates is by far the most important cause of over-consumption, as has been set out in this work, it is not the only cause. Another cause lies in the common occurrence of people eating when they are not hungry, and the conditions that this leads to are not in the author’s opinion basically manifestations of the saccharine disease.
The important question of eating in the absence of hunger has been carefully described in Chapter X, on peptic ulcer, and of the examples set out there perhaps the best is seen when people eat in the company of others, especially if this is attended by the taking of alcohol. One is reminded of the huge meals, accompanied by the drinking of large quantities of port, that took place in past generations, as in the times of the earlier Georges. But there is no need to go back to these extreme examples; the fact is that even today in communal feeding a great deal of food is eaten chiefly because it is there, or for an ulterior motive not connected with the appetite as, for example, in many businessmen’s lunches.
On his prognosis for the issue:
Since this is mainly a work on the causation of disease, it is not really implicated in what civilized man in general, and Westernized man in particular, will do about such causation, if it becomes generally accepted as true. This is an entirely different subject, just as the discovery of smoking as the main cause of lung cancer, and what the public does about it, are two subjects that are entirely different from each other. If the author were asked what he thought the public will do in the present case, over the consumption of refined carbohydrates, he would hazard the guess: in prevention, very little; in treatment, quite a lot; in short, people will go on enjoying themselves till they get hurt. …
It may well be, in fact, that the struggle for existence, in the shape of simple economics, will compel humanity to adapt itself to the consumption of these refined foods. But this adaptation will take many thousands of years and will be accompanied by immense personal suffering.
His suggestions for a natural diet for health (emphasis his):
The diet is based on two rules only, which may be summarized as follows:
1. Do not eat any food unless you definitely want it
Eating food that is not wanted is a most unnatural act, yet frequently takes place today. One reason lies in eating routinely, especially when one is overtired or worried and does not really fancy any food at the time; another reason lies in eating a meal because someone has taken the trouble to prepare it, or in eating food to avoid wasting it; whilst yet another reason lies in eating food on social or business occasions, when it is taken for motives of politeness or policy. On all these occasions ‘if you don’t want it, don’t eat it’. This decision is always made most accurately before coming to the table.
2. Avoid eating white flour and white or brown sugar
This means avoiding on the one hand white bread, pastry, cakes, biscuits and other confectionery; and on the other hand white or brown sugar, jams, ices, chocolates, sweets, and sweet drinks. Substitute a true wholemeal bread and wholemeal flour for the first group, and raw or dried fruit for the second group. This restores the natural fibre to the diet, which will now be shown to be of the greatest importance.
How this prevents obesity (emphasis mine):
Obesity stems from the appetite being deceived by the unnatural concentration present in white flour and in sugar, so that a person eats too much. For example, the average consumption of sugar today is about 5 oz. per head per day (against less than 1 oz. about a century ago). This 5 oz. is contained in nearly 3 lb. of sugar-beet or in up to a score of ordinary apples. Who would consume this quantity of sugar in its natural, dilute form? The same argument applies to white bread, and other articles containing white flour, as compared with unrefined wholemeal bread.
By following Rule 2, above, the natural fibre (roughage) is restored to the diet, and the natural dilution is restored also. As a result the appetite can again be allowed to regulate the amount to be eaten, as it is designed to do, and we can ignore any question of calories, just as all creatures in the wild state ignore them (and they never suffer from overweight).
For the removal of overweight already present, a certain amount of starvation may be necessary, as in the omission of breakfast and afternoon tea — to be done under medical supervision.
No forced exercise is advised in obesity.
[Note: Seems to me that this question of appetite is central to the question of the usefulness of a lower carb diet. Too bad so much of our discussion is on the Eades/Colpo metabolic advantage argument and the Taubes/calories in vs calories out argument.]
As mentioned at the start of the post, please check out the entire book. At over 200 pages in print, the above does a disservice at adequately summarizing it; as mentioned, these are some of the highlights I found most interesting.
However, as with Lustig’s treatise on sugar in general and fructose in particular, perhaps it may will give some readers a bit more pause as far as consuming sugar and refined starch!