The paleodiet won’t cure you, hunter gatherers died of cancer too.

Prof. Alice Roberts writes in The Incredible Unlikeliness of Being (Amazon, iTunes):

…recent changes in our digestive physiology mean that the whole idea of a ‘paleodiet’, purportedly healthier because it recreates the diet we evolved to eat as hunter-gatherers, is off the mark. Firstly diets would have varied from place to place, even back in the Palaeolithic, and many populations have changed genetically since we left that way of life behind. We are not fossilised hunter-gatherers.

Speaking of fossilised hunter-gatherers, although they’re hard to come by, as fossilisation needs the right conditions, they do exist. Most won’t show any signs of cancer, because soft tissues are not preserved. Of the cancers that do typically metastasise to bone, these (prostate, breast, and lung cancer) tend to occur in old age, and hunter gatherers didn’t tend to live long, nor smoke. But here’s one of the earliest examples I could find, a remarkable, but sad case, of an bronze age, hunter gatherer, adult male with a large number of bone metastases, some of them  pictured here:

bone metasteses

Why is this remarkable specimen relevant to today? Because it’s one piece of evidence that a paleodiet (as in, the current trend, as distinct from what hunter gatherers actually ate) won’t prevent cancer, although a generally healthy diet can play a role in preventing some types of cancer. You’d need to speak to a qualified dietitian, not naturopath or chef, for advice on what’s right for you. Furthermore, diet won’t help cure cancer, however as we’ll see you may need listen to proper advice on diet for your type and stage of cancer.

So it’s disturbing to find this advice from naturopath Sarah Stevens on paleodiet chef Pete Evan’s Facebook site, which reads in part:

Specialising in Integrative Oncology is such a rewarding yet frustrating area to work in as I am constantly battling against dietary recommendations from the hospital DAA dieticians who recommend high sugar carbohydrate foods to maintain weight and energy. I am also constantly battling with the message that gets brought back to me that my client is not eat the food plans I recommend as they are “dangerous” and can make them worse! This approach is based of “fear of the unknown” rather than research. It is clearly stated but the World Health Organization (WHO) than an estimated 40% or more of all cancer can be prevented. Dramatic increases in lifestyle risk factors such as un-healthy eating habits and obesity are major contributing factors generally due to a high refined carbohydrate, high hydrogenated (trans) fat and low protein/fat diet.
If I could do one thing to change our conventional dietary treatment for cancer it would be cutting out sugar and refined carbs from the dietary recommendations. In my practice I use a Ketogenic and whole food eating program and have only seen my clients improve in wellbeing, maintain muscle mass and healthy gut function while giving them better quality of life and their bodies the tools to heal…

Food and nutrition are a powerful medicine to heal and repair the body. I encourage you to follow a clean diet; eliminating processed foods, sugars, preservatives and additives. Foods that are in their original state, straight from the tree, ground or animal without being changed or processed means that they are full of phytonutrients, antioxidants, good oils and high in fibre. Choosing whole foods is the basis of a healthy lifestyle.

In other words:

  1. Claims that the paleodiet prevents cancer;
  2. Claims that the cancer patients who need to be on a particular diet to maintain weight and energy, which are important for treatment and quality of life, should actually be on a paleodiet; and
  3. Claims that food can act as a ‘powerful medicine’ for cancer.

As dietitian Kate Van Berkel wrote in a comment on that Facebook post:

I find it incredibly upsetting that Dietitian’s spend professional development time learning how to work along side naturopaths and then receive this sort of response.

I have specialised in nutrition and oncology for 6 years. I work with world class consultants who are holistically focused. As a specialist dietitian I am not only well read, but am also actively involved in further research into the role of nutrition and cancer. This is no blanket approach, and I have NEVER used the Australian guide to healthy eating with an oncology client as the guidelines are not developed for anyone with a medical illness.

Unfortunately with xerostomia, dysguesia, anorexia, nausea, delayed gastric emptying, and severe fatigue, for a lot of the clients a “healthy diet” just will not cut it.

I have worked with thousands of truly inspirational clients who try to eat a wholesome diet and lose 1-2kg a week with a substantial amount of lean body mass disappearing as well (it’s hard to have any quality of life with that going on).

Overwhelmingly current clinical evidence points to weight and muscle loss being the single worst nutritional factor when it comes to cancer survival rates. Evidence also points to the fact that the breakdown of muscle mass released nitrogen which may fuel cancer cell growth.

If my clients are able to eat a healthy diet in whatever form (Paleo or otherwise) it may take, fabulous.

If they are down to liquid foods and a few mouthfuls of solid foods a day (common for some types of cancer) I will not hesitate to use a carefully selected formulated high energy, high protein liquid meal replacement (such as eek! Sustagen/Enprocal/Resource/fortisip/). If it helps to improve the chance of survival, bring it on!

This is what I do, and I love it because I see specialist dietitians helping people maintain their strength, hope and dignity every day. It’s an amazing profession to work for in a setting that is otherwise very “clinical” and medication based.

I encourage anyone going through cancer treatment who is worried about their nutrition to have an open conversation with an oncology dietitian. You can take or leave the recommendations, but at least be fully informed and empowered.

To all the family members reading this, be mindful of pushing your loved ones into your way of eating. In a private clinic many of my clients admit to feeling distress over being pressured into eating foods that they just cannot face from loving but misguided family members. Allow flexibility and make the effort to go to the dietitian with them so that you can speak about your concerns.

Thanks
Kate

Given I share Ms Van Berkel’s concern, I wrote to the Victorian Health Services Commission, who advised:

Under the Health Services (Conciliation and Review) Act 1987, our office receives and deals with complaints from patients or consumers of a health service. While we respect and register your concerns regarding Ms Sarah Stevens we are unable to accept your complaint as a third party. Please appreciate, in these circumstances, our powers are limited. As you did not directly and are not complaining on behalf of someone, who did
receive a health service, this matter is not within our jurisdiction.

While our office may not be able to assist you in investigating these concerns, there are other organisations that will be able to help you to ensure that your concerns are addressed. We have noticed that Ms Stevens has stated she is a member of the Australian Natural Therapists Association (ANTA).

ANTA have standards of practice and a complaints process that registered members must abide by. I would respectfully like to refer you to bring your concerns to the attention of the Australian Natural Therapists Association;
You may also wish to write to them at Australian Natural Therapists
Association, PO BOX 657, Maroochydore QLD 4558 or alternatively, email them
at info@anta.com.au
Further details can be found at this web site:
http://www.australiannaturaltherapistsassociation.com.au/about/complaints_handling.php

You also stated that you believe Ms Stevens is providing dangerous advice;
these concerns can also be lodged with Consumer Affairs Victoria.
Their details can be found on their web site at
http://www.consumer.vic.gov.au/contact-us/make-a-complaint.
If you wish to write to them, their address is located at Consumer Affairs
Victoria, GPO Box 4567, Melbourne VIC 3001
They can be contact on telephone number 1300 558 181 or by email at
consumer @ justice.vic.gov.au

I hope this information was of assistance to you.

So I wrote to the ANTA:

Dear Sir/Madam,

Based on this Facebook post, https://www.facebook.com/paleochefpeteevans/posts/793442640749124
(pdf copy attached), I am deeply concerned that Sarah Stevens, a naturopath operating from Armadale, Victoria, is
1. Providing dangerous advice to the public at large, and
2. Providing dangerous advice to individual cancer patients,
that could seriously compromise their health, even resulting in death, through improper nutrition contrary to proper evidence-based medicine in that area.

I strongly urge you to investigate Sarah Stevens and also issue a public warning on this issue.
I note in particular your quality policy and mission statement (copied below) as well as your scope and standards of practice.
ANTA QUALITY POLICY
ANTA is a quality organisation and aims to deliver quality service at all times.

ANTA MISSION STATEMENT
ANTA’s mission is for Natural and Traditional Therapists to uphold and advance their standing within the community and to provide the public with best practice health care in all disciplines in Natural and Traditional Therapies.

Regards,
Dr Matthew Berryman

The ANTA wrote back:

Dear Dr Berryman

I am writing in response to the complaint you have lodged with the Australian Natural Therapists Association (ANTA) regarding Sarah Stevens.

Sarah Stevens has not renewed her membership with ANTA and is not a registered practitioner/member with ANTA.

As Sarah Stevens is not a member of ANTA, we recommend you lodge your complaint with the Office of the Health Services Commissioner at the following link:

http://www.health.vic.gov.au/hsc/resources/infosheet.htm

Regards

Brian Coleman
Executive Officer
Australian Natural Therapists Association Ltd (ANTA)

Now as her web site does clearly state she’s a member:
Sarah Stevens, registered ANTA memberI wrote to the Luxton clinic where she works:

Dear Madam/Sir,

On the “about” page for Luxton Clinic, it states “Sarah has a Bachelor of Health Science, post-graduate Nutrition Medicine qualifications and is a registered Naturopath with the Australian Natural Therapists Association (ANTA).”, however ANTA state otherwise in the email below.

I look forward to your amendment of this statement, lest it be reported to Consumer Affairs Victoria for misrepresentation in advertising.

Regards,
Dr Matthew Berryman

and Ms Stevens advised:

Hi Matthew,

Thank you for your email regarding my membership with ANTA. I have contacted ANTA and there had been a clerical error in their system which has been corrected today and my membership is still current and effective for my qualifications to date.

I wish to thank you for bringing it to my attention as I was not aware that there was an issue and have spoken to ANTA and my details will be updated on their website in the next 24-48 hours.

Kind Regards,
Sarah

I then wrote on the 11th of March:

Dear Mr Coleman,

Ms Stevens has indicated in the attached email that she is in fact a registered member of the ANTA. That being the case would you please reopen the investigation.

Regards,
Dr Matthew Berryman.

Not having heard anything by the 10th of April, I wrote back to Mr Coleman:

Dear Mr Coleman,

When do you expect the investigation to be complete?

Regards,
Dr Matthew Berryman

and was advised:

Dear Mr Berryman

The matter will be reviewed at our next meeting on the 15th May 2015.

Regards
Brian Coleman

So what was the finding, following all of that?

Dear Dr Berryman

The ANTA Ethics Panel and ANTA National Council reviewed your complaint and the response from Sarah Stevens and decided no breaches of the ANTA Code of Ethics or ANTA Constitution had occurred and no further action is to be taken.

Regards

Brian Coleman

Hoping for at least a little transparency as to why the ANTA finds it both best practice and ethical to provide advice that is contrary to evidence-based practice, I wrote to ask:

Dear Mr Coleman,

Could you please send me a written copy of your findings as well as the response from Sarah Stevens (the only response I received from her as you know was not addressing the issues but pertaining to her membership).

Regards,
Dr Matthew Berryman

however the ANTA are less than transparent:

Dear Dr Berryman

I have advised you of the findings in my email below. Under our rules and regulations, we are not required to provide a copy of the response by our member.
ANTA National Council has advised the matter is now closed.

Regards

Brian Coleman

I also ran Ms Stevens’ Facebook comments past Tim Crowe, Associate Professor in Nutrition from Deakin University who wrote:

Although good nutrition is important to help a person get through cancer treatment and to manage the sometimes-severe side-effects of treatment, there is no reliable evidence of any form of nutrition therapy ‘curing’ cancer. Yet there is a wealth information – some good and some very misinformed and dangerous – that a person with cancer may read or hear about as to what they should eat when they have cancer. It is best to get information about nutrition and cancer through organisations such as the Cancer Council http://www.cancercouncil.com.au/ or an Accredited Practicing Dietitian.

Quite.

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