The Adventist Health Studies
Figure 1: Survival of California Adventist men (1980-1988) and other California men (1985) beyond the age of 30 years. The difference between the 2 groups was significant (P,.001). These were non-Hispanic white subjects. Hazards for 1989 are used for non-Adventist Californians older than 94 years (see the “Subjects and Methods” section of the text). AHS indicates Adventist Health Study; CI, confidence interval.
The Seventh-day Adventist Church (SDA) is a Christian denomination that was founded in 1963 as an offshoot of the Millerite movement in the US during the middle part of the 19th century. Ellen White, the principal founder of SDA, advocated a lifestyle incorporating the following five behaviors: not smoking, eating a plant based diet, eating nuts several times per week, engaging in regular exercise and maintaining normal body weight throughout the individual’s lifetime[1] Adventists also typically eschew alcohol (~8% drink), tobacco (~1.8% smoke), butter, strong seasonings (including pepper), caffeine (coffee, tea, cola) and consider the eating of pork, shellfish, and other foods proscribed as “unclean” in Leviticus as especially unwholesome.[2]
Beginning in 1960, two studies were conducted to determine the effects of the SDA lifestyle on all-cause mortality, as well as on disease-specific mortality and morbidity. The first study was conducted in the interval from 1960 to 1965. The Adventist Mortality Study, also known as the Adventist Health Study-1 (AHS-1) was comprised of 22,940 California Adventists and consisted of an intensive 5-year follow-up, and a more informal 25-year follow-up.[3] The AHS-1 found that the mean lifespan for California Adventist men was 6.2 years longer than for non-Adventist California men. The mean lifespan extension achieved by SDA women was more modest; a 3.7-year advantage over their non-SDA counterparts. These statistics were based on life table analyses.[4]
The reduction in disease specific mortality was impressive, with the overall death rate from neoplasms being 60% lower for SDA men and 76% lower for SDA women.[3, 5] The incidence of breast and colorectal cancer were dramatically lower than in the control population with SDA women experiencing 85% less breast cancer [6-8]and SDA men and women experiencing 62% less colorectal cancer.[3, 9, 10]The incidence of coronary heart disease (CHD) was 66% lower for SDA men and 98% lower for SDA women.[11-13] On average Adventist men live 7.3 years longer and Adventist women live 4.4 years longer than other Californians.
The second Adventist Health Study (AHS-2) took place in the time period between 1974 and 1988 and involved approximately 34,000 Californian Adventists over the age of 25. AHS-2 was designed to try to determine which components of the SDA lifestyle provided protection against specific types of disease. The AHS-2 found that the consumption of red and white meat was associated with an increase of colon cancer and that, independent of meat consumption, eating legumes was protective against the disease.[5, 10, 14] The consumption of nuts was found to be inversely related to the incidence of myocardial infarction, and regular consumption of nuts several times a week reduced the incidence of coronary heard disease CHD by ~50%.[15-17] A strong inverse relationship was found between the risk of CHD and the consumption whole grain wheat bread, as opposed to white bread (~45% reduction in CAD).[16] In men, the frequent consumption of tomatoes and of soy milk was associated with a ~60% reduction in the incidence of prostate cancer.[16, 18, 19]
Figure 2: Survival of California Adventist women (1980-1988) and other California women (1985) beyond the age of 30 years. The difference between the 2 groups was significant (P,.001). These were non-Hispanic white subjects. Hazards for 1989 are used for non-Adventist Californians older than 94 years (see the “Subjects and Methods” section of the text). AHS indicates Adventist Health Study; CI, confidence interval.
Unlike the Cretan diet, the dietary practices of the SDAs are less homogenous and typically incorporate foods commonly consumed by Americans (although with more moderation), including many associated with degenerative disease, such as refined sugar and snack foods. Similarly, the SDA diet typically strives to replace traditional American foods with healthier alternatives, while maintaining the flavor, texture and appearance of the original dishes.[20] One way this is done is by using a range of proprietary textured vegetable protein products (TVP) derived from wheat or soy (with corn or soy oil providing the calories from fat) as meat substitutes. There is also a heavy emphasis on the consumption of vegetables, nuts, whole grains and fruits.[21, 22]
Figure 3: Examples of textured vegetable protein products made to resemble commonly eaten meat dishes in the US.
These products have historically been manufactured by companies owned by or closely associated with the SDA church[23] and this was an added factor in their widespread use. Lentils are also often substituted for meat in traditional American recipes, such as meatloaf and soup. The use of TVP meat substitutes increase compliance by making products that allow for the preparation of foods that fill the cultural niche of beef, chicken and turkey. There are even faux-meat hot dogs available (Figure 3). Nuts are also commonly used as an ingredient in TVP dishes to provide added flavor and a more meat-like mouth feel.[20] Examples of commonly used SDA “meatless meat products” (Figure 3) along with their ingredients and nutritional content are available at http://fatsecret.com/calories-nutrition/worthington-loma-linda#Meatless_Foods.
The primary sources of lipids in the SDA diet have historically been from corn and soy oils, and to a lesser extent oils from nuts (corn oil has partly been replaced by canola oil in the contemporary SDA diet). In examining the commonalities between the SDA and the Cretan diet, the following components seem the most likely candidates to explain the reduction in morbidity and mortality observed in both populations:
- No or very low consumption of red meat
- No or low consumption of meat (excluding fish) in general
- Large consumption of fresh fruits and vegetables
- Use of free range hens’ eggs
- No or low consumption of butter
- No or low consumption of unfermented milk products
- Emphasis on legumes in the diet
- Emphasis on the regular consumption of nuts
- Fat intake primarily in the form of polyunsaturated or monounsaturated fats of vegetable origin
- Regular exercise
- Maintenance of near ideal body weight over the lifespan
- Abstention from smoking
Which Diet for a New Lifestyle?
Figure 4: The Greek Food Column and the three critically important lifestyle elements that accompany it; balance, proportionality and regular exercise.
The Lyon Heart Study clearly showed that the diet of Crete can be adhered to over a period of 5 years. Figure 4 is the Greek Column Food Guide based on the diet of Crete. The visualization of this food guide in the form of a Greek column includes the concepts of genetic variation and nutrition and balanced energy intake and energy expenditure; it is based on foods, not food groups. Although it excludes certain foods made with hydrogenated oils, it does not restrict the intake of naturally occurring foods. It also takes into consideration moderation, variety and proportionality. Dietary guidelines shown in Table 1 provide further information on how to implement the diet of Crete.
Table 1.
The seven dietary guidelines of The Cretan Diet
1. Eat foods rich in (n-3) fatty acids such as fatty fish (salmon, tuna,
trout, herring, mackerel), walnuts, canola oil, flaxseeds and green
leafy vegetables. Or, if you prefer, take (n-3) supplements.
2. Use monounsaturated oils such as olive oil and canola oil as your
primary fat.
3. Eat seven or more servings of fruits and vegetables every day.
4. Eat more vegetable protein, including peas, beans and nuts.
5. Avoid saturated fat by choosing lean meat over fatty meat (if you
eat meat) and low fat over full fat milk products.
6. Avoid oils that are high in (n-6) fatty acids, including corn,
safflower, sunflower, soybean, and cottonseed oils.
7. Reduce your intake of trans fatty acids by cutting back on
margarine; vegetable shortening; commercial pastries; deep-fat
fried food; and most prepared snacks, mixes and convenience
food.
Studies on the diets of hunter-gatherers suggest that (n-3) fatty acids were present in practically all foods that humans ate, and present in equal amounts with (n-6) fatty acids (i.e., 1:1 ratio). The depletion of the (n-3) fatty acids in Western diets is the result of the industrialization of farming, and to a lesser extent, the recent emergence of aquaculture. The high ratio of (n-6) to (n-3) fatty acids (16.74:1 instead of 1:1) is a consequence of the inexpensive mass production of vegetable oils and their substitution in much of the diet for saturated fats as a consequence of economic considerations, government policy (corn and soy subsidies) and erroneous health advice by the “experts.” The latter, led by Ancel Keyes, recommended the indiscriminate substitution of saturated fat and butter with oils high in (n-6) fatty acids to lower serum cholesterol. This effort was successful in reducing the incidence of CVD, however it has not reduced the incidence of other pro-inflammatory diseases, and the mean lifespan has not increased fully commensurate with the decrease in CVD mortality.
The results of the Seven Countries Studies and the Lyon Heart Study based on a modified Cretan diet that is balanced in (n-6) and (n-3) fatty acids, rich in antioxidant micronutrients, and in chemoprotective trace minerals from fruits, vegetables, wild growing herbs and greens is associated with decreased rates of heart disease and cancer; more so than any other diet, drug intervention, or technique. Indeed, all attempts to date to administer nutrients believed to be protective against disease as supplements have been unsuccessful. Attempts to reduce the incidence of CVD with vitamin C, vitamin E and with folic acid and vitamin B-6 (the latter to achieve reduction in elevated serum homocyeteine levels) have failed, suggesting that the biochemical protection these molecules provide in vitro, and in laboratory animal settings, requires the presence of other molecular species in order to act in vivo.
What appears to be unique about the Cretan (and to a lesser extent the SDA diet) is the content of bioprotective nutrients with a broad range of action, specifically the following: 1) a more balanced intake of essemtial fatty acids (EFAs) from vegetable, animal and marine sources; a ratio of (n-6) to (n-3) fatty acids of ;2:1 instead of the 15:1 in most Western diets (it is 16.74:1 in the US); and 2) a diet rich in antioxidants, i.e., high in vitamin C, vitamin E, b-carotene, glutathione, resveratrol, selenium, phytoestrogens, folate, and other phytochemicals from green leafy vegetables; phenolic compounds from wine and olive oil; high intakes of tomatoes, onions, garlic and herbs, especially oregano, mint, rosemary, parsley and dill, which contain lycopene, allyl thiosulfinates, salicylates, carotenoids, indoles, onoterpenes, polyphenols, flavonoids and other phytochemicals used in cooking vegetables, meat and fish.
Some Serious Caveats Regarding the Applicability of Historical Data
In asking people about how long they expect to live, I’m often surprised by the high degree of confidence they exhibit based on the longevity of relatives. If you challenge the assumption that because their aunts, uncles or parents lived into their 80s or 90s that they will too, you will likely be met with the vehement assertion that this fact pretty much guarantees a similar outcome for the respondents. This assertion would be more credible if their long lived 1st or 3rd degree kin were reared under identical, or at least under similar conditions. And therein lies the rub, because this is usually not the case.
Figure 5: Average weekly hours spent on home production from 1900 to 2000 for two aggregates of the population; those in their productive prime, and those in their declining years.
It must be remembered in making historical comparisons with contemporary Westerners in terms of both life expectancy, and dietary or other interventional lifespan studies, that 20th century Cretans and Adventists were, of necessity, far less sedentary than is the average 21st century Westerner today. In this cohort of people housework (household production) involved a considerable amount of exercise, and often no small amount of hard physical labor. Until the middle of the 20th century in the US, laundry was done by hand, in whole or in part, and clothing was hung up to dry, taken down and ironed. Even operating automobiles involved clutching, shifting gears and manual operation of windows – small things by themselves, but cumulatively important.
Figure 6: Between 1950 and 2000 there was a ~ 20% reduction in the types of work classified as “high activity.” What is neither shown nor known is the degree to which both high and low activity jobs have become less strenuous. [24]
Meal preparation in 1965 required ~ 16.5 hours per week and the total numbers of hours spent in home production was on the order of 51.8 hours at that time. [25] As can be seen in Figure 5, time spent on home production decreased significantly beginning around 1960. Beyond the decrease in total hours spent on housework, there was a much larger decrease in the amount of physical effort required. Washing machines and clothes dryers, prepared meal components and entire prepared meals, as well as countless other “labor saving” devices, goods and services have markedly decreased fitness. The same has been true of strenuous physical activity in the work place where the overall number of high activity jobs have decreased by ~ 20% from 1970-2000.[26, 27] There has also been a large shift in the workplace demographic since the mid-2oth century. Life expectancy increased from 47.3[28] years in 1900 to 77.8 years today, a consequence of which (in part) was the exodus of teens from the workforce. In 1920, ~20% of the US labor force was comprised of males aged 15 to 18 years of age.[28] Today, very few teenagers work full time jobs, and the number of teens employed in summer jobs has decreased from ~60% in 1994, to ~40% in 2008.[29] Of those teens who do find summer employment very few are in physically demanding (and consequently usually hazardous) areas of work, such as construction or agriculture. This change, coupled with increased TV viewing and other sedentary activities, translates into reduced fitness in the age 15-30 demographic.
Figure 7: The graph above shows the distribution of the Body Mass Index between the 1971–1975 and 1988–1994 surveys. Over this time, median BMI increased by 0.9; the 75th percentile increased by 1.5; and the 95th percentile increased by 2.7.[238]
In their article, “Why Have Americans Become More Obese?” Cutler, et al., take the contrary position and argue that it is not reduced energy expenditure (or fitness) in the the population, but rather, the reduced investment required in terms of time per calorie consumed, that has been the primary cause of the change in US, and increasingly Western European eating habits (and thus is responsible for the current epidemic of obesity and type II diabetes).[30] Superior food packaging and preservation have cut not just meal preparation time dramatically, but also cleanup time. The mess generated in the preparation of multiple elements of a meal is now confined to the factory and the cleanup is included in the price of the food. It is also no longer necessary to spend as much time cooking, or even heating food, because it can be rapidly prepared and be made ready to eat in a matter of minutes from refrigerator or cupboard by the use of the microwave oven. These technological changes have thus reduced the threshold for eating formerly time consuming and messy to prepare dishes to the point of almost no effort or expenditure of time at all. It is now almost as easy to eat a piece of cake or pie, a brownie, or complex entree as it once was to eat an apple. All the mess and time involved in baking a cake or a pie from scratch is gone.
Regardless of the cause, we are most certainly not our parents or our grandparents, and as the current epidemic of obesity and type II diabetes attests, we are not likely to age or die as they did, either. Any doubts about the difference between “us” and “them” (or even “us then” and “us now”) should be laid to rest by a careful perusal of Figure 7.
The generations who participated in the AHS and Seven Countries Study were also fed differently. In Europe, they were subjected to nearly a decade of reduced calorie consumption, and even in the US, the relatively high cost of calories (in time, if nothing else) combined with less leisure time and fewer options for sedentary work, no doubt acted to limit calorie consumption, compared to today. This reduced calorie consumption may have been protective, and might have served to add years to life even in the presence or the absence of a more optimal diet. These generations of people were also fed on agricultural products derived mostly from small farms where crops and livestock had the opportunity to acquire a broad range of micro-nutrients and phytochemicals that are now less abundant in the food supply.
How Square is Curve Already?
Figure 8: The death rate from cardiovascular disease in the US has plummeted since the turn of century in part due to the replacement of saturated fats with of polyunsaturated fats in the diet.[31]
It should also be pointed out that data from longitudinal studies like the AHS-1&2 and the Seven Countries Study reach us as light does from a distant star. When we point and look at the star in the crook of the handle of the Big Dipper we say, “Look, there’s Alcor!” But of course that isn’t the Alcors we are looking at, but rather the light that shows what they looked like 83 years ago. Similarly, all of the data in AHS-1&2 and Seven Countries Study is a generation or two (or three!) old by the time we have it. The participants in those studies are mostly dead now, as indeed they would have to be in order for us to be able to plot lifespan curves for them. Thus, it is easy to make the mistake of saying, “If I adopt this diet I can expect 7 additional years of life, or 10 additional years of life, because that’s what the study participants experienced.
At least one problem with that assumption is that some of the benefits from both studies have very likely already been realized in the form of the switch from saturated to poly- and monounsaturated fats in the diet, which began in the early 1960s and continues through the present. The most significant benefit from both the Seven Countries Cretan diet and the Adventist Vegetarian diet has been the reduction in mortality (and morbidity) from CVD that has been ongoing since ~1968 in the US. The death rate from CVD has been halved since 1960 when both of these studies were undertaken (Figure 8). To those who vilify Ancel Keys for not getting it just right, I can only say, “Look at (Figure 8) and try to tell me that you could have done better.” So, we’ve undoubtedly used up some of benefit from these dietary interventions in terms of mean lifespan extension.
Figure 9: These curves show the best case extension of mean lifespan that can be anticipated with the Adventist Vegetarian diet or the Cretan Diet.
Finally, it is critically important to understand that both the Cretan and the Adventist Vegetarian diets are really not “diets” at all, but rather lifestyles. Both lifestyles have in common a strong emphasis on low impact exercise and a non-sedentary way of life. Both lifestyles were a product of a time without televisions or computers, and both lifestyles required then, and will require now, considerably greater time for food preparation and cleanup. The upside of that is that we should also eat less, if Cutler et al., are correct. That is important to consider as well, because, leaving aside whether fats, carbohydrates or protein should comprise X- percentage of a given diet’s calories, one thing both these diets have in common is modest to moderate calorie restriction. Five, or possibly even 10 extra years of healthy, productive life should hopefully make the practical costs worthwhile.
The Caveman Diet, or Just How Credulous Are You?
“There are races of people who are all slim, who are stronger and faster than us. They all have straight teeth and perfect eyesight. Arthritis, diabetes, hypertension, heart disease, stroke, depression, schizophrenia and cancer are absolute rarities for them. These people are the last 84 tribes of hunter-gatherers in the world. They share a secret that is over 2 million years old. Their secret is their diet- a diet that has changed little from that of the first humans 2 million years ago, and their predecessors up to 7 million years ago. Theirs is the diet that man evolved on, the diet that is coded for in our genes. It has some major differences to the diet of “civilization”. You are in for a few big surprises.
The basic principles of the Paleolithic Diet are so simple that most high school students can understand them. Within 15 minutes from now you will grasp the major elements. At the technical level, Paleolithic Diet Theory has a depth and breadth that is unmatched by all other dietary theories.” – Dr. Ben Balzer, M.D.
The ideas underlying the Cretan Diet and the SDA Vegetarian diet are complex and do not admit of easy reduction to a catchphrase. The actual foods permitted and consumed in both diets differ markedly – one proscribing all meat, the other urging fish consumption, one obtaining most of the dietary fat calories from PUFAs, and the other from monounsaturated olive oil… It is these differences in the face of the common outcome of greatly improved health and moderate extension of the mean lifespan that are, in fact, key, because they tell us about the likely underlying common mechanisms and thus possibly of their action. They also offer us the opportunity for more choice, and therefore for more flexibility and the likelihood of greater compliance.
The Paleo Diet: A diet so unscientific, only a caveman would do it.
That is not, however, how people make a quick buck. Neither diet is particularly ‘sexy.’ And both diets require an understanding of the underlying biology that makes them work in order to be credible. It’s not possible, or at least not as easy to offer up a one sentence explanation for the feeble minded, such as, “This is a healthy diet that will extend lifespan because it is the natural human diet that our ancestors were evolved to eat.”[32-34] That sounds great because it is simple, easy to understand and “seems right” to a lot of uninformed, ignorant and fearful people. It also speaks to that deep and abiding suspicion that our health (and our other woes) is an artifact of our having lost our way – either from the primordial Garden of Eden, or from our biologically appropriate evolutionary ground state (i.e., before we embarked on agriculture). In fact, the emphasis on a 1:1 or 2:1 ratio of (n-6) to (n-3) fatty acids was derived from observations of contemporary hunter gatherer populations who have a low incidence of inflammatory and age-associated degenerative disease compared to that seen in post-agricultural populations. That was a useful insight that was subsequently validated in many human studies, the best of which extended over a period of decades. That’s the heart and soul of Level 1, Evidence Based Medicine.
In 1988, S. Boyd Eaton, Marjorie Shostak and Melvin Konner published a book entitled The Paleolithic Prescription: A Program of Diet & Exercise and a Design for Living[32] advocating a diet based on what the authors hypothesized the primordial pre-agricultural human diet was like. Subsequently, well over a dozen books have been published advocating variations on this diet based on arm chair hypothesizing from findings in the scientific and ethnographic literature. The diet (depending upon the version you come across) is low (10-15% energy) or moderate in fat , low in carbohydrate (20–40% energy), and high in protein diet (19–35% energy) which provides 55–65% of total calories from meat, 35–45% of calories from non-grain and low glycemic index vegetable sources with a primarily saturated fat intake (10%–58% energy) similar to or higher than that found in Western diets.[35-37]
The first problem with this approach is that the diet is not validated; the AHS and the Seven Counties studies had the considerable advantage of being able to study actual, living human beings under real world conditions, and then apply those insights to other populations, including populations already suffering from CVD. Indeed, that is where so many of the insights, as well as so many of the unresolved questions regarding these diets/lifestyles come from (i.e., the data are complex and robust). Late Paleolithic people are not only long dead and gone, they are really long dead and gone, and contemporary hunter gatherers – the few that remain – cannot be considered equivalent. Ironically, most of the data cited on the relationship between CVD and diet by the originators of the Paleolithic diet are from the Seven Countries Study![32, 37]
Even more to the point, there is present in the hypothesis of Eaton, Konner et al.,[32, 33] the notion that 10,000 years of agriculture is evolutionarily insignificant. In essence, they posit that human evolution with respect to diet stopped 10,000 years ago.[32, 35] At first glance this might seem to be credible, because human evolution has occurred over a period of millions years and it would seem that any changes that would occur in population genetics over a mere 10,000 years must be trivial. However, this is not the case for several reasons. First, the rate of evolution is a function of a complex interplay of multiple factors, including environmental change and selection pressure. It is only necessary to look at the various breeds of dogs, or pigeons created by artificial selection to understand that evolutionary change can be swift.
The introduction of agriculture was a watershed event and it would be astonishing if it was not accompanied by significant evolutionary adaptations to the dietary changes that resulted. To understand that this is so it is only necessary to examine the strong natural selection for the gene that controls lactase production.[38] Human populations with a long history of cattle herding and milk consumption can metabolize lactose present in cow’s milk throughout adulthood, whereas populations that did not domesticate cattle cannot. Natural selection for the heterozygous carriers of the sickle-cell gene to maintain sickle-cell trait in populations exposed to malaria is another post-advent of agriculture evolutionary adaptation. This adaptation was selected for as a direct result of an agriculture-induced alteration to the environment; the clearance of the tropical forests in central Africa, which in turn led to the explosion in the population of the Anopheles mosquitoes that are the vectors for the Plasmodium parasite that causes malaria.
Recently developed techniques for measuring genetic variability now allow for the determination of selection operating in the human genome.[39] Directional selection has been identified in the glucose-6-phosphate dehydrogenase (G6PD) gene, which confers resistance to malaria.[40] What is more, G6PD resistance has evolved not once, but twice in humans, in both Africa and in the Americas.[41] Similarly, the genes expressing chemokine receptor 5 (CCR5) among Europeans, which confers resistance to the human immunodeficiency virus (HIV) are likely to have been selected for within this population over a period of several hundred years in response to Yersinia pestis (bubonic plague) and tuberculosis, both of which use the CCR5 receptor as an entry portal into the host.[42] Numerous other studies have also provided evidence for the recent operation of natural selection on the human genome as a result of very recently developed techniques that allow for comparisons over long sections of DNA.[43-46]
In addition to the conservation of lactase production into adulthood, there is substantial evidence of evolutionary adaptation to the high carbohydrate diet that was a product of agriculture. The incidence of obesity that occurs upon exposure to high calorie “affluence diets” is known to vary greatly by ethnicity. The Pima people (or Akimel O’odham) are a racial group of Amerindians living in central and southern Arizona. One-half of adult Pima Indians have diabetes and 95% of those with diabetes are overweight or obese.
Obesity is thought to be 50-90% heritable. Genome scans in obesity studies are highly reproducible and, despite ethnic and environmental differences, the loci at chromosomes 2 and 10 are generally confirmed as the source of the phenotype. Obesity is “oligogenic,” with expression modulated by “polygenic modifier genes” interacting with the environment in food choices, physical activity, and smoking.[38] Prior to their introduction to the “American” diet after WWII the Pima were not obese and diabetes was extremely rare.[39-41] The diet of the Pima was a very low fat, high carbohydrate diet consistent with the subsistence agriculture of the desert southwest.[42, 43] Some variations in the ectonucleotide pyrophosphatase phosphodiesterase gene-1 (ENPP1) are associated with a 50% increase in the risk of morbid obesity in adults and a 69% increased risk of childhood obesity. An ENPP1 mutation, for example, which is known to protect against obesity and type II diabetes, is present in about 90 percent of non-Africans, but nearly absent in Africans and, not coincidentally, in the Pima. Human evolution in response to environmental change and in response to dietary change is both ongoing and dynamic.[47][44]
Of course, the Paleolithic diet may be the best diet yet conceived. I could give many reasons why I believe this is not so, but absent hard data gleaned from human trials, I can’t prove much. And that is my final and most important point. I did a Pubmed search using the keywords “Paleolithic diet” and I got 67 hits. Of those 67 hits only 9 were papers that involved actual human or animal application of the diet, or even discussion of same. I’ve copied all of the cites for these studies below:
1: Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010 Dec;25(6):594-602. PubMed PMID: 21139123.
2: Jönsson T, Granfeldt Y, Erlanson-Albertsson C, Ahrén B, Lindeberg S. Apaleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7:85. PubMed PMID: 21118562; PubMed Central PMCID: PMC3009971.
3: Klonoff DC. The beneficial effects of a Paleolithic diet on type 2 diabetes and other risk factors for cardiovascular disease. J Diabetes Sci Technol. 2009 Nov 1;3(6):1229-32. PubMed PMID: 20144375; PubMed Central PMCID: PMC2787021.
4: Eaton SB, Konner MJ, Cordain L. Diet-dependent acid load, Paleolithic[corrected] nutrition, and evolutionary health promotion. Am J Clin Nutr. 2010 Feb;91(2):295-7. Epub 2009 Dec 30. Erratum in: Am J Clin Nutr. 2010 Apr;91(4):1072. PubMed PMID: 20042522.
5: Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009 Jul 16;8:35. PubMed PMID: 19604407; PubMed Central PMCID: PMC2724493.
6: Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC Jr, Sebastian A. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009 Aug;63(8):947-55. Epub 2009 Feb 11. PubMed PMID: 19209185.
7: Osterdahl M, Kocturk T, Koochek A, Wändell PE. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr. 2008 May;62(5):682-5. Epub 2007 May 16. PubMed PMID: 17522610.
8: Jönsson T, Ahrén B, Pacini G, Sundler F, Wierup N, Steen S, Sjöberg T, Ugander M, Frostegård J, Göransson L, Lindeberg S. A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond). 2006 Nov 2;3:39. PubMed PMID: 17081292; PubMed Central PMCID: PMC1635051.
9: Eaton SB, Eaton SB 3rd. Paleolithic vs. modern diets—selected pathophysiological implications. Eur J Nutr. 2000 Apr;39(2):67-70. PubMed PMID: 10918987.
If I enter the keywords “Mediterranean diet” I get 2,269 hits, of which 225 are reports of clinical trials. I will not copy those here!
That’s it. Nine papers of poor quality and not a single clinical trial demonstrating reduced morbidity or mortality – even in CHD or type II diabetes. Sixty-seven papers of hypothesizing 25 years after this diet was put forth. That is dismal science and it is inexcusable to take a position advocating such an intervention in the complete absence of any evidence that it will actually extend the human (or the laboratory animal) lifespan when there is a large body of high quality data that supports far less extreme, and far more practical dietary and lifestyle interventions that will accomplish those ends.
I have no problem with people coming up with a hypothesis, however kooky or sane, and then proceeding to try it out – even on people – as long as those people have informed consent and the data they are given is accurate. In looking over the various books and the countless media articles on the Paleolithic diet, I was struck by how much the Paleolithic Diet’s hype reminded me of the Pritikin diet hype, and even more so of the Pearson & Shaw Life Extension Revolution circus from 30 years ago. “Live to be 100!” “Feel great! Experience all day energy every day!” “Lose Weight!” Well, at least one of those is very likely true, and that is that most people who undertake any version of the Paleo diets I’ve reviewed will likely lose weight. But as to the other claims? Right now they are preposterous. The sad thing is that for first the time in history we have one diet/lifestyle choice that satisfies EBM-1 criteria, and another that satisfies EBM-2 criteria. Both are “proven” to reduce morbidity from a range of degenerative diseases, and both have been proven to significantly extend mean lifespan…
Max More, CEO Alcor Life Extension Foundation
As I so often say, “You pays your money and you takes your chances.” Still, it is embarrassing to see cryonicists buy into yet another quick fix cure all, with no appropriate science to back it up. In his article “The Cryo-Paelo Solution”[48] Alcor President Max More advocates the Paleolithic Diet as a life extending add-on to cryonics. This recommendation is supplemented by a web interview.[49] His citations consist these of these popular books on the subject: Loren Cordain, The Paleo Diet; Nora T. Gedgaudas, Primal Body, Primal Mind; Mark Sisson, The Primal Blueprint; Gary Taubes, Why We Get Fat;Gary Taubes, Good Calories, Bad Calories; Arthur de Vany, The New Evolution Diet. The expert More cites as the one to consult for an introduction to Paleo-dieting is Loren Cordain, author of The Paleo Diet. The quote that open this section on the Paleolithic diet is by Dr. Ben Balzer, M.D., and is from the “Introduction” to Cordrain’s book. Need I say more?
End of Part 3
References
1. White E: Ministry of Healing: http://books.google.com/books/about/The_Ministry_of_Healing.html?id=2bu2ry223JAC: Kessinger Publishing, LLC; 1905.
2. Rucker C: The Seventh-Day Diet: A Practical Plan to Apply the Adventist Lifestyle to Live Longer, Healthier, and Slimmer in the 21st Century: Pacific Press Publishing Association 2002.
3. Mills PK, Beeson WL, Phillips RL, Fraser GE: Cancer incidence among California Seventh-Day Adventists, 1976-1982. Am J Clin Nutr 1994, 59(5 Suppl):1136S-1142S.
4. Kahn HA, Phillips RL, Snowdon DA, Choi W: Association between reported diet and all-cause mortality. Twenty-one-year follow-up on 27,530 adult Seventh-Day Adventists. Am J Epidemiol 1984, 119(5):775-787.
5. Grundmann E: Cancer morbidity and mortality in USA Mormons and Seventh-day Adventists. Arch Anat Cytol Pathol 1992, 40(2-3):73-78.
6. Zollinger TW, Phillips RL, Kuzma JW: Breast cancer survival rates among Seventh-day Adventists and non-Seventh-day Adventists. Am J Epidemiol 1984, 119(4):503-509.
7. Fraser GE: Diet as primordial prevention in Seventh-Day Adventists. Prev Med 1999, 29(6 Pt 2):S18-23.
8. Mills PK, Annegers JF, Phillips RL: Animal product consumption and subsequent fatal breast cancer risk among Seventh-day Adventists. Am J Epidemiol 1988, 127(3):440-453.
9. Mills PK, Beeson WL, Phillips RL, Fraser GE: Bladder cancer in a low risk population: results from the Adventist Health Study. Am J Epidemiol 1991, 133(3):230-239.
10. Phillips RL, Snowdon DA: Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists. J Natl Cancer Inst 1985, 74(2):307-317.
11. Fraser GE, Dysinger W, Best C, Chan R: Ischemic heart disease risk factors in middle-aged Seventh-day Adventist men and their neighbors. Am J Epidemiol 1987, 126(4):638-646.
12. Fraser GE, Lindsted KD, Beeson WL: Effect of risk factor values on lifetime risk of and age at first coronary event. The Adventist Health Study. Am J Epidemiol 1995, 142(7):746-758.
13. Fraser GE, Shavlik DJ: Risk factors for all-cause and coronary heart disease mortality in the oldest-old. The Adventist Health Study. Arch Intern Med 1997, 157(19):2249-2258.
14. Giem P, Beeson WL, Fraser GE: The incidence of dementia and intake of animal products: preliminary findings from the Adventist Health Study. Neuroepidemiology 1993, 12(1):28-36.
15. Fraser GE, Sabate J, Beeson WL, Strahan TM: A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med 1992, 152(7):1416-1424.
16. Fraser GE: Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr 1999, 70(3 Suppl):532S-538S.
17. Sabate J: Nut consumption, vegetarian diets, ischemic heart disease risk, and all-cause mortality: evidence from epidemiologic studies. Am J Clin Nutr 1999, 70(3 Suppl):500S-503S.
18. Willett W: Lessons from dietary studies in Adventists and questions for the future. Am J Clin Nutr 2003, 78(3 Suppl):539S-543S.
19. Phillips RL, Snowdon DA: Association of meat and coffee use with cancers of the large bowel, breast, and prostate among Seventh-Day Adventists: preliminary results. Cancer Res 1983, 43(5 Suppl):2403s-2408s.
20. Beck J, Beck, JJ, Jarnes, K.: Adventist Sabbath Dinner Cookbook: Pacific Press Publishing Association; 2001.
21. Council GCoS-dAN: The Seventh-day Adventist Position Statement on Vegetarian Diets: http://www.sdada.org/position.htm. In.; 2010.
22. Health LLUSoP: The Vegetarian Food Pyramid: http://www.vegetariannutrition.org/food-pyramid.pdf. In. Loma Linda: Loma Linda University; 2008.
23. Center S: History of Loma Linda Foods: http://www.soyinfocenter.com/HSS/loma_linda_foods.php. In. Lafayette: Soyinfo Center; 2004.
24. King G, Fitzhugh, EC, Bassett, DR Jr, McLaughlin, JE, Strath SJ, et al.: Relationship of leisure-time physical activity and occupational activity to the prevalence of obesity. Int J Obes Relat Metab Disord 2001, 25:606-612.
25. Ramey V: Time Spent in Home Production in the Twentieth-Century United States: New Estimates from Old Data :http://weber.ucsd.edu/~vramey/research/Home_Production_published.pdf. The Journal of Economic History 2009, 59(1).
26. Borodulin K, Laatikainen, T, Juolevi, A, Jousilahti, P. : Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults. Eur J Public Health 2008, 18(3):339-344.
27. Brownson R, Boehmer, TK, Luke, DA.: Declining rates of physical activity in the United States: what are the contributors. Annu Rev Public Health 2005, 26(421-43).
28. Census USBot: U.S. Bureau of the Census, Historical Statistics of the United States, Colonial Times to 1970. 1971.
29. Camarota S, Jensenius, K. : A Drought of Summer Jobs: Immigration and the Long-Term Decline in Employment Among U.S.-Born Teenagers: http://www.cis.org/articles/2010/teen-study.pdf. In: Backgrounder. Center for Immigration Studies; 2010.
30. Cutler D, Glaeser, EL, Shapiro, JM.: Why have americans become more obese? Journal of Economic Perspectives 2003 17(3):93-118.
31. National Heart LaBI: Morbidity & mortality: 1998 chartbook on cardiovascular, lung, and blood diseases. In. Edited by Health UDoHaHSNIo. Rockville, Maryland: US Government Printing Office; 1998.
32. Eaton S, Shostak, M, Konner, M.: The Paleolithic Prescription: A Program of Diet & Exercise and a Design for Living. New York:: Harper & Row; 1988.
33. Konner M, Eaton SB: Paleolithic nutrition: twenty-five years later. Nutr Clin Pract, 25(6):594-602.
34. Lindeberg S: [Paleolithic diet and evolution medicine: the key to diseases of the western world]. Lakartidningen 2005, 102(26-27):1976-1978.
35. O’Keefe J, Cordain L.: Cardiovascular Disease Resulting From a Diet and Lifestyle at Odds With Our Paleolithic Genome: How to Become a 21st-Century Hunter-Gatherer. Mayo Clin Proc 2004;, 79:101-108.
36. Cordain L, Eaton SB, Miller JB, Mann N, Hill K: The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr 2002, 56 Suppl 1:S42-52.
37. Marlowe F: Hunter-gatherers and human evolution. Evolutionary Anthropology 2005, 14:54 -67.
38. Froguel P, Boutin P: Genetics of pathways regulating body weight in the development of obesity in humans. Exp Biol Med (Maywood) 2001, 226(11):991-996.
39. Bennett PH, Burch TA, Miller M: Diabetes mellitus in American (Pima) Indians. Lancet 1971, 2(7716):125-128.
40. Bennett PH, Rushforth NB, Miller M, LeCompte PM: Epidemiologic studies of diabetes in the Pima Indians. Recent Prog Horm Res 1976, 32:333-376.
41. Zimmet P, Arblaster M, Thoma K: The effect of westernization on native populations. Studies on a Micronesian community with a high diabetes prevalence. Aust N Z J Med 1978, 8(2):141-146.
42. Ravussin E, Valencia ME, Esparza J, Bennett PH, Schulz LO: Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes Care 1994, 17(9):1067-1074.
43. Boyce VL, Swinburn BA: The traditional Pima Indian diet. Composition and adaptation for use in a dietary intervention study. Diabetes Care 1993, 16(1):369-371.
44. Malhotra A, Kobes S, Knowler WC, Baier LJ, Bogardus C, Hanson RL: A Genome-Wide Association Study of BMI in American Indians. Obesity (Silver Spring).
45. More M: The cryo-paelo solution: http://www.alcor.org/magazine/2011/03/07/the-cryo-paleo-solution/. Cryonics (on line edition) 2011.
46. Snyder S: Alcor CEO Max More and the paleo diet: http://samsnyder.com/2011/05/22/alcor-ceo-max-more-and-the-paleo-diet/. In: A Blog by Sam Snyder. Sam Snyder; 2011.
Figure 1: Ancel Keys (January 26, 1904 – November 20, 2004) was the American physiologist and epidemiology of cardiovascular disease (CVD). He was responsible for two famous diets: K-rations formulated as balanced meals with a long shelf life for combat soldiers in World War II and the Mediterranean (Cretan) diet. Keys is shown (at right, above) two months before his 101st birthday. 
Figure 2: The Cretan diet food pyramid.
However, the observations of Keys and Pritkin extended beyond a cause and effect relationship between cholesterol and CVD. In different ways, both men demonstrated that altering the total serum cholesterol level and/or the ratio between the LDL and high density lipoprotein (HDL) species, they could reduce the incidence of the disease. In Pritkin’s case, he even demonstrated that the disease could be reversed by the expedient of a very low fat diet.[78-80] Pritkin demonstrated his theory on a very small population of people; principally those who read his book, or otherwise followed his dietary advice. Keys, on the other hand, conducted an experiment on a grand scale.
Figure 6: The author has serious questions about whether experiments conducted using industrially prepared laboratory animal chows (right) are representative of the results obtained when fresh fruits and vegetable as well as foods consumed in their native state are used (left).
Figure 8: The major active product of the omega-6 fatty acids is arachadonic acid which is converted to the 2-series prostaglandins and 4-series leukotrienes by the action of cyclooxygenase. The 2-series prostaglandins are pro-inflammatory. In addition to the AA produced endogenously there are vast supplies available from the diet, most notably in meat, eggs and peanut oil. In the Western diet there are comparatively few products of omega-3 metabolism to moderate the pro-inflammatory action of excessive dietary omega-6consumption. If the amount of omega-3 fatty acids in the diet is increased, their metabolites (primarily EPA and DHA) compete with arachidonic acid for access to cyclooxygenase resulting increased production of anti-inflammatory mediators as well as a decrease in the pro-inflammatory mediators, thereby significantly reducing the ratio of pro-inflammatory to anti-inflammatory mediators. 
By Mike Darwin
Figure 1: In statistics, a 
Source: For data through 2002, the Congressional Research Service (CRS) compilation from National Center for Health Statistics (NCHS), United States Life Tables, 2002, National Vital Statistics Reports, vol. 53, no. 6, Nov. 10, 2004. For 2003, NCHS, Deaths: Final Data for 2003, National Vital Statistics Reports, vol. 54, no. 13, Apr. 19, 2006.
Figure 2: US life expectancy as a function of age (2008 data set).
Figure 3: Graphic presentation of the leading causes of mortality in the US as a percentage of all deaths.
Figure 4: Nathan Pritikin was the classic outsider to medicine. His background was not even that of an academic, but rather that of a successful inventor who made significant contributions to industrial processes in electronics. He was a consummate scientist: a keen observer with an eye for anomalies in the world around him who generated clever hypotheses, and then hammered them into theory using well designed experiments. He was roundly vilified by the medical and scientific communities of the 1970s thru the late 1980s. His theory, that reduction of total serum cholesterol to ~120 mg/dl, and in particular LDL cholesterol to ~<80 mg/dl, in combination with a program of weight reduction and modification of the diet to exclude simple carbohydrates, keep fat consumption to ~ 10% of calories and eliminate added salt is now widely accepted in a medicine. [2-15]
The Pritikin diet was, in fact, effective at dramatically reducing morbidity and mortality from CVD and type II diabetes.[2, 13, 14, 18-26] However, because the diet eschewed all fats and restricted the calorie intake in fats to 10-15% of the total calorie intake of the diet, with the emphasis on polyunsaturated fats. As previously noted, it proved almost impossible to persuade Alcor members to adopt the diet,[27] or even to embrace a modified version of it, wherein one day a week was a “diet free day,” during which the individual could eat proscribed foods ad lib, as he chose. Somewhat surprisingly, I am still in contact with all six of the surviving individuals who adopted the Pritikin diet between 1974 and 1985; the maximum period of compliance was 6 years, and none of these individuals is still on the diet. Three of these individuals have been treated for cancer, though I would hasten to add that I do not believe that in any of these cases the Pritikin diet was either causative or contributory.
Since the mid-1980s, a significant amount of evidence has accumulated indicating that the very low serum cholesterol levels required to effect the reversal of atherosclerosis can result in mood disorders leading to increased irritability, and even violence.[30-36] Studies of more modest reductions in dietary fat intake have not shown benefit in reducing morbidity and mortality from CVD or cancer, and there is the suggestion that mortality reductions resulting from decreases in CVD, hypertension, obesity and diabetes may be made up for by increases in the incidence cancer, suicide and homicide.[27, 31, 37] However, the bottom lines is that 30 years later, there is still no evidence indicating that the Pritikin diet reduces all-cause mortality, or that the non-compliance obstacle can be overcome. The absence of effect with moderate (i.e., less extreme) or so called “reduced fat” diets is especially discouraging, because it indicates the likelihood of an “almost all or none” effect with little or benefit obtained from partial compliance.[38-40] This is, in fact, the position that Nathan Pritikin took.[41]
By Mike Darwin
Religion offers both forgiveness and concrete ways that we can address these sources of moral ennui in our lives. It is also often a source of very real material and emotional support for those who find themselves down on their luck, sick, old or dying. A good religion takes care of its own and ensures that no member of the flock is turned out on the street to die a beggar. Finally, and perhaps most importantly, religion provides a narrative for peoples’ lives – a story that allows them to make some sense out of what appears to be an otherwise senseless existence,. It doesn’t matter if the narrative is scientifically valid, or if it is especially credible as long as it provides both hope and meaning. Closely related are the promises of an afterlife, not just for the individual, but for his family and community, as well.
Humans are story creatures. We can only understand our world on a daily working basis through narrative. A few of our species can use mathematics to understand the world, but even now there are no maths do not that not require some narrative to relate mathematical insights to the world we inhabit. Most of technology is a result of narrative processes, and the scientific method itself is the essence of a story, in that it has a beginning, a middle and an end: observation, experimentation, hypothesis, experimentation and theory. The scientific method is the (so far) ultimate refinement of the tool of narrative to give us a coherent, and in this case valid understanding of our world. We are also time-creatures, and the essence of a story is what happens over time. We, and the stories we tell, real or imagined, valid or invalid, are thus bound by and included in the Chronosphere.
The thing that killed far more people in the concentration camps of Hitler, Stalin, Mao and Pol Pot than starvation was hopelessness. Strip away hope and you will soon end life. Emily Dickinson may have been right when she said, “Hope is the thing with feathers that perches in the soul…” However, she was certainly wrong when she went on to say, “Yet, never, in extremity, It asked a crumb of me.” Hope requires lots of feeding and is does best when it is raised up on a diet of rational, responsible caring. Hope must be credible and its manifestations must be real and apparent. People seek meaning and succor in religion because they can both see and personally experience its benefits – not just in a promised afterlife, but here and now. One reason for the failure of cryonics organizations is that they are as cold and unfeeling as the stainless steel dewars and liquid nitrogen they employ in the only visible manifestation of their temporal work. Yes, there is some comfort in that, but you don’t even get to touch it until you’re “dead.”
While you are alive what you get from them is bills and yet more requests for money. You get a newsletter which is about as involved and caring for the narrative of your life, and your experience of it, as is an issue of Scientific American or Wired. In fact, it might be argued that those publications are more concerned with your interest and enjoyment of what is to come, because their articles involve you in the putative futures they discuss, if in no other way than asking questions and giving answers with the words “we” and “you” in them. “Will we discover that there are indeed countless universes…” or “So, someday you may well pull up to the pump and instead of filling your car with petrol, you’ll recharge your recharge your tank, which contains a matrix of complex metal hydride, with hydrogen…”
Figure 1: Supercentenarians in “extreme old age”: Jeane Calmette, 121; Ingeborg Mestad, 110; Walter Breuning, 114; Marie-Louise Meilleur, 117.
or…
Figure 3: The EBM pyramid made simple.
A good example of this with direct relevance to life extensionists is the saga of vitamin E in the treatment and prevention of atherosclerosis, and in particular, coronary artery disease.There are many animal experiments showing that vitamin E reduces or inhibits the development of atherosclerosis. Epidemiological studies in humans provided robust support to these data, since consumption of vitamin E in the diet was inversely associated with mortality from cardiovascular disease.[24, 25] And to the theoreticians and mechanists, there was the perhaps even more compelling fact that the free radical biochemistry implicated as being a primary factor underlying atherogenesis (oxidized low density lipoprotein (LDL)) is favorably impacted by the addition of vitamin E and similar chain breaking antioxidants to the diet in supraphysiological amounts.[26] The free radical theory of aging also supports the idea that vitamin E and other antioxidant molecules might reduce the incidence of degenerative disease, and perhaps retard aging. Further, in accordance with both theory and the animal data, administration of vitamin E to human volunteers reduced the level of lipid peroxidation, and in particular reduced the level of oxidized LDL.[27]
Figure 5:*NHS indicates Nurses’ Health Study; HPS, Health Professionals’ Follow-up Study; EPESE, Established Populations for Epidemiologic Studies of the Elderly; IWHS, Iowa Women’s Health Study; MI, myocardial infarction; and ellipses, none.
It is also usually the case that taking multiple drugs, or 
Ray Kurzweil with a portrait of his father.
“And as soon as I had recognized the taste of the piece of madeleine soaked in her decoction of lime-blossom which my aunt used to give me (although I did not yet know and must long postpone the discovery of why this memory made me so happy) immediately the old grey house upon the street, where her room was, rose up like a stage set to attach itself to the little pavilion opening on to the garden which had been built out behind it for my parents (the isolated segment which until that moment had been all that I could see); and with the house the town, from morning to night and in all weathers, the Square where I used to be sent before lunch, the streets along which I used to run errands, the country roads we took when it was fine.”
Actress Marilu Henner was featured on 60 Minutes because it’s a day she’ll never forget — just like every day in her life; pas, present and future.
Given the flashes of such recall most of us experience momentarily and erratically in our lives, this phenomenon begs the question: are all of us recording and storing such a broad bandwidth of information? Is it that we are not storing it, or that we cannot, and for good reason, access it with such fidelity at will? The individuals who possess this capability all describe it as burdensome and at times traumatic – memories come unbidden, constantly triggered by cues in the everyday world around them. And with some of those memories come searing emotions. If we need an evolutionary reason for the stoppering-up of such a prodigious memory in dark, amber bottles, to be dispensed only in needful draughts, these people are living examples.
Figure 2: The only way to beat the Devil is to outsmart him and out-bluff him – as well as have a little luck on your side.
Figure 3: Not all games are created equal and not all gaming venues offer the same odds. Good judgment and skill actually allow a few people to make a very good living playing poker.
Figure 4: The House Edge (HE), or vigorish, is the profit the casino makes by altering the odds in its favor. The HE varies from venue to venue and sometimes from time to time in the same venue. The HE is analogous to the “negatives” your cryonics organization brings to the table.
Figure 5: How many more would have survived if there had been 12, 24, or 48 hours to prepare instead of 2, before the Titanic sank? The odds of survival in a life or death situation are a result of the complex interplay between the time available, the physical resources, the human resources, the absence of panic and lastly, chance. 
Figure 6: We are gambling for our lives; the stakes couldn’t be any higher. Do you want to win, or lose?
Figure 1: The Alcors are the second, smaller and dimmer companion stars to Mizar, the bright stars that comprise the crook in the handle of the Big Dipper constellation. In the Arab world of the 5th Century CE, Mizar’s much less bright (and more difficult to see) companion stars, Alcor-A and Alcor-B were used as tests for good vision. Only someone with the clearest and most acute visions could see the Alcor’s. Alcor-B was discovered early in 2011 using Project 1640m, which makes use of the Hale Telescope’s adaptive optics system. Project 1640 gives the Hale a view almost equal to what is possible in space. The instrument also has the ability to block out the light of a star, allowing faint objects located next to a star to be seen. The Hale, armed with Project 1640, was pointed at Alcor earlier this year and found that it isn’t a single star. Alcor has a small stellar companion that hadn’t been seen before: Alcor-B, a small, dim red dwarf star about one fourth the mass of our Sun. To see Alcor-B you must have the superior vision that only mastery of the most sophisticated technology allows. Alcor-B is thus a test for the clearest and most acute vision – vision capable of seeing things as they really are – not just as they appear to be.
Figure 2: Alcor-B President, Gorton Carpenter, M.D., Ph.D.
Figure 3: The primary existential risks that cryonics patients and Alcor-B staff face in the coming years. Arguably, two of those risks, climate change and economic upheaval are beginning to unfold at present.
Figure 4: The map above shows the probable extent of the spread of a highly infectious communicable disease in the US. By day 87 virtually all populated areas of any size are infected. The inset curve shows the rate of transmission from the start of the infection until saturation is reached at day ~ 87. There is a window of ~ 30-50 days where reverse quarantine measures may be effective, providing that the infection has not already entered our colony from contact with Phoenix, or other large metropolises.
Figure 5: Two views of the Alcor-B Patient Care Bay during the interval from the mid-1990s (left) to the early 2000s (right).
Figure 6: The Alcor-B Patient Care Bay in 2009, shortly before the move to the Mobile, AZ Facility. (Photo by Murray Ballard.)
Figure 7: A contemporary view of the patient care area of the Cryonics Institute’s facility in Clinton Township, MI
Figure 8: At left above, two of the below ground silos that housed Bigfoot dewars at the facilities of CryoSpan, Inc., in Rancho Cucamonga. CryoSpan is no longer in operation.
Figure 9: The relative scales of a standard, immersion LN2 storage Bigfoot dewar, and the ECD-60 dome that now houses Alcor-B’s patients.
Figure 10: The subterranean complex that comprises the maximally hardened parts of the Alcor-B Mobile, AZ Facility. The ECD-60 Dome serves as the hub from which 11 modules radiate like spokes. There are 6 residential modules, a hospital/dental module, a laboratory module which houses an emergency cryopreservation capability, a diesel fuel storage tank, a diesel powered electricity generating plant and a greenhouse which is used for storage of supplies until the facility becomes active in an emergency. The Patient Care Area is the in part of the ECD-60 that adjoins the clinical and technical spokes of the facility. The remainder of the ECD-60 houses the communications and defense center and is used for storage, communal dining and meeting spaces.
Figure 11: At right above, two men from the construction crew stand atop the ECD-60 shortly before the earth backfill was completed. At left above is the Patient Care Area of the facility as it appears today.
Figure 14: Specifications and interior layout of the CAT-12 Residential Module.
Figure 15: In the event of a prolonged existential crisis the current emergency survival plan calls for conversion of all whole body patients to neuro so that everyone can be cared for within 1 or 2 ITS Bigfoot units.
Figure 16: The CryoMech LNP-40 liquid nitrogen (LN2) plant.
Figure 17: Specifications of the CryoMech LN2 plant.
Figure 18: The elements which comprise the LNP-40 LN2 plant: molecular sieve membranes (upper left), air compressor which supplies air to nitrogen sieving membranes (middle right), LN2 collection and discharge dewar (center) and the Joule-Thompson nitrogen liquefier (lower left).
Figure 19: Additional specifications of the CryoMech LNP-40.
Figure 20: The key elements (and their cost) of Mobile Facility’s solar power system. 
Figure 21: Supercapacitors of the kind used to store solar-generated electricity in the Alcor-B Facility to meet the “surge demand” of starting motors.
Figure 22: The cost breakdown and key elements of the patient care essential portions of the Alcor-B Mobile, AZ Facility (2010 US dollars).
Figure 3: In the closing days of 2012the percentage of Americans receiving Federal Food Stamp assistance reached 16.25% of the population, up from 14.2% in June of 2011.[2] The continued deterioration of the US and the global economy coupled with major agricultural failures in the US as a result of drought and record summer heat throughout most of the nation are the factors most immediately responsible for this situation.
Figure 4: The US median household income has been flat or in decline since 1999. Since 2007 the decline has been precipitous and sustained and this is consistent not with an economic recession, but rather with an economic depression. 
Figure 5: Debt as a percentage of personal disposable (i.e., non-confiscated) income.
Figure 6: Personal savings as a percentage of disposable income from 1985 to 2005.
Figure 7: The incredible disconnect between price, earnings, dividends and probable real value of shares; and of economic wealth as a whole. Data analysis and projection by TRP.
Figure 8: Purchasing power of the US dollar from 1900 to 2000.
Figure 9: The US National debt as of 2010, the last year that the TRP econometricians were certain that valid data was being released by the US Treasury Department.
Figure 10: The analogy of cryonics as a bridge to the future, our future, implies that we must both build with enough safety factor to prevent collapse and anticipate existential crises that pose a genuine threat to its workability
Figure 11: Culicidae: Dipter in Dominican amber ~40 million years old.[3]
Figure 12: Buthidae: Scorpiones In Dominican Amber ~25-40 million years old.[3]
Figure 13: Cypress Plant Cell Ultra-structure: Baltic Amber ~45 million years old: 
Figure 14: A corrosion cast of the circulatory system of the human brain. The extensive vascularization of the brain allows for use of the circulatory system as both a mass and heat exchanger. Gas perfusion of the circulatory system prior to cooling to vitrification temperatures leave it accessible during cryogenic storage should fixation and plastination become necessary as a fallback position to cryopreservation.
Figure 15: The head of a fresh (~1.5 hrs post-mortem) human cadaver subjected to vitrification and then deep subzero fixation and plastination with Epon epoxy resin using the FFPS. Accelerated aging tests show both ultrastructural and molecular stability in the range of 1.5 to 2.0 million years.
Figure 16: The Final Fallback Position System (FFPS) for the automated processing of cryopatient cephalons from the deep subzero state, to ambient temperature fixation and solidification (plastination).