March 2009 Issue

The Jungle Effect: Book Unlocks the Power of Indigenous Diets
By Sharon Palmer, RD
Today’s Dietitian
Vol. 11 No.3  P. 38

Daphne Miller, MD, set out on a nutritional adventure around the globe to understand why some indigenous populations live healthier lives. Along the way she made some astonishing discoveries, which she published in The Jungle Effect

Daphne Miller, MD, is one of those doctors whom dietitians flat-out adore. Fit and enthusiastic, she has a passion for food, nutrition, and keeping her patients healthy through lifestyle. “As a family physician, a lot of the work that I do day in and day out is helping people to make positive lifestyle changes. There is a lot of focus on changing diet and exercising,” says Miller, who maintains a private practice as a family physician in San Francisco and is an associate professor at the University of California, San Francisco, where she teaches nutrition and integrative medicine.

“Ironically, I wasn’t trained to do this in my medical education. As a professional, I started to get more training in nutrition and to bring it into my medical practice,” says Miller. “There is a real disconnect for people. It is difficult to distill the information and apply it in order to make lifelong changes. There’s this diet and that diet out there, but it’s difficult for people to sustain weight loss and decreases in blood lipids, blood pressure, and blood sugar.”

It was this challenge of helping her patients find long-lasting success with a healthy lifestyle that prompted Miller to explore new vistas in food and nutrition and share her story with others.

Inspirational Angela
Miller’s inspiration for her nutritional journey came when Angela walked through the door of her San Francisco medical office. Angela was born in Rio de Janeiro, Brazil, to a mother of Italian descent and a father whose ancestors were Maués Indians. Her mother liked to cook heavy meals, and Angela recalled being overweight and tired as far back as she could remember. When she was 8, Angela’s parents separated, and she went to live with her father’s relatives in the rainforest, where she played and ate fish soup, taro, beans, and fruit. She lost weight and felt good. But when Angela returned to Rio, her weight and lack of energy also returned.

After high school, Angela moved to New York, where she continued to gain weight and feel fatigued. By the time she moved to San Francisco in her 30s and made an appointment with Miller, Angela had suffered through many weight loss diets and doctor consults, yet she was overweight and borderline hypertensive and had pain in her knees.

Six months later, Miller found herself volunteering in a small Peruvian village in the Amazonian basin. By coincidence, this village was located less than two days’ slow boat ride west of Angela’s family home in the rainforest. “As I was volunteering in the village, I noticed that the elderly weren’t getting the chronic diseases that I saw in the U.S., such as hypertension and diabetes. I collected the recipes and saw that food was a significant factor,” says Miller. “These foods evolved together. The recipes and ingredients were a key factor. They tasted wonderful and kept people healthy. It’s survival of the fittest; throughout evolution, the fittest diets have kept people the healthiest.”

Miller collected some of the traditional recipes and passed them on to Angela, who started eating her childhood “jungle diet” and enjoyed weight loss and renewed vitality. Miller had a breakthrough: Perhaps these indigenous diets had something to teach people about health. “In general, the places that have intact indigenous diets have healthier people. I began to sort through the literature, picking out places around the world with what I call ‘cold spots’—places with low rates of chronic diseases. I focused on colon and breast cancer, cardiovascular disease, and depression,” she says. The concept for her book The Jungle Effect was born.

A Nutritional Adventure
Miller’s book is not your everyday nutrition read. The author didn’t conduct all of her research for the book from her cozy office in San Francisco. She traveled to cold spots around the world—canyons, deserts, islands, frozen lands, and jungles—to learn more about how indigenous diets affect health.

The Jungle Effect brims with real-life stories that come all the way from Miller’s waiting room in San Francisco to villages around the world. She gathers the everyday problems her patients experience, such as prediabetes and obesity, and crosses the globe to explore cold spots where these problems occur far less often. Miller then takes readers to local villagers’ kitchens, farms, hillsides, and tables to sample their indigenous food culture. From picking wild greens on the hillsides of Crete to exploring a Copper Canyon antidiabetic home garden, Miller delivers nutritional nuggets in a shimmer of travel and adventure. 

Two big players in the food and nutrition world have warmly received The Jungle Effect. Michael Pollan, author of The Omnivore’s Dilemma and In Defense of Food, says in a review on Miller’s Web site, “In this bracingly hopeful and eminently practical book, Daphne Miller shows us how we can bring the wisdom of traditional diets to our own plates in the interest of both our health and our pleasure. The Jungle Effect is a fascinating, useful, and important book.” Nutrition expert and author Andrew Weil, MD, wrote the forward to Miller’s book, noting, “This is a groundbreaking book, based on original research, that describes novel dietary strategies for reversing the progression of chronic diseases and maintaining optimum health. Moreover, the dietary wisdom that Daphne Miller presents is fully consistent with the findings of cutting-edge nutritional science.”

The Power of Indigenous Diets
It’s no surprise that populations migrating to the United States find themselves mired in nutritionally related chronic diseases, including obesity, diabetes, heart disease, and cancer. Dietitians see this in their practices every day. In her book, Miller explores the “migration effect,” as well as the effects of modernization on populations that have never left their small villages. She traces “authentic” recipes to see how they have changed over generations. For instance, Miller takes a look at her own Ukrainian grandmother’s recipe for borscht, which was made with canned sweetened beets, generous amounts of sour cream, and store-bought chicken broth. But in her grandmother’s hometown of Chodorov, borscht was prepared using fresh grated beets, light chicken stock, salt, pepper, and a dollop of yogurt or clotted cream. The effects of modernization can be seen in indigenous diets around the world.

How did these cold spots develop indigenous diets that are formulas for health? It’s not as if their early ancestors understood how to highlight nutrition superstars such as fiber, omega-3 fatty acids, monounsaturated fats, and antioxidants. Throughout history, our ancestors relied on internal guides to determine which foods nourished them; thus, they slowly developed an indigenous cuisine. They passed down the knowledge about which plants made them healthy, how to cultivate foods, food-related customs and rituals, and which foods were appealing. The sources of their foods were local, natural, and unprocessed. Animals were fed on open pastureland and used sparingly with nothing left to waste. And there you have the power of indigenous diets.

This is a far cry from the way people eat today in Western societies, as they become influenced by media, experience a lack of food traditions and rituals, and feast on a surplus of modern, processed foods. Refined foods are often filled with sugars, salts, and artificial ingredients. Meat supplies can come from animals raised in pens, fed manufactured feeds, injected with antibiotics, and given hormones. Vegetable oils are extracted, thanks to modern technology, resulting in an abundant supply of cheap oil that has upset our omega-6 to omega-3 fatty acid balance.

Miller believes there are valuable lessons to be learned from the cold spots she travels to in The Jungle Effect. Along her journey, she shares a collection of observations, tips, and research highlights that can easily impact Americans’ way of eating, no matter where they live. Miller also includes a collection of indigenous recipes to introduce the flavors of cold spots from Copper Canyon, Crete, Iceland, Cameroon, and Okinawa.

Copper Canyon
The first destination readers take with Miller is to Copper Canyon, Mexico, one of the most geographically inaccessible locations on her journey. Miller considered Copper Canyon because of her pursuit to understand the type 2 diabetes epidemic, which is dramatically affecting Latinos, Asian Americans, Native Americans, and African Americans. Remarkably, Copper Canyon, home to more than 50,000 Tarahumara Indians living in remote communities deep within the canyons, is a cold spot for diabetes. “The Tarahumara Indians of Copper Canyon are also called the Mexican Pima. They are blood relatives of the Pima Indians of Arizona. The Tarahumara have some of the lowest rates of diabetes compared with the [Arizona] Pima, [who have] some of the highest rates of diabetes in the world,” Miller explains.

In the kitchens and farms of Copper Canyon, Miller discovered a bounty of local foods: corn, beans, squash, eggs, chicken, chiles, herbs, spices, nuts, berries, wild greens, cactus, seeds, oranges, tomatoes, avocados, and occasional wild game or fish.

“I was surprised to find that the Tarahumara are eating a high-carb diet,” says Miller. “But the type of carbohydrates are unrefined, such as their hand-ground tortillas, beans, and squash. It turns out that when these foods are combined, a lot of healthy interactions occur. For example, the glycemic index of the corn is actually reduced to match that of the beans. The Tarahumaran diet also includes healing spices and other plant foods that have been shown to lower blood sugars. Nopal cactus, for example, has a substance that acts just like glucophage, a diabetes medicine. Research has shown that over 300 plants that grow in Mexico have blood sugar-lowering effects. When I read about this research, I had a real epiphany. Not only are Latinos who move to the States suddenly being overwhelmed by highly processed, modified foods, they are also losing their traditional food medicine. Could this at least partly explain why the rates of diabetes are so high in the U.S. Latino population? We haven’t even begun to understand about the pharmacological impact of these protective foods.”

On the island of Crete, Miller began her search for the foods that protect against heart disease. The heart-protective qualities of the Mediterranean diet have been well documented since Ancel Keys began his landmark Seven Countries Study in 1958. In Crete, Miller toured an olive farm, hunted for horta (wild greens), sampled whole grain rusks, sipped grape must, and came to an interesting conclusion at the end of her sojourn.

“I was looking for key healing foods,” she says. “Many local people gave me their opinion about this, but it seemed to be biased, depending on their interests and profession. Some said it was the olive oil, another said it was the fresh vegetables, another said it was the grape must, another said it was the whole grains, and another said it was the fish. The truth is that the research can’t identify one specific food; it looks like it’s the whole diet and the way the foods are prepared. It’s the actual recipes that are eaten day in and out over the years. People have modified fasts, they eat slowly, use little plates, eat rich foods sparingly, and eat seasonally. It is the food combinations and the way people are eating rather than one specific ingredient. We’re always trying to reduce things, but reductionism does not necessarily help us understand the nutritional benefits of certain foods.”

Miller’s travels took her to Iceland for a surprising reason: This cold island nation is a depression cold spot. Once in Iceland, she mingled with fish farmers and sheep; sampled wild game, fresh milk, and wild berries; and found very few vegetables for the eating.

Miller says, “In Iceland, there are disproportionately low rates of seasonal affective disorder, depression, bipolar disorder, and postpartum depression. When you consider its northern location, this is remarkable. They eat more fish per capita than anywhere in the world. Even Icelanders [who] don’t eat fish have very high omega-3 fatty acid levels. Whatever they eat, even lamb, has high omega-3 fatty acid levels. The lamb eat the tundra grass, which is high in ALA [alpha-linolenic acid], which converts into EPA. Even the wild berries are high in ALA, and the milk is high in omega-3 fatty acids. They are literally bathing in omega-3 fatty acids by eating wild foods. They have a great source of nutrients, and not just through fish.

“What’s surprising is how little of what we consider vegetables are eaten there,” she continues. “In fact, many Icelanders I talked to said they were vegetable haters. The truth is that greens and many vegetables cannot grow on the island. But they are able to get their antioxidants through surprising ways, like waxy potatoes, cabbage, and wild berries. I suppose they could import more greens, but they prefer their traditional foods. There is a feeling that this is what we do and we keep healthy.”

Cameroon, where Miller once worked as a community health trainer, surfaced as a cold spot for colon cancer. In the tiny village of Ntui, she encountered a complex, delicious indigenous cuisine of stews flavored with vegetables, legumes, grains, peanuts, and spices. Wild game meats are used sparingly, and fermented foods such as sour milk, relishes, pickled meats, and fermented grains are plentiful. Wild foraged greens and fats made from whole foods are a common feature in the diet.

“In Cameroon, there are low rates of colon disease in general and colon cancer. We tend to focus on fiber as an important player in preventing these diseases. But in Cameroon, the traditional diet suggests that there are also other important factors at play. For example, they use meat as a spice, and their diet is rich in antioxidants through the leafy greens in their diets. They use small amounts of unrefined oils, which are made through rudimentary pressing techniques. Lots of their foods are fermented and are rich in probiotics. There is research looking at the importance of probiotics in colon disease,” says Miller.

The last leg of Miller’s journey was Okinawa, Japan, a cold spot for breast and prostate cancers. She met beautifully preserved older Okinawans and delved into markets with a rainbow of colorful fruits and vegetables such as yams, squash, cabbages, greens, papayas, and melons. Miller observed that people drink three cups of green tea per day. A variety of sea vegetables, fish, and soy foods are staples. And surprisingly, pork is popular. 

“In Okinawa, the elderly population has surprisingly low breast and prostate cancer rates,” she says. “They don’t even do mammograms in older women there. When you walk through the markets, you see so many foods likely to help maintain a healthy glandular system, such as seaweed and soy. There is a soy controversy in the U.S. over whether it causes cancer, but in Okinawa, they were eating a lot of real soy in the unrefined form, like edamame. Tofu was the most refined soy I saw there. There is a link between more refined soy products and cancer promotion, while eating the whole soy is likely to have a cancer-blocking effect.”

She continues: “It was also fascinating to see how pig is revered in that culture. Pork is in all meals, but they use just a little bit as flavor. The pigs are fed wild yam, so they’ve eaten healthfully. These free-range pigs have a healthier fat composition with higher omega-3 fatty acid content.”

Nutrition Lessons at the End of the Journey
Once readers have weaved their way through The Jungle Effect, it’s easy to ponder the question, “Where do I get started?” Miller sums it up: “It comes down to the same issues that everyone is focusing on these days—food that is fresh, local. I think it is also important to use recipes that have evolved over time in a culture. I believe these recipes offer us a lot of wisdom about the optimal way to combine foods to get the most delicious taste and the greatest nutritional benefit. The most important thing to realize is that it is hard to be healthy and not cook. Take up the pots and pans and cook; it doesn’t take a lot of equipment or a fancy kitchen. I saw people preparing meals around the world in kitchens most Americans would consider substandard. We need to start to learn to make our own food. We need more nourishment, celebration, mindfulness, recipes, and rituals. We need to nourish ourselves, using foods that were traditional to our ancestors.”

— Sharon Palmer, RD, is a contributing editor at Today’s Dietitian and a freelance food and nutrition writer in southern California.

Indigenous Diet Key Components
• Foods that are local, fresh, and in season

• Food cultivation techniques and recipes passed down through the ages

• Food traditions: communal eating, eating for satiety rather than fullness, observation of fasts and other food rituals

• Sugar that comes from whole foods such as honey, fruits, vegetables, and whole grains

• Salt that comes from natural unprocessed sources such as fish, sea greens, and vegetables

• Naturally raised meat and dairy as a precious commodity: meat and dairy in small quantities to complement vegetables, whole grains, and legumes; organ meats and whey used in cooking; and liberal use of proteins from nonmeat sources such as nuts, legumes, and whole grains

• Nonmeat fats from whole nuts, seeds, grains, and fatty fruits, minimally processed oils such as olive, palm fruit, or coconut oil

• Fermented and pickled foods

• Healing spices

—Reprinted with permission from The Jungle Effect