Friday, January 30, 2009

Couchsurfing the movie

Here it is: a promo by Couchsurfing founder Casey Fenton and sidekick to introduce 'Couchsurfing: the movie'.

Watch and learn, people. And prepare to cringe.

It's essentially a shout-out ahead of a documentary they're planning. They are looking for three Couchsurfers with "inspiring missions". Candidates are being asked to send in a short video message and, if Couchsurfing HQ likes what they see, they'll pick up the tab for your dream trip (or the production company they're teaming with, or one of their partners, will.)

Great opportunity, eh? Except they've made it sound like the most bog-standard travel comp in history. "My inspiring mission? I totally wanna go to the Amazon, and, like, meet local tribes and stuff."

Hopefully, the finished product will be a different story and have a very different style. Otherwise we could be in for two hours of "hilarious" (ahem) tongue-in-cheek comedy, followed by you-had-to-be-there outtakes.

It seems the site with details for video applications,, is currently down.

Which makes me wonder is this sequence supposed to be on the internet at all, or has it leaked? Did they really want to show this to the world?

Thursday, January 29, 2009

Secret suppers: where to dine with locals worldwide

What could make you feel more at home when travelling than an invite to dine at someone's house? It sure beats a restaurant for making an experience relaxed and personal.

But how do you go about getting such invites? Is the only option to make unsubtle hints to people you've just met in a bar or metro queue? ("Mmm, I just love homecooking. Sigh, I sure miss it. If only I found someone who...").

Well, before you resort to such desperate measures, read on. There are plenty of people round the world willing to have you round for dinner. You just need to know where to find them.

Call them in-home restaurants, secret supper clubs, salon dinners, or whatever you wish: they've been going for years and the internet is making them easier to track down than ever.

Personally, I love the idea. I've tried two so far: Casa Saltshaker in Buenos Aires and Jim Hayne's Sunday Dinners in Paris (which I wrote about in the Guardian last Saturday). I've also visited La Cocina Discreta in Buenos Aires, although I have yet to put their food to the test.

The set-up varies from home to home. They might resemble an intimate restaurant, a dinner party, a buffet at an informal get-together
, or an arts club with music and poetry. Typically there's a fee involve, but it's often reasonable.

So apart from a good feed, what do you get? A peak around a local house (within reason - noses out of the medicine cupboard), a sociable evening out (rather than just dining with your same old husband/wife/mate - yawn), the chance to hang with some locals (cue lots of insider tips for the rest of your stay), and maybe some new friends (further dinner invites if you're very lucky).

And the hosts? For them, it's a great way to meet people, share a passion for food/life/travel, and maybe even earn some extra cash. Tips on starting your own: here.

I've been doing some research and have uncovered lots great in-house restaurants around the world. I've also been corresponding with some of the people running them, who, by nature of what they do, are always interesting characters with stories to tell. I'm now longing to meet Jessica Buck who runs the arty Portland dinner club, D'Merde, which she describes as
"a toast to the spirit of Parisian Salons in the early 1900". [Website seems to be down, but stay tuned.]

So, it was during the course of this research that I had a brainwave: "I know! I'll compile all the ones I've found into a handy blog. What a great resource!"

So, I ploughed on, finished it (below), and then came across a version by Dan Perlman of Casa Saltshaker that is far, far better and makes mine look rather pitiful. Bah. (Just kidding - everyone should check it out, and his ever-interesting blog.)

Anyway, here's my little list nonetheless.
You never know there may be a few different ones on here. The London one is very new (a tip-off from my editor at the Guardian).

Paris, France, 1: (Sunday night)
Paris, France, 2: (Saturday night)
Paris, France, 3: (Sunday night)
London, UK:
The Secret Ingredient
Dusseldorf, Germany: Sunday Dinner Parties
Portland, Oregon, US:
Buenos Aires, 1: Casa Saltshaker
Buenos Aires, 2: La Cocina Discreta



And here's a link of world's best dining clubs that various Aussie papers nicked from Travel+Leisure magazine via Reuters last month. Rather unhelpfully, they include no contact details whatsoever. I guess the reader is just expected to Google around until they find them.

Tuesday, January 27, 2009

Vitamin K2 and Cranial Development

One of the things Dr. Weston Price noticed about healthy traditional cultures worldwide is their characteristically broad faces, broad dental arches and wide nostrils. Due to the breadth of their dental arches, they invariably had straight teeth and enough room for wisdom teeth. As soon as these same groups adopted white flour and sugar, the next generation to be born grew up with narrow faces, narrow dental arches, crowded teeth, pinched nostrils and a characteristic underdevelopment of the middle third of the face.

Here's an excerpt from Nutrition and Physical Degeneration, about traditional and modernized Swiss groups. Keep in mind these are Europeans we're talking about (although he found the same thing in all the races he studied):

The reader will scarcely believe it possible that such marked differences in facial form, in the shape of the dental arches, and in the health condition of the teeth as are to be noted when passing from the highly modernized lower valleys and plains country in Switzerland to the isolated high valleys can exist. Fig. 3 shows four girls with typically broad dental arches and regular arrangement of the teeth. They have been born and raised in the Loetschental Valley or other isolated valleys of Switzerland which provide the excellent nutrition that we have been reviewing.
Another change that is seen in passing from the isolated groups with their more nearly normal facial developments, to the groups of the lower valleys, is the marked irregularity of the teeth with narrowing of the arches and other facial features... While in the isolated groups not a single case of a typical mouth breather was found, many were seen among the children of the lower-plains group. The children studied were from ten to sixteen years of age.
Price attributed this physical change to a lack of minerals and the fat-soluble vitamins necessary to make good use of them: vitamin A, vitamin D and what he called "activator X"-- now known to be vitamin K2 MK-4. The healthy cultures he studied all had an adequate source of vitamin K2, but many ate very little K1 (which comes mostly from vegetables). Inhabitants of the Loetschental valley ate green vegetables only in summer, due to the valley's harsh climate. The rest of the year, the diet was limited chiefly to whole grain sourdough rye bread and pastured dairy products.

The dietary transitions Price observed were typically from mineral- and vitamin-rich whole foods to refined modern foods, predominantly white flour and sugar. The villagers of the Loetschental valley obtained their fat-soluble vitamins from pastured dairy, which is particularly rich in vitamin K2 MK-4.

In a modern society like the U.S., most people exhibit signs of poor cranial development. How many people do you know with perfectly straight teeth who never required braces? How many people do you know whose wisdom teeth erupted normally?

The archaeological record shows that our hunter-gatherer ancestors generally didn't have crooked teeth. Humans evolved to have dental arches in proportion to their tooth size, like all animals. Take a look at these chompers. That skull is from an archaeological site in the Sahara desert that predates agriculture in the region. Those beautiful teeth are typical of paleolithic humans and modern hunter-gatherers. Crooked teeth and impacted wisdom teeth are only as old as agriculture. However, Price found that with care, certain traditional cultures were able to build well-formed skulls on an agricultural diet.

So was Price on to something, or was he just cherry picking individuals that supported his hypothesis? It turns out there's a developmental syndrome in the literature that might shed some light on this. It's called Binder's syndrome. Here's a description from a review paper about Binder's syndrome (emphasis mine):

The essential features of maxillo-nasal dysplasia were initially described by Noyes in 1939, although it was Binder who first defined it as a distinct clinical syndrome. He reported on three cases and recorded six specific characteristics:5
  • Arhinoid face.
  • Abnormal position of nasal bones.
  • Inter-maxillary hypoplasia with associated malocclusion.
  • Reduced or absent anterior nasal spine.
  • Atrophy of nasal mucosa.
  • Absence of frontal sinus (not obligatory).
Individuals with Binder's syndrome have a characteristic appearance that is easily recognizable.6 The mid-face profile is hypoplastic, the nose is flattened, the upper lip is convex with a broad philtrum, the nostrils are typically crescent or semi-lunar in shape due to the short collumela, and a deep fold or fossa occurs between the upper lip and the nose, resulting in an acute nasolabial angle.
Allow me to translate: in Binder's patients, the middle third of the face is underdeveloped, they have narrow dental arches and crowded teeth, small nostrils and abnormally small sinuses (sometimes resulting in mouth breathing). Sound familiar? So what causes Binder's syndrome? I'll give you a hint: it can be caused by prenatal exposure to warfarin (coumadin).

Warfarin is rat poison. It kills rats by causing them to lose their ability to form blood clots, resulting in massive hemmorhage. It does this by depleting vitamin K, which is necessary for the proper functioning of blood clotting factors. It's used (in small doses) in humans to thin the blood as a treatment for abnormal blood clots. As it turns out, Binder's syndrome can be caused by
a number of things that interfere with vitamin K metabolism. The sensitive period for humans is the first trimester. I think we're getting warmer...

Another name for Binder's syndrome is "warfarin embryopathy". There happens to be
a rat model of it. Dr. Bill Webster's group at the University of Sydney injected rats daily with warfarin for up to 12 weeks, beginning on the day they were born (rats have a different developmental timeline than humans). They also administered large doses of vitamin K1 along with it. This is to ensure the rats continue to clot normally, rather than hemorrhaging. Another notable property of warfarin that I've mentioned before is its ability to inhibit the conversion of vitamin K1 to vitamin K2 MK-4. Here's what they had to say about the rats:

The warfarin-treated rats developed a marked maxillonasal hypoplasia associated with a 11-13% reduction in the length of the nasal bones compared with controls... It is proposed that (1) the facial features of the human warfarin embryopathy are caused by reduced growth of the embryonic nasal septum, and (2) the septal growth retardation occurs because the warfarin-induced extrahepatic vitamin K deficiency prevents the normal formation of the vitamin K-dependent matrix gla protein in the embryo.
"Maxillonasal hypoplasia" means underdevelopment of the jaws and nasal region. Proper development of this region requires fully active matrix gla protein (MGP), which I've written about before in the context of vascular calcification. MGP requires vitamin K to activate it, and it seems to prefer K2 MK-4 to K1, at least in the vasculature. Administering K2 MK-4 along with warfarin prevents warfarin's ability to cause arterial calcification (thought to be an MGP-dependent mechanism), whereas administering K1 does not.
Here are a few quotes from a review paper by Dr. Webster's group. I have to post the whole abstract because it's a gem:

The normal vitamin K status of the human embryo appears to be close to deficiency [I would argue in most cases the embryo is actually deficient, as are most adults in industrial societies]. Maternal dietary deficiency or use of a number of therapeutic drugs during pregnancy, may result in frank vitamin K deficiency in the embryo. First trimester deficiency results in maxillonasal hypoplasia in the neonate with subsequent facial and orthodontic implications. A rat model of the vitamin K deficiency embryopathy shows that the facial dysmorphology is preceded by uncontrolled calcification in the normally uncalcified nasal septal cartilage, and decreased longitudinal growth of the cartilage, resulting in maxillonasal hypoplasia. The developing septal cartilage is normally rich in the vitamin K-dependent protein matrix gla protein (MGP). It is proposed that functional MGP is necessary to maintain growing cartilage in a non-calcified state. Developing teeth contain both MGP and a second vitamin K-dependent protein, bone gla protein (BGP). It has been postulated that these proteins have a functional role in tooth mineralization. As yet this function has not been established and abnormalities in tooth formation have not been observed under conditions where BGP and MGP should be formed in a non-functional form.
Could vitamin K insufficiency be related to underdeveloped facial structure in industrialized cultures?  Price felt that to ensure the proper development of their children, mothers should eat a diet rich in fat-soluble vitamins both before and during pregnancy. This makes sense in light of what we now know. There is a pool of vitamin K2 MK-4 in the organs that turns over very slowly, in addition to a pool in the blood that turns over rapidly. Entering pregnancy with a full store means a greater chance of having enough of the vitamin for the growing fetus. Healthy traditional cultures often fed special foods rich in fat-soluble vitamins to women of childbearing age and expectant mothers, thus ensuring beautiful and robust progeny.

Slumdogging it: will a movie boost India's 'slum tourism'?

Will Oscar-tipped Slumdog Millionaire see a rush of tourists on Mumbai's shantytowns? That's what the Telegraph has predicted. It seems this could be the City-of-God-versus-the-favela-tour controversy all over again.

The subject was picked up today on Vagablogging. "I've never really understood how movies inspire people to travel," writes the author. Really? Big sweeping movie images of a foreign land just don't do it for you?

A Vagablogging reader adds: "It’s easy to judge a 'poverty tour' without actually experiencing one but ironically slum tours can be very educational and may be the very way to start change."

I'm not sure about the irony, but other than that, I agree. I've touched on this subject before with Harlem "ghetto" tours and I'm sure I will again.

Tourists here in Buenos Aires could confine their entire visit to the trendy neighbourhood of Palermo and think Argentina is the land of milk and honey (with lattes, wine and steak thrown in too). Many will never see the shanty towns here, which unlike Brazil, are kept more hidden away.

I visited one - the notorious Villa 31 - on a previous stay, not on a tour but with a friend. She was a local headmistress, who was looking to set up a teaching programme there and get some volunteers from overseas to help out. I can't see that this is a bad thing. I'm meeting up with her again in the next couple of weeks and will report back on how she got on...

Sunday, January 25, 2009

The Tokelau Island Migrant Study: The Final Word

Over the course of the last month, I've outlined some of the major findings of the Tokelau Island Migrant study. It's one of the most comprehensive studies I've found of a traditional culture transitioning to a modern diet and lifestyle. It traces the health of the inhabitants of the Pacific island Tokelau over time, as well as the health of Tokelauan migrants to New Zealand.

Unfortunately, the study began after the introduction of modern foods. We will never know for sure what Tokelauan health was like when their diet was completely traditional. To get some idea, we have to look at other traditional Pacific islanders such as the Kitavans.

What we can say is that an increase in the consumption of modern foods on Tokelau, chiefly white wheat flour and refined sugar, correlated with an increase in several non-communicable disorders, including overweight, diabetes and severe tooth decay. Further modernization as Tokelauans migrated to New Zealand corresponded with an increase in nearly every disorder measured, including heart disease, weight gain, diabetes, asthma and gout. These are all "diseases of civilization", which are not observed in hunter-gatherers and certain non-industrial populations throughout the world.

One of the most interesting things about Tokelauans is their extreme saturated fat intake, 40- 50% of calories. That's more than any other population I'm aware of. Yet Tokelauans appear to have a low incidence of heart attacks, lower than their New Zealand- dwelling relatives who eat half as much saturated fat. This should not be buried in the scientific literature; it should be common knowledge.

Overall, I believe the Tokelau Island Migrant study (among others) shows us that partially replacing nourishing traditional foods with modern foods such as processed wheat and sugar, is enough to cause a broad range of disorders not seen in hunter-gatherers but typical of modern societies. Changes in lifestyle between Tokelau and New Zealand may have also played a role.
The Tokelau Island Migrant Study: Background and Overview
The Tokelau Island Migrant Study: Dental Health
The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health
The Tokelau Island Migrant Study: Weight Gain
The Tokelau Island Migrant Study: Diabetes
The Tokelau Island Migrant Study: Asthma

Saturday, January 24, 2009

The Tokelau Island Migrant Study: Gout

Gout is a disorder in which uric acid crystals form in the joints, causing intense pain. The body forms uric acid as a by-product of purine metabolism. Purines are a building block of DNA, among other things. Uric acid is normally excreted into the urine, hence the name.

On Tokelau between 1971 and 1982, gout prevalence fell slightly. In migrants to New Zealand, gout prevalence began at the same level as on Tokelau but increased rapidly over the same time period. Here are the prevalence data for men, from Migration and Health in a Small Society: the Case of Tokelau (I don't have data for women):

This paper found that the age-standardized risk of developing gout was 9 times higher in New Zealand than on Tokelau for men, and 2.7 times higher for women.

The Tokelau Island Migrant Study: Background and Overview
The Tokelau Island Migrant Study: Dental Health
The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health
The Tokelau Island Migrant Study: Weight Gain
The Tokelau Island Migrant Study: Diabetes
The Tokelau Island Migrant Study: Asthma

Friday, January 23, 2009

Going local in Paris, part 2

Published in today's Guardian: an account of my meeting with the so-called godfather of travel-networking, Jim Haynes.

Every Sunday since the mid-70s, Jim has opened his Paris apartment for any traveller that cares to join him for dinner. An estimated 120,000 have done it so far.

I think I am slightly in love with Jim Haynes and here's betting that, if you take up his invite, you will be too.

To get your name on the list, just go to his website,

Thursday, January 22, 2009

Save money: rent your room to travellers

"Get a lodger to help pay your mortgage," advised the Times at the weekend. It seems they've caught on to sites, such as Crashpadder and Airbed&breakfast, which allow users to rent out spare rooms and turn their place into a temporary B&B. They're peer-to-peer accommodation networks, like, but with the added twist of allowing cash to exchange hands and profits to be made.

Although I've had my reservations about such sites in the past, they certainly have potential. I think we could be looking at the next big thing here and we're sure to see more start-ups in the near future.

This week, I came across another one,, which runs under a motto of "rent your room to the world". Although it's new to me, it has been operating since 2007 and it looks like a good place for new hosts to start.

Until now, one of my concerns about these sites is they allow hosts to charge anything they want for their room and offer no pricing structure whatsoever. So, one thing I like about Roomft is its "value your room" function, which allows users to complete a very short survey about what they are offering and, as a result, suggests would be a reasonable per-night price. At least this adds some sort of scale to the process and gets hosts to think more realistically about what people need when travelling. Room size, location, transport links, internet facilities and local amenities should all be taken into account. charges the host a small booking fee, but doesn't take commission on the room price. By contrast, Airbed&Breakfast allows hosts to set any price they want, up to $3,000, with no guidance, other than pointing out the average charge is $90. The site also then takes 5-12% commission - meaning if you get overcharged, they still profit.

So, if you really are looking to boost your income through renting a spare room, RoomFt could be the most economical option. As part of a sign-up incentive, they are also giving every new host three free bookings. This means that hosts can rent out their rooms to travellers three times, at no charge whatsoever.

And, even when that booking fee does kick in, it's unlikely to break the bank. The site says the fee costs "one credit", which is "equivalent to £1 UK, $2 US dollars, €1.50 euro or 250 Yen". That seems highly reasonable, especially if these rates still stands for travelling Brits, for whom last year's £1 = $2 rate now seems like a distant memory.

Pictured: A special edition cereal made by Airbed&Breakfast and available through their site for $39 a box.

Wednesday, January 21, 2009

The Tokelau Island Migrant Study: Asthma

Asthma may be another "disease of civilization", uncommon in non-industrial cultures. Between 1980 and 2001, its prevalence more than doubled in American children 17 years and younger. The trend is showing no sign of slowing down (CDC NHANES surveys).

The age-standardized asthma prevalence in Tokelauan migrants to New Zealand age 15 and older, was 2 - 6 times higher than in non-migrants from 1976 to 1982, depending on gender and year. The highest prevalence was in New Zealand migrant women in 1976, at 6.8%. The lowest was in Tokelauan men in 1976 at 1.1%.

A skeptic might suggest it's because these adults grew up around certain types of pollen or other antigens, and were exposed to new ones later in life. However, even migrant children in the 0-4 age group, who were most likely born in NZ, had more asthma than on Tokelau.

What could contribute to the increased asthma prevalence upon modernization? I'm not particularly knowledgeable about the mechanisms of asthma, but it seems likely to involve a chronic over-activation of the immune system ("inflammation").

The Tokelau Island Migrant Study: Background and Overview
The Tokelau Island Migrant Study: Dental Health
The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health
The Tokelau Island Migrant Study: Weight Gain
The Tokelau Island Migrant Study: Diabetes

The Tokelau Island Migrant Study data in this post come from the book Migration and Health in a Small Society: The Case of Tokelau.

Thanks to the EPA and Wikipedia for the graph image (public domain).

Monday, January 19, 2009

The Tokelau Island Migrant Study: Diabetes

This post will be short and sweet. Diabetes is a disease of civilization. As Tokelauans adopted Western industrial foods, their diabetes prevalence increased. At any given time point, age-standardized diabetes prevalence was higher in migrants to New Zealand than those who remained on Tokelau:

This is not a difference in diagnosis. Tokelauans were examined for diabetes by the same group of physicians, using the same criteria. It's also not a difference in average age, sice the numbers are age-standardized. On Tokelau, diabetes prevalence doubled in a decade. Migrants to New Zealand in 1981 had roughly three times the prevalence of diabetes that Tokelauans did in 1971. I can only imagine the prevalence is even higher in 2008.

We don't know what the prevalence was in Tokelauans when their diet was completely traditional, but I would expect it to be low like other traditional Pacific island societies. I'm looking at a table right now of age-standardized diabetes prevalence on 11 different Pacific islands. There is quite a bit of variation, but the pattern is clear: the more modernized, the higher the diabetes rate. In several cases, the table has placed two values side-by-side: one value for rural inhabitants of an island, and another for urban inhabitants of the same island. In every case, the prevalence of diabetes is higher in the urban group. In some cases, the difference is as large as four-fold.

The lowest value goes to the New Caledonians of Touho, who are also considered the least modernized on the table (although even their diet is not completely traditional). Men have an age-standardized diabetes prevalence of 1.8%, women 1.4%. At the other extreme are the Micronesians of Nauru, affluent due to phosphate resources, who have a prevalence of 33.4% for men and 32.1% for women. They subsist mostly on imported food and are extremely obese.

The same patterns can be seen in Africa, the Arctic and probably everywhere that has adopted processed Western foods. White rice alone (compared with the combination of wheat flour and sugar) does not seem to have this effect.

The data in this post are from the book Migration and Health in a Small Society: the Case of Tokelau.

The Tokelau Island Migrant Study: Background and Overview

The Tokelau Island Migrant Study: Dental Health
The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health
The Tokelau Island Migrant Study: Weight Gain

Sunday, January 18, 2009

NYC: When Couchsurfing goes wrong

Check out the Irish Times online for an article about the potential downsides of Couchsurfing. Their writer certainly didn't get a very warm reception from his NYC hosts, a couple who seemed to be in the midst of their own relationship meltdown.

I empathise with the writer although I do think there are some lessons to be learnt on both sides here. Here are some tips for all couchsurfers to keep in mind.

1. Do not presume you will always get a front door key to your host's home. In London, I don't offer guests a key. This is because I have housemates and, even if I deem a person trustworthy, I don't feel it is up to me to make that decision on their behalf too. However, I do make this clear on my profile and it was certainly bad form of these NYC hosts to wait until the morning to tell their guests that they expect them to vacate the building when they go to work.

2. Select your host wisely. If you're on a short city break, where your host can make or break your whole experience, it pays to do a bit more research than you would if you were on a schedule-free round-the-world trip, where you can change plans and move on the next day if necessary. Exchange a few emails with your host in advance to build up an idea of the sort of reception you might get on arrival.

3. I imagine the Irish Times writer would have been a lot more tolerant if his hosts hadn't been so frosty, however, you can't complain if a New York City apartment is cramped. It probably feels the same for your hosts too, and yet they've agreed to share it with you.

4. If it's that bad, move on. Granted, that's not so easy in New York, where hotel rooms and couches are in high demand. However, if it's got to the point where you are "escaping" your hosts and dread even thinking about them, then spending a few minutes to send a couple of mails to some alternative hosts is surely worth a try. The hugely active NYC forum has a sub-group for last-min couch requests.

5. Finally, and most importantly: the golden rule. Couchsurfing always works better if you socialise with your hosts and don't just use it as a place to crash.

Saturday, January 17, 2009

Home swaps: a beginner's guide

When staying in a hostel or hostel, no matter how you spend your days, you can't escape feeling like a tourist. That's why, this week, I forced myself to move on from the best hostel in Buenos Aires (more on that at a later date) and into houseshare. It's a temporary arrangement with a couple of expats, so hardly complete local immersion, but it still feels good and I confess to getting a little buzz when walking down "my" street with door keys in hand.

Another good way to get this "at home" feeling when travelling is to try a home swap. If you've never tried it, today's Independent carries a full beginners' guide.

According to the article, the UK's biggest home-swap company, Home Link, expects to organise more than 13,000 exchanges in 2009. Vietnam, Senegal, Oman and the Reunion Islands are among the destinations on their books.

Tempted? "Get to work now," says the Indy. "The busiest time of the year for UK swappers to set up trips is between January and March."

Down with the prisoners in La Paz

Bolivia's San Pedro Prison is back in business. In the tourist business, that is. It’s never really been out of every other sort of business. Behind the heavy concrete exterior, it operates its own real-estate trade, cocaine factory, and, allegedly, does a good line in counterfeit banknotes. It's such practices that lead it to become subject of a cult book, a forthcoming film from Brad Pitt’s production company and, according to Lonely Planet, “the world’s most bizarre tourist attraction”.

There’s certainly no prison like it. The inmates here are expected to make a living just as they do in the outside world. The more enterprising might practice a trade or become proprietors of internal restaurants (complete with Coca Cola sponsorship), while all are expected to pay for their accommodation. Whole families live inside, with prisoners’ wives and children being able to come and go. And, even more bizarrely, every backpacker in town wants in.

Getting a tour of San Pedro Prison in central La Paz became a cult backpacker attraction a few years ago. However, safety concerns circa 2003 caused a complete crackdown and, until recently, only those willing to masquerade as a foreign prisoner's long-lost relative could get through the iron gates.

At the end of last year, that changed. The tours are back and gaining entry is now easier than ever. I wrote about my recent visit in today's Guardian.

Now, a typical day in San Pedro sees the place is swarming with backpackers. I joined about a tour with about eight 20-to-30-somethings: English, Irish and a couple of Scandinavians. Within a few minutes we crossed paths with another similarly sized group, one terrified member clutching his Bolivia guidebook to his chest as if it might double as a shield.

I've done prison tours before - most recently in French Guiana, where Papillion was once held - but these places have been long out of action. San Pedro, by contrast, is very much a working prison -
a place of corruption, violence and extreme poverty.

Is prison tourism a step too far in local tourism? I've tried to cover the pros, the cons and the ethical dilemmas in my article to let people draw their own conclusions. There were certainly times when it felt voyeuristic and uncomfortable. But, then again, I don't believe travel experiences always have to be sugar-coated. We should be learning about all sides of life in the places we visit.

Bolivia has lots of slightly dubious tourist attractions. Another involves going to see the mines of Potosi, which have almost medieval working conditions, child labour and appalling health-and-safety. And yet, for exactly these reasons, it can provide a quick thrill for tourists, who can spend a couple of hours ducking in and out of the claustrophobic shafts. I couldn't bring myself to do this one.

The most important thing, however, is that all these situations are approached sensitively and with respect. The danger, when they start herding tourists in and out as they are doing (up to 50 entering a day), is that it becomes just another "must do" and there is far less personal impact.

As for visiting prisons, here's some parting advice from Prisoners Abroad:

"We get quite a few requests from the public asking us about prison visiting, generally if they are going on business, or on holiday (including round the world trips). We don't arrange visits ourselves but tell people to get in touch with the British Consul in the country direct. We also run a pen pal scheme for people wishing to write to a prisoner which is a vital lifeline to the outside world. There is more information on volunteering on our website."

Friday, January 16, 2009

The Tokelau Island Migrant Study: Weight Gain

Between 1968 and 1982, Tokelauans in nearly all age groups gained weight, roughly 5 kilograms (11 pounds) on average. They also became slightly taller, but not enough to offset the gain in weight. By 1980-82, migrants to New Zealand had become especially heavy, with all age groups weighing more than non-migrants by about 5 kg (11 lb) on average, and 10 kg (22 lb) more than Tokelauans did in 1968.

The body mass index (BMI) is a rough estimate of fat mass (although it can be confounded by muscle mass), and is the weight in kilograms divided by the square of the height in meters [BMI = weight / (height^2)]. A BMI of 25 to 30 is considered overweight; 30 and over is considered obese.

The graphs I'm about to present require some explanation. The data in each graph were collected from the same individuals over time (15-69 years old). That means some weight gain is expected, as this population normally gains weight into middle age (then loses weight). What's interesting to note is the difference in the rate of weight change between migrants and non-migrants. The first two data points in 1968 are baseline, and compare non-migrants with "pre-migrants" still living on Tokelau. The second two data points in 1981-82 compare the same individual migrants in New Zealand with the same non-migrants.
Unless they all decided to become body builders, migrants to New Zealand gained more fat mass than Tokelauans between 1968 and 1982. The rate of weight gain in New Zealand was more than twice as fast for men and more than 50% faster for women than on Tokelau.

Why did Tokelauans and especially migrants to New Zealand gain weight?  Probably because they had greater access to a wide variety of calorie-dense, palatable foods of modern commerce.  The introduction of wheat and sugar, at the expense of coconut and traditional carbohydrate sources, was the main change to the Tokelauan diet during this time period. See this post for a graph.

Finally, there's the question of exercise. Did a change in energy expenditure contribute to weight gain? The study didn't collect data on exercise during the time period in question, so all we have are anecdotes. During this time, men living on Tokelau progressively adopted outboard motors for their fishing boats, replacing the traditional sails and oars. Their energy expenditure probably decreased.

But what about women? Tokelauan women traditionally perform household tasks such as weaving mats and preparing food. Their energy expenditure probably didn't change much over the same time period. Since both men and women on Tokelau gained weight, it would be hard to argue that exercise was a dominant factor.

How about migrants to New Zealand? Here's a quote from Migration and Health in a Small Society: the Case of Tokelau:
Overall it is our belief that most of the migrants expend greater energy in their work than is currently the case in Tokelau.
Exercise doesn't appear to have been the main factor, although the data don't allow us to be totally confident about this.

Some local blogs for the weekend

Desert island blogs: now that's a sign of the times. Following the premise of the long-running Radio 4 show Desert Island Discs - where a guest is asked to pick songs they'd want to have with them if stranded from civilisation - Cool Travel Guide has turned to the blogsphere and selected the travel blogs they'd continue to follow if island-bound. Author Lara Dunston admits that electricity and wifi might prove a problem - and email access means you probably wouldn't be stranded long - but let's just go with it. Especially as Going Local made the list and wants to enjoy the moment. Being deemed one of "coolest travel blogs on the web" by Cool Travel Guide is cool indeed.

What would make my own blog list for a desert island?
Of course, Lara's would be up there for me: lots of great tips, inspiring stories and yet never overlooking the difficulties of life on the road. It's also the site I recommend to those trying to break into travel writing as Lara has covered this extensively.

But what else? Here's my pick of the best local-travel blogs on the web:

Home Exchange Travels Everything you need to know about house exchanges from a New-York-based blogger with countless swapping experiences behind her.

Gridskipper Expert, insider knowledge on a range of world capitals. Always on the button and ultra quirky.

Couchsurfing the world - An online travel journal from DJ Ajam, from Bolton, who is aiming to couchsurf his way around every country on the planet.

Open Couchsurfing The behind-the-scenes blog for those interested in how Couchsurfing really works.

Make Travel Fair Newly relaunched, it's cleaner, sharper and more informative than ever. You can catch some Going Local content on their from time to time too.

And what about all the local destination blogs? The possibilities are endless. Here in Buenos Aires, you can't beat Saltshaker for foodie tips. And, back home in London, much respect goes out to the London Review of Breakfasts, who's author never tires of his quest to find the city's best places for starting the day.

However, when I think about it, would a really want to read about a good fry-up and a perfectly brewed cuppa on a desert island? Maybe I should reconsider ...

[Photo of the Indian island of Lakshadweep. Taken by
Lenish Namath and posted on WikiImages. It's not actually deserted, so does offer internet access if you're a blog addict.]

*Postscript 17/01/09: Vote for your favourite travel blogs in the Lonely Planet Travel Blog Awards.

Thursday, January 15, 2009

Stepping out of cyber travel and into reality

"Apaga la tele. Vive tu vida." Turn off the TV. Live your life.

I saw this piece of street art in Valparaíso, Chile last month. Good advice, wouldn't you say? However, seeing as I rarely watch TV, turning off my laptop might be a better resolution for me.

Like many people, I spend a lot of time in front of my computer for my work. Consequently, the last thing I want to do is socialise online too. I have zero interest in virtual travel on sites such as Second Life.

Nonetheless, I am all for using the internet as a social stepping stone. That's why I like travel networking. Although you meet the people online, these virtual meets are soon transferred into real, life-enhancing experiences.

Map-based social network is the latest to encourage its members to get out more. In 2007, the site launched as an online community featuring worldwide maps where members pinpoint local attractions, sites, happenings, or just about anything they want. However, in a new twist, they've now launched the "Local Guides" subdivision, which highlights specially selected members who are willing to meet with others in person and show them around.

Here's how they describe it:
Local Guides are informal ambassadors volunteering to represent their unique parts of the world. They offer a unique perspective beyond traditional travel writers and editors, they are real locals offering up first-hand gems of information about their homes. They are eager to share and to connect.
Sounds good. So far the site has handpicked guides in Taipei, LA, Orange County, Malaysia and Chennai. More to come. Read more about it on Make Travel Fair.

Wednesday, January 14, 2009

The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health

Let's get right to the meat of this study. It's relevant to the hypothesis that saturated fat is a cause of cardiovascular disease.  Tokelauans traditionally obtained 40-50% of their calories from saturated fat, in the form of coconut meat. That's more than any other group I'm aware of.

So are the Tokelauans dropping like flies of cardiovascular disease?  I don't have access to the best data of all: actual heart attack incidence data. But we do have some telltale markers. In 1971-1982, researchers collected data from Tokelau and Tokelauan migrants to New Zealand on cholesterol levels, blood pressure and electrocardiogram (ECG) readings.

The Tokelauan diet, as I've described in detail in previous posts, is traditionally based on coconut, fish, starchy tubers and fruit. By 1982, their diet also contained a significant amount of imported flour and sugar. Migrants to New Zealand had a much more varied diet that was also more typically Western: more carbohydrate, coming chiefly from wheat, sugar and potatoes; more processed sweet foods and drinks; more red meat; more vegetables; more dairy and eggs. Sugar intake was 13 percent of calories, compared to 8 percent on Tokelau. Saturated fat intake in NZ was half of what it was on Tokelau, while total fat intake was similar. Polyunsaturated fat intake was higher in NZ, 4% as opposed to 2% in Tokelau. I don't have data to back this up, but I think it's likely that the n-6:n-3 ratio increased upon migration.

Blood pressure did not change significantly over time in Tokelau from 1971 to 1982, if anything it actually declined slightly. It was consistently higher in NZ than in Tokelau at all timepoints. Men were roughly three times more likely to be hypertensive in NZ than on Tokelau at all timepoints (4.0% vs. 12.0% in the early 1970s). Women were about twice as likely to be hypertensive (8.1% vs. 15.0%).

On to cholesterol. Total cholesterol in male Tokelauans was a bit lower on average than in New Zealand, but neither was particularly elevated (182 vs. 199 mg/dL). LDL was also a bit higher in NZ males (119 vs. 132 mg/dL). Triglycerides were lower in Tokelauan men than in NZ (80 vs. 114 mg/dL). There were no differences in total cholesterol, LDL cholesterol or triglycerides between Tokelauan and NZ women.  It's interesting that serum lipids don't correspond at all to saturated fat intake.

But does it cause heart attacks? The best data I have from this study are ECG readings. These use electrodes to monitor the electrical activity of the heart. There are certain ECG patterns that suggest that a person has had a heart attack (Minnesota codes 1-1 and 1-2). The data I am going to present here are all age-standardized, meaning they are comparing between groups of the same age. On Tokelau in 1982, 0.0% of men 40-69 years old showed ECG readings that indicated a probable past heart attack. In NZ in 1980-81, 1.0% of men 40-69 years old showed the same ECG readings. In Tecumseh U.S.A. in 1965, 3.5% of men 40-69 years old showed the same ECG pattern. I don't have data for women.

These data don't prove that no one ever has a heart attack on Tokelau. Tokelauans do have heart attacks sometimes, and they also have strokes (at least in modern times). But they do allow us to compare in quantitative terms between genetically similar people living in two different environments.

This is consistent with what has been observed on Kitava and other traditional Pacific island cultures: a vanishingly small incidence of cardiovascular disease while they retain their traditional diet and lifestyle (and sometimes even when some processed Western food has been introduced). When diets and lifestyles become modern, there is invariably a rise in the incidence of chronic disease.

These data raise serious questions about the role of saturated fat in cardiovascular disease. Tokelau underlines the fact that a non-industrial diet and lifestyle may be a more significant protective factor than the quality of ingested fat.

Unless otherwise noted, the data in this post are from the book Migration and Health in a Small Society: the Case of Tokelau.

Hostels vs hotels vs couchsurfing: part 2

What do today's budget travellers prefer: a hostel, a hotel or a couch? It seems the debate that I touched on a couple of weeks ago has been continuing over at Vagablogging, the blog of high-profile travel writer, Rolf Potts. The post - "Hostels go upscale as budget travelers discover couchsurfing" - refers to's announcement that hostel bookings by North Americans increased 20% in 2008. The site puts this down to hostels going upmarket and no longer being the last resort for just the skintest of travellers.

Now as hostels install pools and bypass the bunks for more single rooms, prices are inevitably being pushed up. Could they be pricing out their original market? With iPods and laptops now part of the typical checklist, backpacking is certainly not the frugal experience it once was. Last April, the YHA opened London Central (pictured), a £4m hostel offering wifi, pop art and organic cider. Although, from £12 a night, it's certainly not badly priced by London standards.

Vagablogging is predicting more budget travellers will switch to couchsurfing for a more affordable way to travel in these lean times. I think we'll also see people searching for cheap alternatives on the likes of Airbed&breakfast, Crashpadder and LeapLocal.

Budget travellers should be rejoicing. Not that long ago there were no such facilities tailored to their needs. Now we have choices.

Tuesday, January 13, 2009

Couchsurfing with a family is child's play

"Couchsurfing: not just for students and hippies." This could have been a slogan for my travel-networking experiment last year. One of my main aims was to show people that the concept offers something for everyone. As long as the attitude is right, there is no such thing as being the wrong age, the wrong economic group or the wrong marital status.

I was particularly keen to show that having kids doesn't prevent you from getting involved and, rather than expecting readers to take my word for it, I set about finding someone who could talk from experience. I can't remember how I first came across Leigh - I think it was just from searching the's families group - however we started corresponding via email while she was living in Panama. She shared some stories about couchsurfing with her husband and four-year-old daughter, Lila; and I, in turn, shared these with Guardian readers at the end of one of my columns.

To be honest, I've been sharing them ever since. Every time someone tells me they love the idea of couchsurfing but it's not an option now they have children, I use Leigh's story as an example of why it's never out of the question. I love the way that Leigh - a writer who's originally from New York - uses the site not just to stay with other families, but sometimes to simply find another family to go to the beach with. What a great idea. Mum and Dad get some interesting new company; Lila gets local playmate.

Why am I bringing this story up again now? Last week I clicked on a post on's Buenos Aires forum and found someone was suggesting a meet-up for any writers in town. It was Leigh. She'd moved on from Panama and was spending some time in Argentina, where I'm now based. I wasted no time dropping her a line and we soon arranged to meet for a mid-morning coffee at little place I know in Barrio Norte - Clásica y Moderna. It has a bookshop at the back, a live pianist, and some very strong coffee that had us jabbering for hours.

Leigh turned out to be just as inspiring in the flesh. It was great to hear more about her couchsurfing experiences, such as when they stayed with a single dad in Belgium. "It soon felt like we were visiting family of our own. It was wonderful," she recalls. She also says she gets a very good response rate from hosts because she takes time to select them and gives lots of detail about who they are and what they are looking for. She says that's one difference about couchsurfing with kids: there are lots more questions to ask in advance.

Lila is one luckly girl to be having all these great experiences at such a young age. I also love the way Leigh is encouraging her to document her travels along the way: Lila gets control of the family camera and Leigh posts the pictures on her blog, thefutureisred. You can browse her online gallery, including this self-portrait above, under the heading "What Lila sees".

What another great idea for helping kids get the most out of travelling. I can't wait to see how Lila portrays the family's impending move to Salta in Argentina's far north.

Sunday, January 11, 2009

Facebook: Delete 10 friends, get a free Whopper

Fast-food chain Burger King has created "Whopper Sacrifice", a Facebook application that will give you a coupon for a free hamburger if you delete 10 people from your friends list.

Is social networking getting nasty? Or just moving with the times? As people's "friends" lists move into quadruple figures, an occasional friends cull could soon be common practice. On Friday, I met a hostel owner here in Buenos Aires who claims to have 2,000 "friends". "I'd say I actually know about 1,000 of them," he said. The rest are just people - or, in some cases, places, events or attractions - he has said 'yes' to without a second thought.

Personally I draw the line at adding places or events, as I have no desire to be bombarded with marketing messages. However, I do have a couple of people on my friends list that I talked to for a few minutes in a hostel. "Are you on Facebook?" is now just as common a question as "Where are you from?".

Admittedly, the site is a great resource when travelling, especially for helping you keep in touch with everyone back home and the people you meet on the road. Having been in my current hostel for nearly a month, I've got to know some of the other guests well. These are people I'd like to stay in contact with and catch up with again if our travel itineraries cross. Without Facebook, it's hard to remember every other backpacker's plans: who will be back in Buenos Aires later in the year, who you've tentatively arranged to meet in Uruguay in late summer etc etc.

However, some travellers are going even further and using the site to help make their plans. I've recently come across two Buenos-Aires-themed Facebook groups: one for people looking for a housemate and another for people who were in the city for Christmas and New Year. For this sort of thing, I'd say there are better places to look than Facebook (such as Couchsurfing forums or Craigslist), but it looks as though the site is becoming a one-stop shop for many users.

I'm sure I have some Facebook friends who would neither notice or be offended if I sacrificed them for a Whopper. Although in my case, unless veggie version is an option, I'm more likely to be the sacrificed one.

Then again, looking at the above picture - a Japanese Terriaki Whopper taken from Wiki Images - is it really worth the effort?

Saturday, January 10, 2009

The hottest barrio in Buenos Aires

Want to know the hottest barrio in Buenos Aires right now? Start by looking beyond Palermo, which reached its boiling point so long ago that its soul is now danger of evaporating. Head instead to Villa Crespo, which is just starting to simmer.

It's not a place where you'll find rows of hip bars and nightclubs, but you'll be in your element if you are the sort of tourist who is happy to leave the guidebook alone, wander aimlessly, and enjoy soaking up local life. Here you're likely to encounter residents having a makeshift asado (BBQ) on the pavement, admire antique furniture in ramshackled street-side shops, or catch a glimpse through a window into one of the local artists' studios.

On my last three visits to the city, this barrio has been my favourite place to wander. It still has the cobbled streets and low-rise houses that you find in Palermo, but it's much more "tranquilo", as they say here. I love the way hip bars, like Ocho7Ocho (878 Thames, pictured), rub shoulders with some of the most old-school joints in town, like the delightful 1930s icecream parlour, Scannapieco (Córdoba 4826).

I tipped Villa Crespo as the place to be in Buenos Aires in last Saturday's Guardian Travel.
You don't have to be a local to be down with the local knowledge, but you do need to look beyond the obvious. How did I find the places I tipped in the Guardian? Aside from spending many an hour pounding the cobbles, I simply asked those in the know.

One afternoon, I had a particularly good brainstorming session round the kitchen table at La Cocina Discreta. Run by Alejandro and Rosana, this is one of the city's newest in-home restaurants. The pair gave me lots of good pointers - including alerting me to their friend, Shoni Shed, who hosts blindfolded gigs in his house (see the article for details).

In the end, I was spoilt for choice. Here are some of the other local finds that I couldn't fit in the article:

Carlitos (Scalabrini Ortiz, 701) - This popular pancake house has hundreds of options that are filling and cheap (10 - 15 pesos). To make things a little more interested, the best combos are named after famous people. Try a Chaplin (roquefort, onion, ham); a Pablo Neruda (cheese, tomato and oregano); or even a rather odd homage to the inventor of Viagra (cream cheese, roquefort, celery, green olives). Open from midday until 1am. 3am on Friday, Saturday, Sunday.

Thymus (Lerma 525)
Stylish restaurant in a converted home on a sweet residential street just behind Corrientes. It's run by a sculptor and famed for its multi-course tasting menu. Evenings only, Mon - Sat. Book ahead on 4772 1936.

La Perla (Canning y Triunvirato)
Classic bakery and a Villa Crespo institution. Stop by for facturas (little pastries to be enjoyed with coffee or mate). I haven't had chance to check it out myself yet, but it is highly recommended by La Cocina Discreta and they haven't been wrong yet.

Thursday, January 8, 2009

Couchsurfers coming up from the underground

Is it me? It the time of year? Or are there really more couchsurfers than ever in Argentina?

When I was on my Going Local trip last year - meeting locals while staying in a mix of hostels and homestays - the times I crossed paths with other travelling couchsurfers were rare. Occasionally we'd meet when staying with a particularly active host, who organised multiple meet-ups, but, generally, it seemed like a behind-the-scenes community, going on quite apart from the hostel scene.

However, since arriving in Argentina, every other traveller seems to be a couchsurfer, or part-time couchsurfer. I met at least four while staying in a hostel in Cordoba - all had failed to get a host because the student city was in the middle of exam period. Then, in Buenos Aires, I soon met another three: one in a bar, one in my hostel and one friend-of-a-friend, who used's BA forum board to find his houseshare - with a fabulous terrace where I ended up seeing in the new year (pictured).

Argentina is certainly a good place for a Couchsurfer to be. Aside from the obvious attractions (the steak, the wine, the culture, the diversity of landscape), it is also within the top 25 Couchsurfing countries (with nearly 9,000 members), while Buenos Aires is in the top 20 cities.

The BA Couchsurfing forum is quite simply fantastic for any new arrival in the city and yet, refreshingly, it is not just the domain of expats. Most of the regular users are Argentinean and seem to have limitless enthusiasm for new arrivals in their capital. On NYE they posted a hugely helpful list of suggestions of what to do in the city, including open invites for house parties and a camping gathering on the delta. Today I noticed a post from a Canadian newcomer asking how safe BA is for cyclists. Within no time, she received a string of helpful responses, including an offer of a personal bike tour.

I met a lot of these great people back in July and now I'm going to be staying in Buenos Aires for the foreseeable future I must admit that knowing about this forum has really taken the edge of any fear about not meeting people or getting homesick. I've already joined them for their regular Monday outing to an incredible percussion night called La Bomba del Tiempo and am sure this was the first of many for me.

However, here's hoping the balance is kept. Everyone that utilises the goodwill of such forumites should be willing to give something back to the community to keep it going and not just pop in to use it as some sort of nuevo Craigslist. I'm hoping that once I am more settled I can help out some newcomers to the city and, in one way or another, some locals too. My first mission: to find a way to get some specialist books from the UK over to a friend I met via I've had no shortage of folks back home expressing a desire to visit, so hopefully it won't take long.

Wednesday, January 7, 2009

Things get tricky for Fiiki

With so many travel-networking sites out there now, wouldn't it be easier if a single site pooled all the accommodation options into one, easy-to-view list? Need a bed somewhere? Just look for your destination on their drop-down menu and, bingo, every host listed on every hospitality site on the web suddenly appears before your eyes. This is exactly what the folk behind had planned. Unfortunately for them, the travel-networking community wasn't quite so keen.

The aim of Fiiki's portal was to collate information from around 10 different hospitality sites, including, and
The trouble was Fiiki seemed to have ignored members' privacy settings and thus opened up all manner of online copyright issues.

The forums of are now awash with suggestions that the site's creator must have signed up as a member, then proceeded to copy info without permission. Predictably, members are unimpressed. Hospitality sites work by creating a network of trust; if any non-members can find you through Fiiki, it defeats the object.

Fiiki also seriously underestimated the loyalty people have to their travel-networking site of choice. The more you use these sites, the more you realise each has a very different personality. While a member of might welcome likeminded fellow members, they may not be so keen to open up to members of

What erks members even more is the way Fiiki has misrepresented their details. For example, if someone types in New York, a snapshot of a Couchsurfing profile might appear reading: "Contact Belinda, 27, from Brooklyn, for a 100% chance of being hosted". This is totally inaccurate. The % figure displayed on all profiles refers to the response rate to messages. Belinda may be polite enough to respond to 100% of messages, but this does not mean she ALWAYS hosts EVERYONE.

The Fiiki crew also showed their ignorance by including sites such as UK-only StayDon' If they had done their research they would know the site is currently down and works on a very different, token-based system. You can't simply sign up, drop someone an email and turn up on a doorstep. general manager Matthew Brauer has addressed members' concerns on the site's message boards: "I just wanted to let everyone know that CouchSurfing has not endorsed or approved the content on [...] CouchSurfing does have the right to request the removal of member profile information from the Fiiki website, including information from profiles that are set to viewable by non-members. Our legal team is currently looking into it."

Looks like the legal team have made some progress as Fiiki is now out of action. The homepage reads simply: "Due to legal issues we're currently unable to offer our services. Please come back later". Before it went down, I emailed them via their contact us page to ask for more information on the official launch they'd said was "coming soon". So far, no comment. I'm guessing they've got some homework to do first.

Tuesday, January 6, 2009

The Tokelau Island Migrant Study: Dental Health

I'm always on the lookout for studies that can confirm or deny the information in Nutrition and Physical Degeneration. Traveling around the world in the 1920s and 1930s, Dr. Weston Price found a number of non-industrial cultures that had excellent dental and overall health, including a high resistance to tooth decay, perfectly straight teeth, and wisdom teeth that erupted without impacting. These same cultures developed extreme dental problems, including severe dental decay and crooked teeth in the younger generation, upon adopting modern European foods. These foods always included white flour and refined sugar, with variable contributions from canned goods and vegetable oils.

I have detailed information on the Tokelauan diet beginning in 1968 and ending in 1982. The traditional diet until the 1960s consisted of coconut, fish, breadfruit, pulaka, fruit, pigs, chickens and wild fowl. These are typical Polynesian foods. From the 1960s through the 1980s, Tokelauans gradually adopted flour and sugar as major carbohydrate sources, partially displacing starchy breadfruit and pulaka intake as well as coconut. They also began eating low-quality canned meats that partially replaced fish in their diet. Total calorie intake fluctuated between 1,500 and 2,000 kilocalories but did not trend in any particular direction over time. Here's a graph of macronutrient changes:

I found a study on the dental health of Tokelauans that I thought would be a fitting way to kick off this series. It's titled "Changed oral conditions, between 1963 and 1999, in the population of the Tokelau atolls of the South Pacific". I was only able to get my hands on the abstract, but that was enough. In 1963, Tokelauans were consuming roughly 15 lb of white flour and 10 lb of sugar per person per year. By 1980, the numbers were 60 lb and 69 lb for flour and sugar, and the trend was showing no sign of slowing down (see the graph in the previous post). I don't have numbers for 1999, but they're likely to be higher than in 1980, given the trend. For comparison, in 2006, the average American ate 117 lb of flour per year.

Let's look at a graph. This represents the DMF score (decayed, missing or filled teeth) of Tokelauans 15-19 and 35-44 years old, in 1963 and 1999. I've connected the two data points with lines to give an idea of the trend.

Dental decay increased eight-fold in adolescents and more than four-fold in adults. I don't know what their dental health was like before 1963, but I can only guess it was better than when this study was conducted, due to the fact that the Tokelauan diet was already partially modernized in 1963. The authors conclude "a serious decline in oral health has occurred over the past 35 years."

Does this sound familiar? It should be, because it's been known at least since the 1930s. Here's a quote from Nutrition and Physical Degeneration, describing the Tongan islanders, another Polynesian group:
The limited importation of foods to the Tongan Islands due to the infrequent call of merchant or trading ships has required the people to remain largely on their native foods. Following the war, however, the price of copra went up from $40.00 per ton to $400.00, which brought trading ships with white flour and sugar to exchange for the copra. The effect of this is shown very clearly in the condition of the teeth. The incidence of dental caries [cavities] among the isolated groups living on native foods was 0.6 per cent, while for those around the port living in part on trade foods, it is 33.4 per cent. The effect of the imported food was clearly to be seen on the teeth of the people who were in the growth stage at that time [i.e., they developed crooked teeth]. Now the trader ships no longer call and this forced isolation is very clearly a blessing in disguise. Dental caries has largely ceased to be active since imported foods became scarce, for the price of copra fell to $4.00 a ton. The temporary rise in tooth decay was apparently directly associated with the calling of trader ships.
0.6 percent is one tooth in every 167. In other words, less than one in five people had even a single cavity. That's without the benefit of tooth brushing, fluoride or any of the tools of modern dentistry. 33.4 percent tooth decay in Tongans living on modern foods means they had 11 cavities per person, a bit less than Tokelauans had in 1999.

Weston Price's anecdote above is remarkably similar to something that happened on Tokelau in 1979. The atolls didn't receive their normal shipments of European foods for a five-month period, during which they resorted to traditional foods. Here's an excerpt from the New Zealand Herald from June 11, 1979:
What will happen the day the country runs out of fuel and the ships stop bringing those "essential" foods like sugar and flour? Tokelauans recently found out what the answer to that question was- they got healthier. One of the victims of cyclone Meli earlier this year was the passenger cargo ship Cenpac Rounder, chartered five times per year by the Tokelau Affairs office in Apia. Left high and dry on a reef South of Fiji it was badly damaged and could not be moved. So ever since January the three Tokelau atolls have not received fresh supplies. Late last month the first ship called in, chartered by the Tokelau Affairs office. The Secretary of the office said that when the ship arrived the atolls had run out of fuel. So the fishermen had returned to the traditional sail, a sight on the lagoon that had almost been forgotten, thanks to the outboard motor. There was no sugar, flour, tobacco and starch foods either- and the atoll hospitals reported a shortage of business during the enforced isolation. It was reported that the Tokelauans had been very healthy during that time and had returned to the pre-European diet of coconuts and fish. Many people lost weight and felt very much better including some of the diabetics.

Sunday, January 4, 2009

The Tokelau Island Migrant Study: Background and Overview

Tokelau's troubles began in 1765 with its 'discovery' by British commodore John Byron. Traditionally, residents of the three small coral atolls collectively called Tokelau (Nukunonu, Fakaofo and Atafu) lived an isolated subsistence lifestyle, relying almost exclusively on coconut, seafood, wild fowl and fruit for food. The first reliable account of the Tokelauan population, by an American expedition in 1841, found the people there healthy and happy. Here's an excerpt from Migration and Health in a Small Society: the Case of Tokelau (1992):
The expedition considered the people living there to be healthy and handsome... They all appeared to be thriving on their 'meager diet' of fish and coconut, for no evidence of cultivation was seen... People of both sexes were tattooed with geometric designs and figures of turtles and fish. The numerous reports and journals of the Expedition leave the impression of a generally admirable people - amiable (though cautious), peaceful, orderly, and resourceful.
Between 1841 and 1863, the population of Tokelau was reduced to a fraction of its original size by epidemics and kidnapping by slave ships. The old social and religious order was broken, and the inhabitants were converted to Christianity by overzealous and competing Protestant and Catholic missionaries. During this time, Tokelauans also gained new food sources from other Polynesian islands, including breadfruit trees, pulaka (a starchy tuber), pigs and chickens. Breadfruit is a starchy fruit used like plantain.

Tokelau became a territory of New Zealand in 1925, and Tokelauans were granted New Zealand citizenship in 1948. In 1963, a government-assisted migration program was established to (voluntarily) bring Tokelauans to the New Zealand mainland, as the population of Tokelau had reached a cozy 1,870 people. When a cyclone devastated coconut and breadfruit crops in 1966, Tokelauans began taking advantage of the assisted migration program in earnest. By 1971, roughly half of Tokelauans lived on the New Zealand mainland.

There are two reasons why the Tokelau Island Migrant study is unique. First, it's one of the best-documented transitions from a traditional to a modern lifestyle, studied over decades on Tokelau and in New Zealand. Regular visits by physicians recorded the health of the population as it shifted from a relatively traditional diet to a more Western one. The second thing that makes this population unique is they traditionally have an extraordinarily high saturated fat intake from coconut. They derive between 54 and 62 percent of their calories from coconut, which is 87% saturated. This gives them perhaps the highest documented saturated fat intake in the world. This will be a test of the "diet-heart hypothesis", the idea that dietary fat, cholesterol and especially saturated fat contribute to cardiovascular disease!

Through the late 1960s, cargo ships visited Tokelau every three months, making only small contributions to the islanders' diets. In 1968, just two percent of Tokelauans' calories came from sugar. By 1978, the number had risen to 8 percent, and by 1982, 14 percent. The increase came chiefly from refined sugar and sweetened imported foods. In 1961, ships brought 12 lb of flour per person per year to Tokelau, increasing to 60 lb per year by 1980. During this time, importation of low-quality canned meats such as "mutton flaps" and chicken backs, and sweets also increased. Rice imports declined in the 1970s. The diet of migrants to New Zealand rapidly became highly Westernized, containing a higher proportion of refined carbohydrates such as flour and sugar, more red meat and poultry, and less coconut and seafood.

Here's a nice quote from Migration and Health in a Small Society: the Case of Tokelau, to set the tone for the rest of the posts in this series:
In the mid- and late twentieth century, 'Western diseases'- that is, diseases of affluence (Trowell and Burkitt 1981)- have become the major health risk for Polynesians, because of exposure to cosmopolitan diet patterns and life-style.
The varying cultures and resource bases of islands in the Pacific have influenced the degree to which their populations have been modernized and thus exposed to Western diseases. At one end of the spectrum are relatively traditional subsistence societies such as those on Tokelau and on the low islands- for example Pukapuka, Manihiki, and Rakahanga in the Northern Cook Islands. These atolls are characterized by the almost complete absence of soil, by the inhabitants' dependence on coconut in varied forms, and by a bountiful supply of fish as a major part of the traditional diet. Their populations are notable for their low levels of blood pressure, high rates of infectious disease, and low rates of coronary heart disease, obesity and diabetes. At the other end of the spectrum are those Polynesian societies, such as the Hawaiians and the Maori of New Zealand, who were submerged by 'Western' settlers and the dominating cultures they brought with them. These populations have inevitably acquired the diseases of the 'West', sometimes to an exaggerated degree.
That quote could have been straight out of Nutrition and Physical Degeneration, despite being published 60 years later. Good science is timeless. Join me in future posts as I explore the health of Tokelauan society as it transitions from a traditional diet and lifestyle to a modern one.