American J. Cardiology 86:256, 2000

Our Ancestors Had It Right


    Mary Hanudel-Larsson's stress test.

The absorption of just the right amount of iron through the intestine (duodendum) might have provided significant cardiovascular advantages to early man, the Masai of today, and conceivably has been advantageous to an extraordinary urban athlete. Excess iron may be more detrimental than iron deficiency, because high iron levels can lead to the formation of highly reactive hydroxyl radicals and lipid peroxidation, conducive to early atherosclerosis. Furthermore, there must be enough protein in the diet to sequester iron.(1)

But can we, with our modem diet and often iron supplements, establish a proper balance? Before the development of the crudest of weapons, early man probably survived by chasing his "lean meat," until the animal dropped from exhaustion, probably even during the hot. dry seasons.(2) It is conceivable that early man supplemented water scarcities with the blood of his prey. This is supported by observations of today's Masai of East Africa who drink 3 to 5 quarts of cow's milk daily, but during the dry season of 4 to 5 months, ingest fresh cow blood, mixed (balanced) with milk. Yet the Masai have minimal atherosclerosis (3) and are talented endurance athletes.

Might the consumption of animal blood in the form of "blood pudding" simulate the apparent advantages of the Masai food intake? The case of 40-year-old Mary Hanudel-Larsson suggests this possibility. Larsson was studied by me in Toledo, Ohio, soon after having won the USA title of Ultramarathoner of the Year in 1987. At the time of my study, she was running 30 km/ day, preparing for an upcoming 1,000-km race in Australia, but was plagued with numerous stress fractures, intermittent amenorrhea, and pronounced stress-related gastrointestinal bleeding. Subsequently, a magnesium-loading test (4) indicated severe magnesium deficiency, which may adversely affect the homeostatic regulation of iron.(5)

In the early 1990s she moved to Sweden, and soon adapted a Swedish custom, ingesting rich blood pudding containing cow's blood (as with the Masai), but mixed with flour and fat, consuming during heavy training over 500 g/week up to now. The amenorrhea completely subsided along with cessation of stress fractures despite a persistent exercise program of 120 to 150 km of running each week, swimming, and rowing-machine training, totaling 15 to 20 hours/week. In 1997, Larsson won a 24-hour USA race (213 km), and in that year and also in 1998 set new course records in Japan in 250-km races. There has been no requirement for correction of anemia since moving to Sweden.

William J. Rowe, MD
Swanton, Ohio 28 March 2000

1. Andrews NC. Disorders of iron metabolism. N Engl J Med 1999:341:1986-1995.
2. Carrier DR. The energetic paradox of human running and hominid evolution. Anthropology 1984;25:483-495.
3. Ho KJ. Biss K, Mikhelson B, Lewis LA. Taylor B. The Masai of East Africa: some unique biological characteristics. Arch Pathol 1971:91:387-410.
4. Rowe WJ. Extraordinary unremitting endurance exercise and permanent injury to normal heart. Lancet 1992:340:712-714.
5. Kimura M. Yokoi K. Iron accumulation in tissues of magnesium-deficient rats with dietary iron overload. Biol Truce Elem Res 1996:51:177-197.