Monday, January 30, 2012

Paleo Diet Article in Sound Consumer

I recently wrote an article for my local natural foods grocery store, PCC, about the "Paleolithic" diet.  You can read it online here.  I explain the basic rationale for Paleo diets, some of the scientific support behind it, and how it can be helpful for people with certain health problems.  I focused in particular on the research of Dr. Staffan Lindeberg at the University of Lund, who has studied non-industrial populations using modern medical techniques and also conducted clinical diet trials using the Paleo diet.

"The residents of Kitava lived exclusively on root vegetables (yam, sweet potato, taro, tapioca), fruit (banana, papaya, pineapple, mango, guava, watermelon, pumpkin), vegetables, fish and coconuts," writes Dr. Lindeberg. His research shows that Kitavans appear to be free of obesity, diabetes, heart attacks, stroke and acne. In the 1960s, American researchers studied thousands of Ugandans and Nigerians living traditionally and found their heart attack risk to be essentially zero, even among the elderly, while the same study found that comparable populations in the United States had a risk of up to 23 percent.
Why do we suffer from disorders that non-industrial populations — even our recent ancestors — largely escaped? Modern medical research continues to grapple with this problem, but we can begin to answer it by asking a simple rhetorical question: what would we feed a wild animal in captivity if we wanted to keep it healthy? If we fed eucalyptus leaves to a tiger, would it thrive? What if we fed meat to a koala? Each animal is adapted to a particular ecological niche where it evolved to thrive. Exiting that niche, particularly by eating the wrong food, causes health problems.
I also threw in some anecdotes from a local Paleo diet adherent and a local MD who uses the Paleo diet in her clinical practice, Dr. C. Vicky Beer.  I interviewed Dr. Beer for the article; she sent me a detailed response but I was only able to include snippets.  I'll be publishing the rest of the interview here soon. 
"People who significantly increase the amount of vegetables, fish, nuts, lean meats and fresh fruits in their diet, and who reduce their grain, dairy, and legume intake have lower blood sugars, usually lose weight, and usually have more energy," says Dr. C. Vicky Beer, a local physician who uses the Paleo diet in her clinical practice. "Every patient I have ever had with diabetes who has adhered to the Paleo diet for most of the time has experienced dramatic results," she adds.
I also point out in the article that hunter-gatherers were not the only healthy non-industrial populations, human evolution has occurred since the Paleolithic, and many people today can include traditionally-prepared grains, legumes and dairy as part of a healthy diet.  But if you eat like the average American...
The top six calorie sources in the U.S. diet today are grain-based desserts (cake, cookies, etc.), yeast breads, chicken-based dishes, sweetened beverages, pizza and alcoholic beverages. 
...you can expect the diseases of civilization to come knocking sooner or later.

63 comments:

Anders said...

Sound encouraging :), call my self a fish eating vegetarian (aka pescetarian) and would have hard to give up the beans. Now I only need to find some nice paleoish veg friendly breakfasts and then I almost a pescetarian paleo :). One questio though what does the paleo folks think of non grass feed livestock? Do they eat them or is it considered "toxic"?

//olme

Paul Hagerty said...

The wild animal analogy is perhaps the most persuasive to the uninitiated. It's a favorite of mine. I like to extend it to environmental enrichment and behavioral allowances, and mention killer whale connective tissue weakening to the point of dorsal fin collapse, when constrained to a lap pool, as analogous to the bodily wilting of a hunter-gatherer, when constrained by a cubicle.

Incidentally, anyone know of researchers who are actively investigating ways to make the typical work week and conditions more natural and humane without compromising productivity? That would be an excellent application of the paleo-inspired living philosophy that I have not seen addressed.

Paul Hagerty said...

Hi Anders,

Welcome. It sounds as though you would have an easy time adopting a Kitavan-inspired diet. (It was described in the piece.)

You didn't say whether you currently make allowances for egg or dairy. If you do, pastured-eggs are from chickens that eat a diet of grasses and insects, as they would have done when wild. (Interestingly, even organic "free-range" chickens spend a vast majority of their time cooped up eating an unnatural grain-based diet.) Add to the eggs gently cooked starchy and non-starchy roots, shoots, and leafy vegetables and you are on your way. Raw butter, ghee, or butter oil from pastured-cows is a favorite supplement or cooking fat for paleo-diet adherents. (Ghee and butter oil can have undetectable levels of lactose and casein, but of course exercise caution if you are lactose-sensitive.) Coconut oil and palm oil are other cooking oil options that are sometimes recommended as they have a higher smoke point and are therefore safer when heated than the now ubiquitous, olive oil (still good for salads). Fermented cod liver oil is another favorite supplement.

As for beans - realize that legumes, nuts, and grains contain plant embryos. If a plant is evolved to propagate and widely disperse its embryos, it would be disadvantageous to have an embryo that was easily digested by foraging animals. Therefore, plants evolved compounds which defend against such digestion and are thought to trigger food sensitivities or allergies in people. It turns out that traditional cultures frequently took extra steps to make legumes, nuts, seeds, or grains, if they were consumed at all, more nutritious by fermenting them or submitting them to the more abbreviated version of simply soaking them in mildly acidic medium for 12 hours or so. Dr. Stephan Guyenet, host of this blog, has articles on these traditional preparation methods.

As for the grass-fed beef question - the most recent wild ancestors of cows subsisted off of grasses, not corn or rice, so I personally view grain-fattened cattle as the sickly, obese, pre-diabetic, science experiment byproduct to their more natural and healthy grass-fed counterparts. If you are contemplating giving grass-fed beef a try, you might want to look into the numerous virtues of organ meats and grass-fed beef liver, in particular.

Good luck in your paleo-inspired dietary experimentation!

Jason Sandeman said...

Looking forward to the interview!
My question is a bit tricky: what if person has an almost impossible way to get pastured products due to local laws and regulations? For instance, here in Quebec, it is impossible to get pastured eggs unless you raise chickens, and then that may even be against city bylaws.
I am not having any luck finding a butcher that caries grass-fed beef, or who will even touch it, given the strict province health board laws.

What is a paleo person to do then?

mod alert said...

I read your previous article it has a lot of info, that is best you leave a link for this in current article people will see this easily.

modalert

fg said...

Dr. Guyenet, thank you for your article, really interesting.

What would you say is an acceptable weekly intake of grains? Like, is it okay to eat pasta once or twice a week? How about white bread?

I eat a "whole foods" diet, have done so all my life (I am 35), but I have also eaten grains until a month ago.

Also the paleo community seems to very liberally use animal fat, do you agree with this?

Many thanks.

Paul Hagerty said...

In the PCC piece, Stephan brought up the hominin evolutionary transitional period, around 2.6 million years ago, from a plant-based diet of fruits, leaves, and some insects to a diet with a significant amount of meat in it. This reminded me of a lecture from the human paleontology course I took as an undergrad. I hope others find it as interesting as I do.

Stephan highlights what is thought to be one of the most crucial transitions in our evolution. Around this time, there is hominin fossil evidence of robust craniums with prominent, gorilla-like cranial crests, suggestive of sites for the attachment of large muscles of mastication which could support chewing fibrous plant material as modern gorillas would. Also appearing around this time in the hominin fossil record, are craniums wholly missing any semblance of a cranial crest. Most interestingly, these same skulls have a marked increase in cranial capacity. The third intriguing find corresponding to this evolutionary period is archaeological evidence of the first stone tool use.

Coincidence?

In 2004, Stedman and colleagues at the University of Pennsylvania, published their conclusions in Nature that a null mutation of an ancient and robust myosin gene (MYH16) occurred around the very same time that skulls without cranial ridges and with increased cranial capacity appear. Their findings support the hypothesis that the loss of expression of this robust myosin gene relieved the evolutionary constraint on encephalization posed by the cranial architecture necessary to support the attachment of large muscles of mastication, and by extension, a fibrous herbivorous diet.

http://www.nature.com/nature/journal/v428/n6981/full/nature02358.html

(This finding has been challenged by Dr. George Perry (now at Penn State) and colleagues at Arizona State University based on their conclusion that the MYH16 mutation is much older than the corresponding fossil evidence. Disputes such as this are not uncommon in human paleontology to my knowledge, but it is not my field.)

http://mbe.oxfordjournals.org/content/22/3/379.long

It has also been suggested that the significant metabolic demands of encephalization gives rise to a relatively unique predicament in which dietary demands cannot be easily met without the consumption of energy-dense meat.

http://www.ncbi.nlm.nih.gov/books/NBK53561/

Strontium Pup said...

Stephan,

Your article is a great introduction to the concepts of the Paleo diet. I am sharing it with people who I think will benefit from it.

I will be happy when such an article can be written without the word "lean" prefacing references to meat. May that day come soon!

Miki said...

Nice article. One slight correction. Cooking is not likely to have happened prior to 400,000 years ago as there is no evidence of fire control on a routine basis (one contested near volcanic activity site in the Levant out of hundreds of the same period)and even than it seems that plant food was never the main component until 20,000 years ago when plant processing stone tools appear.

Paul Hagerty said...

Jason Sandeman,

Here's a paleo meeting in Montreal -

http://paleo-diet.meetup.com/cities/ca/qc/montr%E9al/

Hope that helps.

(I need to step away from the blog...this is a bit too rewarding.)

Razwell said...

Why do Paleolithic Diet advocates misrepresent what Weston A. Price, the man, actually said in his book. He was FOR dairy, was NOT against grains ( he himself commeneted on oat cakes, wheat etc.)

While I generally support the Paleolithic Diet concept, many if its promoters are not representing genuine anthropology.Genuine anthropologists do not make the claims well known Paleolithic Diet promoters do.

Most people on the Internet are complete scammers promoting their way of eating.

Science does not understand how cells work all that well yet.Because of this, it is NOT possible yet to know the optimal diet for humans.

Anybody, from ANY camp , who is talking like the KNOW the best diet or suprememly 100 % confident about nutrition is trying to fatten their wallet. Nutritional science is still in its infancy. Eventually, we will know the optimal diet.

The fruitarians are biggest crackpots of them all though.

Cancer LOVES- LOVES to be well fed, you know........ It is unlikely that a high quality diet is going to have much of an impact .Although there are some specific food with specific preventitive benefits for specific cancer types.

The answers to the optimal diet for humans will not be found on any Internet guru's forum.

Hopefully , most people will eventually realize this.



Dairy and UNREFINED grains are NOT bad. Maximum variety in the diet is key.

I am not holding Weston Price as the ultimate guru, but at least he was honest. People are MISREPRESENTING the ACTUAL book by him called Nutrition and Physical Degeneration.

People promoting paradise diets for health or complete prevention are QUACKS. It is HEALTH FRAUD. Diseases HAPPEN, people are mortal and age.

Many disease have nothing at all to do with diet nor can they be improved even.

There is no reason in the world to believe that our Paleolithic ancestors did not ALSO have coronary artery disease. I would love to put their remains ( if you could) through an IVUS. THAT would tell the complete story.

We have come full circle, huh?

Steven Sashen said...

My biggest question about paleo is this: What about individual differences?

Many in the Paleo community also talk about humans being endurance hunters, built to run long distances.

Well, I'm not one of those. I'm a sprinter. Always have been. And if you talk to my sprinter friends, they have the same story. We've NEVER been able to run long distance. We *can*, though, do something that distance runners can't do: run extremely fast over short distances, and have a disproportionate amount of strength (I'm 50 years old, weigh 149, and deadlift 450 pounds... and I'm NOT a powerlifter).

The idea that a natural sprinter and a distance runner would have similar dietary needs strikes me as unlikely.

And, fwiw, I've never liked meat in my life (fish is okay, but not bottom feeders and shellfish). The other day, someone gave me some grass-fed bison that, according to everyone else at the table, was AWESOME. I couldn't find one aspect of the flavor or texture that was in any way enjoyable.

I'm also curious about whether calorie restriction gets conflated with paleo. That is, I often meet people who've switched to paleo and rave about their weight loss and, when you look, it's clear that they're eating way fewer calories than before.

I wonder about the indigenous tribes -- what's the calorie count and fiber count in their diet (not just the composition)? And what's their activity level?

Backing up to individual differences again, the people I know who love paleo also like dietary fat and find protein and fat satiating. I don't. I've never liked fats, don't digest them well, and don't find them filling.

Thoughts?

JBG said...

I was startled to notice in the article that Lindeberg's "Mediterranean" diet included "oils and margarine". Now "oils" is unclear, maybe it was mostly olive oil, but margarine is surely not "Mediterranean" in any traditional sense. One has to wonder how much better the Med group might have done without the margarine.

I will remark in passing that I find Sashen's post very interesting and contributive. By contrast, I don't know whether to be annoyed or amused by Razwell's repeated declarations about how little we know accompanied by a number of flat statements of things HE knows, adorned by MANY words in ALL-CAPS.

Razwell said...

It's NOT "what I know" JB

It is what REPUTABLE ,TOP ,PIONEERING, WORLD RENOWNED ,INTERNATIONALLY RECOGNIZED SCIENTISTS on the subject of obesity know ( as well as anthropologists and all things Paleolithic)

hERE is a HINT: it is NOT congruent WITH WHAT THE iNTERNET GURUS SAY.

And THEY admit vast UNKNOWNS. I have researched this very thoroughly and KNOW what these scientists say ABOUT OBESITY ESPECIALLY.

Look to REPUTABLE information, NOT the standard Paleolithic gurus or fruitarian gurus. NONE of them are correct.

Kindke said...

oh how times have changed, guyenet is now a fully fledged fat phobic.

Razwell said...

While I am nowhere near Dr. Douglas Coleman on the subject of obesity, I am WELL ABOVE these various Internet guru commercial dieting industry book salesmen- WELL ABOVE.

I won't name names but you know the usual popular suspects with massive followings. ( I am not talking baout Stephan here)

All of my posts are the curent cutting edge information and on firm solid ground on weight regulation.

My sources are world renowned. it IS true that we do not know much about nutrition yet, and have massive amounts to learn about obesity.

The Internet gurus are SURE it is the patients' fault. Genuine science tells a much different sotry. It is ONLY "your fault" if you have about 10 pounds to lose and lead a deliberate crappy lifestyle.

However, morbid obesity is completely different issue altogether. Genuine science tells a much different story.

My message os not popular with uninformed Internet gurus, because they have never bothered to actually read what science has to say on the matter. Yet they invoke it ALL the time........



My OWN assumptions about obesity and coronary artery disease a decade back were completely wrong.

I would bet you 100 dollars and IVUS scan on these primitive cultures would reveal EXTENSIVE coronary artery disease.

How ere they prmitive cultures diagnosed as NOT having CAD? Was an IUVUS done? Nom it was not.

Coronary angiogram is outdated and MISSES A TOOOON of plaque. Fact. I have researched this from reputable sources such as Dr. Stevn Nissen, the head of the BEST coronary care unit int he world- The Cleveland Clinic.

Stephan Guyenet said...

Hi fg,

That is entirely individual. I would suggest trying different amounts and seeing how you feel. As for myself, I feel best when most of my starch comes from root vegetables like potatoes and sweet potatoes, but I do eat grains and beans regularly. I'd say I eat 60:40 roots:grains/legumes.

As for animal fats, what I can say with some confidence is that they don't seem to be intrinsically harmful within the normal range of intakes. I don't know much about the long-term effects of diets that are very high in animal fat within the context of a modern diet/lifestyle. Anecdotally, it seems to work well for some people, others not so much.

Hi Miki,

I acknowledge that there is quite a bit of uncertainty about when our ancestors first began to use fire. There is some evidence of controlled fire use by Homo erectus going back as far as 1.5 million years. Whether that was typical of the species or not is not clear.

Hi Steven,

You bring up some excellent points. In my article, I specifically avoided making macronutrient recommendations for Paleo diets because a) Paleolithic diets were probably just as variable as modern hunter-gatherer diets, and b) we aren't all built the same today.

I see a lot of people assuming that Paleo means low-carb, but I disagree with that. I think it stems in part from isotope data from European Paleo HGs who apparently ate a lot of meat. I don't dispute that, but there is no evidence that those people were our ancestors. Europe was overrun by agriculturalists from the Middle East, and modern Europeans are a mix of indigenous HG groups including Neanderthals, and agriculturalists from the Middle East. For most if not all ethnic groups in Europe, the agriculturalist genes likely predominate. These agriculturalists did not pass through a Northern climate where carnivory would have been favored.

There is also data from Cordain's group suggesting that most contemporary HGs eat less carb than most industrialized people do today. Emphasis on "most". There was a range, and as far as I know, there is no evidence that the groups on the higher end of the range were any fatter or less healthy than those on the lower end.

Regarding your point about calorie intake, I think that's also highly relevant. One of the most important aspects of a diet is whether or not it naturally promotes a healthy calorie intake. The Paleo diet can do that for many people, but there's more than one way to achieve that through diet. Another way is via the roughage plant-based diets. Simply prepared food that centers around vegetables, unrefined starch, etc.

Kezza said...

Thanks for the interesting article. You state that "...traditionally prepared grains, legumes and dairy can be healthy foods for many people." Do you have more info on which ethnic groups are more likely to tolerate grains, legumes etc.?

Anders said...

Hello Paul,

Well I do eat eggs and some dairy ( like yoghurt ). Tricky part would be to adapt the taste to eating hot food for breakfast when one is used to müsli and yoghurt :).
I think I prefer to watch the cow out in the fields instead of eating them but I don't mind that other people eat them (we are omnivores by nature).
Thanks for the answers!

//Anders

Steven Sashen said...

Stephen,

You just touched on a point I was thinking about seconds before I read your comment, namely, I wonder how the amount of protein that most paleo people recommend on a daily basis compares to indigenous tribes and what HGs could get (ignoring for a moment that most HGs probably didn't even eat every day, let alone have some sort of animal protein 3x/day).

Oerloper said...

I want to add to Dr. Lindberg's studies another research project about Paleo:
http://www2.canada.com/theprovince/news/story.html?id=cf0a7395-3f4b-4e74-b77d-7e3404e1be5f&k=53770&p=1

Carl said...

Stephan said "and modern Europeans are a mix of indigenous HG groups including Neanderthals, and agriculturalists from the Middle East."
Have "They" ever proven that Neanderthals were genetically related to modern Homo Sapiens??
Thanks

FeelGoodEating said...

I've asked this many a time but have never gotten an answer from anyone....namely how much protein is optimal?

All the footage I've seen from HG tribes, they eat very little protein. Full fat and all parts for sure but the portions are very small. Perhaps 2 to 4 oz a day max. Sharing the "kill" with the entire village doesn't make for very big portions...... This is where I see the biggest disconnect with our emulation of a "paleo diet"

Thoughts ?

Marc

TWJS said...

@Carl--DNA

Proven or concluded?
"Comparing genomes, scientists concluded that today’s humans outside Africa carry an average of 2.5 percent Neanderthal DNA, and that people from parts of Oceania also carry about 5 percent Denisovan DNA"

http://www.nytimes.com/2012/01/31/science/gains-in-dna-are-speeding-research-into-human-origins.html?_r=1

Don S said...

FeelGoodEating,

Cordain's landmark article answers your question:
http://www.ajcn.org/content/71/3/682.full

"This high reliance on animal-based foods coupled with the relatively low carbohydrate content of wild plant foods produces universally characteristic macronutrient consumption ratios in which protein is elevated (19–35% of energy) at the expense of carbohydrates (22–40% of energy)."

Stephan,

I am puzzled. Why did you include chicken based meals as being against that ancestral macronutrient profile? It is lean animal protein and many hunter gatherer groups eat birds. In fact recent research shows that eating more chicken is protective from stroke risk. See:
http://stroke.ahajournals.org/content/early/2011/12/29/STROKEAHA.111.633404

" In multivariable analyses, higher intake of red meat was associated with an elevated risk of stroke, whereas a higher intake of poultry was associated with a lower risk. In models estimating the effects of exchanging different protein sources, compared with 1 serving/day of red meat, 1 serving/day of poultry was associated with a 27% (95% CI, 12%–39%) lower risk of stroke, nuts with a 17% (95% CI. 4%–27%) lower risk, fish with a 17% (95% CI, 0%–30%) lower risk, low-fat dairy with an 11% (95% CI, 5%–17%) lower risk, and whole-fat dairy with a 10% (95% CI, 4%–16%) lower risk"

Don S said...

As far a fat goes ...

Randomized controlled trials show that for any given fat intake level replacing saturated fats with PUFAs results in fewer coronary heart disease events. See
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000252

If one is trying to replicate the HG macronutrient balance then modern fatty beef and pork fails. The meat sources that HGs (and one presumes our ancestors) ate was in comparison quite lean, and much higher in both MUFAs and PUFAs than modern beef. Look at it this way - the top protein level of the HG groups in Cordain's article was 35% , the lowest carb level 22%. That leaves a top portion for fat at 43% (and if that fat was blubber then it was mostly MUFA not saturated fat). 78% non-carb max. The math means that the diets with the highest protein and lowest carb had to have meat sources that were about 45% protein, not the 30% protein and 70% fat of most modern beef steaks (see http://nutritiondata.self.com/facts/beef-products/3768/2 ) Now bison will get you there. So will eating fish and poultry. But a diet that consists of mostly modern beef without concern for choosing lean sources will NOT replicate a HG (and again, presumably Paleolithic) macronutrient balance.

Eat fatty foods if you want, but justifying it as "Paleolithic" is fooling yourself.

Don S said...

Hmm. Link got cut off. The PUFA/SFA CHD article is:
Mozaffarian D, Micha R, Wallace S (2010) Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS Med 7(3): e1000252. doi:10.1371/journal.pmed.1000252

Sanjeev said...

> The idea that a natural sprinter and a distance runner would have similar dietary needs strikes me as unlikely.
________
Hi Steven, good to "see" you about.

Actually they turn out to be similar. Very few athletes of any stripe do well with low carbohydrate -long or short distance. The key is in the competitiveness - the ability to produce anaerobic work for short periods, but longer than a few minutes.

The Kenyans (distance) don't do it and the Jamaicans (sprinting) don't.



click

or copy and paste the below for assured work safety
http://www.bodyrecomposition.com/training/cyclical-ketogenic-diets-and-endurance-performance-qa.html

I might suspect that even competitive meditation would require a high carbohydrate diet ; ) not that you do that ...

Sanjeev said...

I've asked this many a time but have never gotten an answer from anyone....namely how much protein is optimal?
________
depends.

It's complicated.


(I'm channeling an author I admire ... he wrote a whole book on the subject, broad coverage but slanted toward athletes)

For example, older persons respond with much less anabolism to an amount of protein that's anabolic for younger folks.

burn victims not fed a lot of extra protein catabolize a ton of muscle to get glutamine

Burning glycogen stimulates proteins internal to muscle that break down muscle protein

It's Lyle McDonald. His web page link's in my post above.

I hope that's not considered commercial spamming.

Sanjeev said...

> The Kenyans (distance) don't do it and the Jamaicans (sprinting) don't.

"it" being low carbohydrate

Why does invalid English make sense when you press "post" but not after?

David Sucher said...

Is there a bio-chemical basis for the Paleo Diet?

I take for granted that no sane person is still eating Wonder Bread and Twinkies. Especially PCC members. Simple foods, avoid dessert, moderate alcohol seems to be the core of any (what I would describe)

Based on reading your article, it sounds to me as if the major difference in the Paleo diet versus the Mediterranean (or any other PCC-oriented diet) is that the Paleo eschews
-- grains i.e. pasta, bread, breakfast cereal* etc
-- dairy i.e. cheese, milk
-- legumes e.g. peanut butter, pea soup
* I assume that no one I know has eaten Tony-the-Tiger breakfast cereal for decades or even most granolas.

Do I have that right? I don't follow diet-talk much (so maybe I got the pea soup wrong.) But that's the gist. Correct? Eliminate or de-emphasize grains, dairy and legumes?

Well I don't get it. Maybe I missed it in the PCC piece. I'm not asking about history and anthropology and archaeology but the science, the chemistry -- why are grains, dairy and legumes so problematic from a bio-chemical perspective?
Mind, I am not disagreeing -- just curious.

Is there a bio-chemical basis for the Paleo Diet?
(I am also curious about why our paleo ancestors would have been eating _lean_ meat. I assume that they would _everything_ including the fattiest stuff they could find.)

(My own sense is that the great majority of our ills are from insufficient exercise and too much food, of any type, though of course compounded by the Industrial Diet. )

Anyway, your article was very interesting and I am glad PCC is raising it.

Stephan Guyenet said...

Hi David,

There is sort of a biochemical/neurobiological basis for the Paleo diet, but honestly not much about diet-health is understood at a molecular level in general so you could come up with a biochemical rationale for just about any diet if you wanted to. The most important thing with diet research at this point in the game is not so much what the mechanistic rationale is, but what the actual results are in controlled diet trials. However, if I were to make a mechanistic rationale, it would look something like this. The Paleo diet has these advantages over the typical diet and certain other health diets:

-High micronutrient content, including high potassium and magnesium and a high potassium:sodium ratio

-Omnivorous, so it contains all essential nutrients

-Leaves out most foods that contain problematic substances for many people, such as wheat (gluten) and dairy (lactose, casein). I acknowledge that these are not necessarily problematic for everyone.

-Does not necessarily restrict any macronutrients

-Excludes industrially processed energy-dense food that is nutrient-poor and encourages overeating

-Paleo forces people to eat simple food, typically cooked in the home, and this encourages a healthy calorie intake and avoids nasty industrial ingredients

I hope it was clear from the article that I'm not claiming Paleo is the Optimal Diet for All People. Although I recognize that strict Paleo has helped many people, I don't really eat Paleo, personally. I eat Paleo plus beans, non-gluten grains, and a modest amount of pastured dairy, which I prepare in my home using traditional methods. One of my main sources of starch is potatoes, which I consider Paleo but some people wouldn't.

Kurt G. Harris MD said...

"Although I recognize that strict Paleo has helped many people, I don't really eat Paleo, personally."

My sentiment as well.

With regard to the good doctor you quoted, I can only sigh deeply when I read "lean meats and nuts" and see that contraposed to "dairy and legumes"

The legumes case has always been weak with the exception of junk food like peanuts, and the dairy indictment is so baseless as to be just plain irritating.

I think paleo diets as a whole, like low carb, turn out to be right for the wrong reasons.

1) avoiding grains eliminates industrial high energy density highly palatable concoctions made from wheat flour - bread, cake, donuts, pastries, chips etc.

2) Avoiding dairy means avoiding highly palatable things like milk, ice cream and cheese, which helps many people control the reward aspects of diet and hence energy balance - "casein" is for most people no more a menace than bovine serum albumin from paleo-approved lean beef.

3) Real whole foods are low reward and high in micros no matter what you call the diet.

More and more I like "simple whole foods non-industrial diet" as it covers most of what actually works and why.

Aravind said...

I essentially eat the way Stephan describes, based on essentials. I have come up with a new term for this way of eating. I call it Archevore. Trademark pending.

Actually I've thought about just calling it a Toxiphobe's diet because neolithic toxin avoidance seems to be the Pareto Principle at its finest with respect to nutrition. Barring serious medical issues, the rest of ones dietary tweaks are arguably in the weeds.

David Sucher said...

Thanks, Stephan.

Well, while I am hardly convinced but I like experimenting so I'll try the Paleo for a week and see if there are any changes.

David Sucher said...

I had some Google-time today with the Paleo Diet and FWIW, according to US News' survey, the Paleo Diet doesn't rank high -- in fact it's at the bottom:
http://health.usnews.com/best-diet/best-overall-diets?page=1

I am only reporting, not advocating one way or another.

Thomas said...

@Kurt Harris,

"I think paleo diets as a whole, like low carb, turn out to be right for the wrong reasons."

Thank you for taking the dogma out of the paleo diet-I think you are likely right on here. Yes, right for all the wrong reasons. Your explanation takes the irritating and speculative (but cock sure) dietary anthropological bend out of it and breaks its health benefits down simply. And that is enough. Nice job.

Paul Hagerty said...

The "whole simple foods" terminology might be easier to digest. It does seem less dogmatic to me too.

Anders,

Your breakfast of choice suggests to me you may be quite healthy. If you are healthy and feeling great, why change your favorite breakfast?

David Sucher,

I read the US News diet rankings as well. Subsequently, I found an article written by one of the panel members who did the ranking, Dr. David Katz. I found his perspective illuminating.

http://www.huffingtonpost.com/david-katz-md/best-diets_b_950672.html

I appreciate your healthy skepticism and doubt that retorts from "paleo" people would convince you, but Dr. Loren Cordain of Colorado State is THE MAN and got an approving nod from Katz him self.

http://thepaleodiet.com/archives/3187

Paul Hagerty said...

Here's the URL for the article where David Katz advocates a paleo diet and gives a respectful and approving nod to Cordain -

http://www.huffingtonpost.com/david-katz-md/paleo-diet_b_889349.html

Razwell said...

Hi, Stephan,

I generally support a Paleolithic way of eating- but the real way - which was varied. Eating whole foods.It's the best we have so far.

However, how can the vegans or even the Paleolithic crowd make the claim that Kitivans, and other such cultures ( and even people in the China Study)and Paleolithic Man himself had very little or no coronary artery disease.

These people probabloy never went through coronary angiograms let alone the extremely accurate , cutting edge IVUS test. Since CAD is nto a disease of the veesel lumen, but rather the vessel WALL, it will not hsow up many times on coronary angiogram tests.

So the ONLY way to treliably tell with certainty if these poeple actually had or did not have CAD is to put all of them through an IVUS test looking milimeter by milimeter section by section with IVUS.

Then will will know.

The disingenuous people over at low carb forum banned me for making this point. It is absolutely logical and valid. Everything was deleted and my account was gone. They have a clear agenda just like DurianRider does.

Coronary angiograms are completely outdated and miss MUCH - A TON. IVUS can reveal rather entensive plaque in the coronary walls.
Jim Fixx , had the IVUS been available back then, would have learned he had heart disease. The technology back then told him he had no CAD just because his lumen was clear.

So may poepl are sent home being told they are fine, when IVUS would have detected all coronary angiograms miss. THis is scary and dangerous.

Who knows what we would have found if Paleo Man's remains ( if you could) China Study poeple, and Kitivinas etc. were pout through an IVUS test? Who knows?

Don S said...

The biggest problem is that "Paleo" has been taken over by the hype-masters and encompasses a variety of nutritional profiles many of which have little in common with any of the varied nutritional profiles that early omnivorous and adaptable humans may have eaten. (Which again was never a high saturated fat diet.)

Does Paleo just mean eating lots of beef even though modern beef is much higher in SFA than the animal source protein humans ate throughout the world during most of our history?

Does it mean avoiding foods that meet the macronutrient balance of those times better than modern beef because they were not as commonly eaten then?

How can one "rate" such a nutrition approach that means whatever a particular seller of one or another approach wants it to mean?

That US News and World Reports rating was low mainly because of the lack of data. Cordain's rebuttal (http://paleozonenutrition.com/2011/06/12/clinical-studies-supporting-paleo-diet-rebuttal-to/ ) notes several studies, but those studies range from:
a group of 10 Aborigines switching from a Western diet to no grain, wild "kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey";
to one comparing a diet "based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts" (with reported averages of 24% protein, 32% carbs, and 39% fat) to one without nuts and with margarine(!), dairy, and grains (20% protein, 42% carbs, 39% fats);
to one of "lean meat, fruits, vegetables and nuts" that "contained 30% of calories from proteins, 32% from fat (mainly unsaturated) and 38% from carbohydrates" compared to a "usual" one that "averaged 18% of calories from protein, 44% from carbohydrates and 38% from fats".

The largest of those studies had 29 participants.

None of these studies had the very low carb that many of the media "Paleo" gurus advise, or had the saturated fat levels that those gurus suggest and even encourage. They all used lean protein sources and included lots of vegetables, root vegetables, fruits, and nuts.

No one can seriously conclude that those few, fairly small studies, prove that eating lots of fatty beef is A Good Thing or say anything about grain, let alone legumes.

Yup, a diet relatively higher in lean protein (24 to 30% of energy needs), low in SFAs, high in PUFAs and MUFAs, with lots of a variety of vegetables, root vegetables, fruits, and nuts, (hence high in fiber and many phytochemicals) does well on many proxies of long term health. That much we can say from those studies. Saying more would be a work of imagination. May be true, may not be, but is exclusively speculative.

Strontium Pup said...

@Don S

You might want to read Stephan's summary of that SFA/PUFA meta-analysis (note the nice title).

http://wholehealthsource.blogspot.com/2010/03/leave-your-brain-at-door.html

Asim said...

What is the basis that the Middle East were primarily agricuturalists, considering the region is often hot and arid, and water is relatively sparse. At the same time, milk has always been a staple of the beduoin diet.
How does one define Middle Easterner?

I may be an idiot, but coupled with the fact that many animals and humans as well share a genetic code upto 95% percent in such cases, and show widely different behavior even in a biological sense, and much of science is advancing in a way that the genetic expression is regulated not by the 'protein' sequence, but 'junk' DNA, does one really believe that we can tell who our ancestors are based upon
numbers like 2.5% DNA and the like?

Further, much of what is 'agriculture', because of it being soluble and insoluble fiber, is really a matter of the gut bacteria, the implication being toleration is about whether one has the necessary enzymes from bacteria in the gut to break down a particular food...

I'm beginning to think nutrition is nothing but hog-wash...

Oh and take a look at the latest pictures of an untouched Peruvian tribe...

http://i.i.com.com/cnwk.1d/i/tim/2012/01/31/120131-Peru_isolated_tribe-AP120131119675_620x350.jpg

The sure as hell look pretty obese to me....

Asim said...

food intolerance is primarily a result of the lack of necessary flora to digest a certain staple... if your persistent enough to eat food that has the necessary bacteria attached to it, you'll eventually be able to tolerate that food...

Asim said...

Another point about plant foods in the wild versus plants foods in the home... eating off a tree with minimal washing is different than eating with extensive washing 'modern' society does today... the former has a wide range of bacteria that can settle in the gut, the latter, not so...
it's not simply about the type of food a paleo ancestor ate...

modern civilization is heavily dependent upon anti-biotics, has now become infatuated with Purell, dries their skin out without excessive usage of soap, wiping off more bacteria, kids sit inside on the internet and jungle gyms with dirt everywhere are deserted...

no wonder allergies are on the rise and people can't 'handle' foods...

Don S said...

StroniumPup, thank you for pointing that post out to me. I've now read his critique. He is accusing the authors of falsifying their methods, a very serious charge. "Cherry picking" studies to be included in a meta-analysis based on knowing the results and excluding those with findings that do not agree with an a priori belief would be a huge ethical violation. If he is really making that charge he should bring his evidence of such to the journal and the article would need to be retracted. OTOH it may be that Stephan is, in this case, merely letting his a priori belief lead him to a faulty analysis. PUFAs automatically means "bland unnatural foods"? C'mon.

Asim, that is just a plain untruth. Lactose intolerance is due to an enzyme not present in the gut wall. No amount of new gut flora will make one lactose tolerant. Some intolerances are allergy or otherwise immunologically based. And no amount of bacteria on food will make humans into ruminants.

Asim said...

Don S...

Are you claiming that gut bacteria don't carry the enzymes necessary to break-down lactose?

Asim said...

BTW Don, notice the words "primarily".. of course I'm not making a blanket statement that humans can eat grass like a cow...

Asim said...

An allergies are immunologically-based... intolerances are primarily the result of a lack of enzymes from gut flora to break down a particular food... there is a reason why a foreign traveller may get diarrhea from eating the same food as a local eating from the same plate, only after time being able to tolerate it quite well after persistently eating...

Don S said...

Asim, the enzyme that breakdown lactose is in the small intestinal villa. If you have the enzyme you break it down and absorb it there. We all have bacteria that break down lactose in the large intestine. If it gets there in appreciable amounts because you did not absorb it up higher then that process of fermentation is what causes gas, bloating, and diarrhea.

Some fermentation may be a good thing, that is the current work on resistant starches and various fatty acids, too much fermentation is painful, embarrassing, and potentially very messy.

JBG said...

I found this comment of Cordain's especially interesting, and apparently a turn-around from his previous position favoring lean meat:

"Actually, the most recent comprehensive meta analyses do not show fresh meat consumption whether fat or lean to be a significant risk factor for cardiovascular disease (20-25), only processed meats such as salami, bologna, bacon and sausages (20)."

http://thepaleodiet.com/archives/3187

David Sucher said...

I'm new to this diet and so I am looking into what is "allowed" or not.

And I find that honey -- the sweet substance produced by BEES -- is on the NO list.

Is that generally agreed? i.e. by Paleos.

(You can hear my increasing skepticism.)

Asim said...

Don S,

So what your essentially saying is that any food we do not have the necessary gut flora to break-down, which includes pretty much the wide-specturm of fruits and veegatbles, we are allergic to, leading to a big mess, because we lack the necessary enzymes in the 'villa'?

http://www.ncbi.nlm.nih.gov/pubmed/15612492

"The live flora in dairy product could improve lactose digestion in male adult lactose malabsorbers."

Do you think breast-milk isn't fortified with the bifidobacteria?

If your having a messy problem, it's precisely because your lacking in the gut flora necessary to break-down the 'food'...

Asim said...

Cordain has shifted his position on saturated fat, as pointed out by David...

Razwell said...

Hi, David,

I can show you a video on YouTube of remote Amazonian people making bread ( gasp) and easting lots of honey.

Leila said...

@ Jason Sandeman - here's a link to sources of pastured meats in various provinces - http://eatwild.com/products/canada.html#top

I'm in Alberta & have found pastured meats for sale at my local farmer's markets.

Don S said...

Asim,

No, that is not what I am saying. I am saying that your statement that intolerances can be all addressed by building the right bacteria is untrue.

To stick with the lactose intolerance example: yes, live culture yogurt will produce marginally less hydrogen when ingested than will heat treated yogurt with the amount of lactose. The reason is not because we are being colonized with those bacteria (the "probiotic effect"; a good thing though that may be for other reasons), but mostly because they are releasing their enzymes as they get lysed. There are also some probiotic effects of yogurt bacteria that help reduce the symptoms of lactose intolerance, but those effects are not aiding in digestion of it. And in any case, the [i]primary[/i] cause of lactose intolerance, as an example, is lactase deficiency.

Please note: I would agree with a statement that endorses the benefits of fermented (live culture) dairy. We could have a long discussion with many articles to cite regarding that. There is also an emerging body of work understanding the critical role that the human intestinal microbiome plays in metabolism, and the roles that colonization based on infant feeding practices and long term dietary patterns play in establishing particular microbiome enterotypes. (There are three main human gut microbiome enterotypes, apparently - Bacteroides and Prevotella, and Ruminococcus - and the enterotype seems determined by what our long term dietary habits are. The role these microbiomes play in the symbiotic creatures that we plus our microbiomes are is still being worked out but is suspected of having significant impact on a variety of long term disease states including obesity. ) This is fascinating stuff. But to claim that intolerances are primarily from not eating the bacteria that digest the food and that "if your persistent enough to eat food that has the necessary bacteria attached to it, you'll eventually be able to tolerate that food" is to claim something that is simply not true.

Jane said...

Loren Cordain believes, quite understandably because everybody believes it, that the micronutrients most deficient in US diets include iron and zinc but not copper or manganese.

In the UK, the RDA for copper is the same as the average intake. I have established in correspondence with the Department of Health that this is not a coincidence. The argument seems to be this: we know copper deficiency is rare, therefore the average intake must be enough.

Even a cursory glance at the work of Leslie Klevay should convince everyone that copper deficiency is very common. The RDA in the US was recently established at exactly the level found by Klevay to produce symptoms of heart disease in human volunteers. Too low, in other words.

Much the same things can be said about manganese. Nobody believes manganese deficiency exists. In fact it may be the most important and widespread deficiency of all, even more so than magnesium.

Here is a paper showing that even supposedly healthy grass-fed beef is extremely high in iron and zinc, and extremely low in copper and manganese. The iron-manganese ratio especially is high almost beyond belief: around 100. The ratio in wheat, so reviled by the Paleo people, is 1.

http://www.ncbi.nlm.nih.gov/pubmed/20374819

Asim said...

DonS:

"To stick with the lactose intolerance example: yes, live culture yogurt will produce marginally less hydrogen when ingested than will heat treated yogurt with the amount of lactose. The reason is not because we are being colonized with those bacteria (the "probiotic effect"; a good thing though that may be for other reasons), but mostly because they are releasing their enzymes as they get lysed. There are also some probiotic effects of yogurt bacteria that help reduce the symptoms of lactose intolerance, but those effects are not aiding in digestion of it. And in any case, the [i]primary[/i] cause of lactose intolerance, as an example, is lactase deficiency."

I don't see anywhere how your response disagrees with what I stated. These gut bacteria provide the lactase which breaks down the dairy, helping reducing the intolerance. When these bacteria are present, then the issues of gas and bloating and other symptoms which are often mistaken for allergies, disappear.

Asim said...

It is bineg recongized that what is often declared an allergy nowadays is not an allergy, but intolerance and the World Health Organization has reported this fact as well.

andrew siddle said...

Your article is a great introduction to the concepts of thepaleo diet. I am sharing it with people who I think will benefit from it.

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