How Do You Feel About the Paleo Diet?

Not for Paleo: Whole grain banana pancake topped with yogurt, mixed berries, and strawberry puree.  This is certainly not healthy…

I was asked “How do you feel about the Paleo diet?”

Answer:  NO!  But first, let me explain just a bit more.

I feel that the Paleolithic prescription has both pros and cons. Weight control is easier when people eat more fruits and vegetables and leaner meat. It is also easier when portions are controlled no matter what the food may be. I wish I could get people to eat more fruits and vegetables. Also, I am a huge proponent of locally produced, unprocessed foods. Keep food simple. But in my profession I need proof, not hearsay or testimonials from athletes. To take hearsay or testimonials as proof of validity is simply naive. Obviously there is a need for more scientific evidence. Not evidence that is being used to sell a product. Three Drs. selling products do not convince me, with or without shirts on. People sellout everyday.

However, the last thing I want to do is argue about a diet. Who am I to tell anybody any different, it is not like I have ever studied nutrition, nursing, food science, or biochemistry…

So hear is a thought:

To accurately attribute the desired results of a diet to the alteration one or a few variables is like saying, “Hey, I feel better after I drank that bottle of snake oil.” Sure you did drink it, but what else did you do? Did you isolate all variables and perform the study as a double blind cohort study? I will bet you did not. The proposed evidence and reasoning used to promote this diets is lacking and claims made from the diet “creators” worry me.

For example, the claim of nutrient density superiority between grains vs greens or vegetables does not entirely match up. Whole wheat flour has twice as much magnesium as kale (by weight), yet kale has twice as much vitamin A (IU). Both contain greater and lower amounts of varying nutrients. This holds true for all foods. Now consider nutrient density AND absorption rate. On average iron from an animal source is absorbed at a rate of 25% depending on dietary factors like other food ingested and current iron status of the body. Non-heme, or non-animal sources are absorbed at a 17% absorption rate depending on dietary factors like other food ingested and current iron status of the body. Yet pork has 1/4 the amount of iron than whole wheat flour has. These two factors make the claim of “nutrient superiority” difficult to determine. Because no food can be perfect, balance and variety are important. Just as too little of one nutrient is bad, too much can be as well. Think about fiber. How much fiber is ingested on the Paleolithic diet? Whole grains are a great way to get the carbohydrates and calories in a diet. The same amount of carbs from vegetables will provide a great deal of fiber. Could it be too much fiber?

My other concern is feasibility. How feasible is it for a family to eat a Paleolithic diet? What are the added expenses (monetary and health) of eliminating whole grain, legumes, and dairy products and replacing it with more meats, fruits, and vegetables. Sure, there are sales on these items but will people get sick of eating chicken and the same fruits and vegetable for two weeks. Should we not eat cooked foods? Without cooked foods I wager that we would not have evolved this far today and that people would die much sooner. And what about the diet lacking in sources of calcium and vitamin D. Supplements can help, but correct me if I am wrong, I don’t think cavemen went to the local drug store on a regular basis. If processed foods are a “No No” then how could processed supplements be OK. Even our tap water is processed. Nutrient balance is easier to achieve with a balanced diet. The 2010 Healthy American Guidelines stress the importance of variety, balance, and moderation of ALL food groups. And if you think there is some sort of conspiracy that drives these recommendations you should also know that the latest edition of The Nordic Nutrition Recommendations (NNR) were published at the beginning of this month. The NNR has been been updating these recommendation every year since 1980 and is an authority in the topic. In short they state that typical features of a healthy diet include plenty of vegetables, fruit and berries, LEGUMES, regular intake of fish, vegetable oils, WHOLEGRAIN, reduced fat alternatives of meat and DAIRY, and limited intake of red and processed meat, sugar, salt and alcohol. In addition, how did the cavemen attain and eat their food? The foods that a caveman ate are very different than that of today. Does seasonality apply to the Paleolithic diet for us today as it did for real cavemen? Should we eat apples when they are in season and exclude other out of season foods? Should we be limited to only the food indigenous to the region in which we live? These kinds of restrictions decrease the feasibility of the diet yet were the driving forces for a caveman’s diet.

And the claims of “toxic” grains just seems ignore. It is not just grains have toxic portions. We have all heard that seeds in apple contain arsenic. No worries however because we do not eat them, nor the toxic portions of grains. Other products that have toxic portions include cherries, apricots, plums, onions, garlic, and rhubarb, all of which are included in the Paloe diet. Further, too much of anything can be negative. Vitamin E can take on oxidative principles if ingested in too great an amount. Does that make it bad?

My last concern is the genetic claim that our DNA somehow dictates what we should eat. Yes there is a lot of research into Nutrigenomics, yet it is still in in the infant stages of development. Further, it is not surprising that cavemen have similar DNA to humans (or at least claimed in pro-Paleolithic research) because they are a subclass of homo-sapiens. However, it is an impossibility that the DNA is 100% identical. There are no people on earth with the exact same DNA. And if there is they are called “clones.” So to use this as proof as to why we are not equipped to eat grains, dairy, or legumes is the antithesis of logic. A false statement cannot be used to justify something. Identical twins even have variances in their DNA, so how can we have the same DNA as cavemen? Besides that, how can the creators of these diets account for the presence of lactase, sucrase, and alpha-glactosides. If we have not adapted, why do we have enzymes used for digestion of the very food they claim that we are not equipped to process. All I am saying is that the proof is not there, just like there was not conclusive evidence for blood letting or witch hunts. Yes, people can achieve results from supposedly following the Paleolithic Diet, but are the results caused by the diet itself or other factors.

In addition there is not a ton of long term research on the effects of the Paleolithic diet. Personal testimonials are often times convincing, hence the reason that they are used to sell an idea or product. But when it comes to diet it is very important to consider the many variables affecting one’s diet. It is nearly impossible to identify the singular cause of a claimed benefit related to a diet without conducting the strictest of studies while in an environment designed to eliminate extraneous variables. The longterm health consequences of a higher protein, and thus higher fat, saturated fat, and cholesterol diet is well documented. Yes, protein is essential for life and needed for many many actions in the body like immune and brain function, but there are numerous studies also examining and touting the health benefits of whole grain consumption too. Not only does it help to control the risks of diabetes, heart disease, homocysteine levels, and inflammation among others. A balance between all the food groups will more likely provide the benefits and not the negatives from each groups.

To ascertain the benefit of eliminating one or more food groups for the entire population of the world just seems like a bad call. And it is certainly not the best approach to creating a healthy lifestyle. Grains are essential to fulfilling the energy needs of endurance athletes as well as the bellies of families. Barring overconsumption or certain conditions they are perfectly safe to consume. Eliminating whole food groups, in this case grains, legumes, and dairy, increases the likelihood of nutrient deficiency as well as decreased longevity.

There is simply not enough evidence to support the Paleolithic diet and plenty of evidence to refute the diet. There is great need for further research into the topic and hearsay does not hold up to current research. What are results of eliminating whole grains, dairy, and legumes in 20 or 30 years. And as far as the non-evolution of the gastrointestinal tract, without doing any real research into the claim, I find it hard to believe that we have evolved from cavemen to where we are now only to leave one of the most frequently regenerating pieces of our anatomy behind the evolutionary train. . .

In the end, any weight loss from the Paleolithic diet is most likely related to controlled calories and I bet a degree of glycogen depletion which, you know, is great for endurance athletes. Its not like they need energy or anything. In the end calorie control is the driving force for weight loss. Any credible long term weight loss study (2 years and greater) will show you this. Maybe cavemen were healthier because they lived only a fraction of our lifespans. Chronic diseases, in many cases do not develop overnight and take time to kill, but lions kill in a relatively shorter time.