The paleo diet is based on the premise that humans evolved as hunter gatherers during the last 2 million years. Around 10,000 years ago we become agriculturalists, settling, collecting seeds and growing cereal grains, domesticating animals and drinking their milk. The theory proposed by Professor Loren Cordain and others is that this is a short time from an evolutionary perspective, and we have not adapted to digest and deactivate some of the proteins and anti-nutrients in these foods. As well, grains are high in starch leading to excessive amounts of carbohydrates in our diet. We have become sicker as a species with a growing list of health issues such as gut inflammation, obesity, heart disease and type 2 diabetes.
The evolutionary discordance has increased even further in the last 100 years as we have added increasingly larger amounts of highly processed foods, sugar, synthetic additives, and chemically extracted vegetable oils, which relegate natural whole hunter-gatherer type foods to a smaller and smaller percentage of our diet. (Picture: UK diet source)
A number of excellent papers have been written on the subject. (1, 2, 3, 4, 5 )
Added to this, some researchers have studied modern-day hunter-gatherers, or people whose diets are devoid in cereal grains, processed food, and chemically extracted vegetable oils, and found them to be healthy and virtually free of modern disease. (6, 7, 8 )
A modern paleo diet is one which uses the principles from evolutionary biology and designs a diet by asking the question – what is the healthiest diet for humans from an evolutionary perspective using modern foods? How can we mimic the hunter-gatherer diet, using foods available from our own environment? Modern nutrition science is not neglected and we use that to further modify the diet to reach one that is as healthy as possible.
There are many who criticise the paleo diet trend
There was no one paleo diet (no-one disagrees with this). We no longer have the food available that we had in cave man times (of course, agreed again). We have evolved in the last 10,000 years to handle these foods; the main argument here is lactase persistance after weaning, then using this reasoning to apply it to other foods. However as Dr Alessio Fasano points out, and science backs up – no-one is yet able to properly digest gluten. (For Critiques see Christine Wariner, TED talk, and Marlene Zuk, Paleofantasy, and counters to these critiques Robb Wolf, Mark Sissons, Paul Jaminet, Angelo Coppola)
Critics say leaving out entire food groups is unhealthy and dangerous. However, Cordain’s research points out that a Paleo diet using modern available foods is highly nutritious.
Paleo diet criticisms miss the point
We are not trying to copy some imagined diet that our ancestors ate, we are trying to find the healthiest diet for humans using readily available local food, using knowledge gained from both evolutionary biology and current nutrition science.
Many people (including paleo advocates) misinterpret the paleo diet
A paleo diet is not necessarily meat based, nor it is high fat, or very low carbohydrate, it is a diet based on eating a certain quality of food, that which is as unprocessed as possible, food that is freshly gathered from the land. By default, however, cutting out highly processed grains and sugars, will reduce carbohydrates to moderate, rather than the current excessive levels.
How I define paleo
The paleo diet is a whole food based approach to eating: preferably locally grown quality protein from poultry, meat, fish and seafood, fruit and vegetable carbohydrates, and whole food fats, like nuts, freshly pressed oils and avocado. Your diet should give you adequate, but not excess, carbohydrates and fats sufficient for your fuel needs, and protein to maintain lean body mass. Your paleo diet should be varied and supply all essential vitamins, minerals, essential fatty acids, amino acids, antioxidants, polyphenols and fibre. (This slide below is from my paleo seminar)
Food that does not work for you as an individual is not eaten, for example those with auto-immune conditions may not tolerate nightshade plant foods. Likewise, and this may be contentious for paleo purists, I don’t believe everyone needs to completely avoid non paleo foods. Well prepared legumes for example provide certain types of gut healthy fibre for those who tolerate them.
Which brings me to a bugbear:
The trend to make paleo replacements of grain based foods and treats misrepresents the spirit of a paleo diet
The popularity of the paleo diet has given rise to a huge entrepreneurial trend for ‘paleo’ processed foods, where an ingredient that is acceptable to eat on the paleo diet is refined and used in vast quantities to reproduce the very foods we are trying to avoid, such as bread, cakes and cookies. These ingredients are turned into another highly processed, energy dense food. I have nothing against these foods, and treats are a part of food enjoyment, (and I am not one for deprivation!) but a paleo diet in essence is not based on processed food even if made from paleo compatible ingredients.
Four reasons why the paleo diet benefits health for many
Why won’t the paleo diet go away? Many people when they switch to a paleo diet get extraordinary results; if your health dramatically improved or excess body fat fell off effortlessly, wouldn’t you be excited? Paleo eating will not go away – people will not stop being enthusiastic when their life changes for the better. Paleo eating is now being promoted by a growing number of health practitioners, and there are a number of research studies confirming its effectiveness for type 2 diabetes, markers of heart disease, blood pressure reductions, weight loss, appetite control and multiple sclerosis.
There are many aspects of paleo eating that contribute to people getting these life changing results. Here I outline the main ones.
1. The paleo diet gives relief to those with undiagnosed celiac disease, wheat and gluten intolerance or sensitivities.
It is estimated that up to 80% of those with celiac disease in Western countries have not been diagnosed. (9, 10, 11, 12 ) Many of these people have silent celiac disease where they have no typical gut symptoms. The list of symptoms and health problems caused by celiac disease is staggering, and many people suffer health problems that neither they nor their doctor have picked up as celiac or gluten sensitivity as being a cause. It is estimated that for every person suffering celiac disease there are another 6 that suffer non celiac gluten sensitivity. (13 ) A recent study in Australia showed that 58% of the population carries genes that predispose them to celiac disease, so potentially many more people could be affected. When gluten is removed from their diet, life can change dramatically for the better. Here are just a few problems that people suffer from with undiagnosed celiac disease or gluten sensitivity:
- Underachievement in education and working life
- Unexplained Infertility, miscarriage, adverse pregnancy outcomes
- Iron or folate deficiency
- Auto-immune disorders
- Fibromyalgia
- Dental enamel defects, mouth ulcers and Atrophic Glossitis
- Multiple Neurological problems
- Also, but not limited to hyposplenism, reduction in bone mineral density, liver function abnormalities, neuropathy, psychological disturbances, fatigue, myalgias, arthralgias, asthma, weight loss, bloating, abdominal pain, bowel changes, alopecia, headaches, menstrual irregularities. (14, )
- Non celiac gluten sensitivity has also been linked with numerous health problems including abdominal pain, nausea and diarrhoea, bloating and wind, eczema, headaches, joint pain, chronic tiredness, numbness in hands or feet, muscle cramps, depression, hyperactivity, attention disturbances, and painful mouth ulcers. (15 )
The list could go on… on a final note – if you do think your health issues might be gluten related – I recommend you test for celiac disease before trying out a paleo or gluten free diet.
2. Some with celiac disease do not get complete gut healing without cutting out additional foods – which the paleo diet does
Up to 30% of people with celiac disease do not go into remission on a gluten free diet, that is they continue to show anti bodies to gliadin and transglutaminase, and / or have on-going gut inflammation. One study showed after a gluten free diet for 6 months only 8% of individuals showed complete normalisation of villous architecture (the gut cells, and all the folds).
A subset of those with celiac disease continues to suffer severe gut inflammation and on-going deterioration of the villous architecture. This is called refractory celiac disease, type 1 (mild), and type 2 (severe)
In this previous post I outlined how people with celiac disease can react to a number of other proteins in other foods, which sets off an antibody reaction in much the same way gluten does. A paleo type diet reversed refractory celiac disease in one study. Read the full post:
Celiac disease? Why you should not eat dairy, corn, quinoa, oats and instant coffee.
3. People with auto-immune diseases often get a reduction in symptoms, and improvements in clinical markers of disease
There are numerous anecdotes of people who have had remarkable improvements, and although these do not constitute clinical studies, the sheer number of success stories, like these cannot be ignored. Dr Alessio Fasano pointed to 3 factors common to all auto-immune disease: A genetic predisposition, an antigen which triggered the self antibodies, a way for the antigen to cross the gut barrier, increased gut permeability where the antigen can interact with the immune system. Leaky Gut and Auto-immune disease, Fasano.
The paleo diet removes foods and addresses lifestyle factors that contribute to gut permeability. By healing the gut epithelium, and removing possible antigens (gluten is an antigen for celiac disease), autoimmune triggers are reduced. Sarah Balantyne, PhD, and Loren Cordain, PhD have posts describing how certain foods contribute to auto-immune disease. The whys of food in the paleo auto-immune protocol, Sarah Balantyne, The paleo diet – autoimmune conditions and food, Loren Cordain
In this paper Prof Cordain outlines a rationale for treating rheumatoid arthritis with a paleo diet. Modulation of immune function by dietary lectins in rheumatoid arthritis
Dr Terry Wahls has recently completed a pilot study using a paleo diet with multiple sclerosis sufferers resulting in significant clinical improvements in fatigue. (23)
Dr Jean Seignalet, a French doctor, put many of his patients with auto-immune diseases on an ancestral diet and logged the success rates he had with each group. Dr. Jean Seignalet, ancestral diet and auto-immune disease trials
Paleo Auto-immune bloggers – link here
4. The paleo diet reduces the risk of diseases linked with the excess intake of free sugars
In 2005 New Zealanders ate 138 grams of added sugar per day – that is 32 teaspoons per day (16). Sugar (and in the USA high fructose corn syrup) is a di-saccharide (2 – sugars) with a glucose and fructose linked. More than half this sugar is added in the form of sugar sweetened drinks (liquid sugar) (Image: sugarstacks.com)
Free sugars have no nutritional value, unlike fruit which comes in a package with fibre, vitamins and polyphenols.
Free sugars cause numerous health problems, and when removed many of these reverse:
- Heart disease (20)
- Contributes to metabolic syndrome; high LDL cholesterol, low HDL cholesterol, high triglycerides, insulin resistance and central obesity (internal abdominal fat) (21)
- Fructose increases gout (22)
- Increased risk of obesity (23)
The paleo diet does not contain any free sugars, so in this respect is extremely healthy.
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that cross-hatch makes this difficult / impossible to read.
I wonder if it stands out more on your computer? I can barely see the crosshatch on mine.
I can hardly make out the cross hatch on my macbook. Great article!
GREAT post Julianne! I especially enjoyed your discussion of people who misinterpret the Paleo diet and people who believe they can maintain their absurdly high sugar intake with no adverse consequences by making “paleo” cakes, cookies, pies, etc.
Also like your consistent documentation of all key points with scientific references.
My feeling is far too many people go to dogmatic extremes with all kinds of diets, including Paleo. We can make educated guesses about what paleo diets (plural) might have looked like and we can also be sensible in a modern context and look at the “Blue Zones” around the world where people typically live to 90-100+ years – in excellent health even at those ages. None of the Blue Zones follow a strict Paleo way of eating in fact most of their food – probably about 90% of it – is whole plant foods including whole grains and legumes. They shun processed foods, use very little sugar in any form and especially in Okinawa they eat mineral rich seafood 3 times a week, plus lots of seaweeds, with hardly any meat at all in their diet.
So combining the best of Paleo and Blue Zone lifestyles (it’s all about lifestyles in total, not just the foods) according to your own comfort zone and what your body “tells you” you need, makes sense to me.
I’m looking forward to your Part 2 on the Paleo Diet.
Thanks again!
Tom
Thanks Tom, I agree, and I like to combine aspects of mediterranean and blue zone diets too.
Nice article. Interesting paper by Cordain. I would suggest balancing Cordain by watching this talk by Kuipers https://www.youtube.com/watch?feature=player_embedded&v=XwLE4jB4xvs
In this talk he does extensive mythbusting on what actually constitutes an ancestral diet with reference to seafood (at least >35%) and the importance of related nutrient such as DHA and Iodine along with other considerations concerning LA and ALA.
I referenced one of Kuipers papers – which I love. This one http://www.ncbi.nlm.nih.gov/pubmed/22894943 _ And I’ve just found a free download http://humanoriginsleiden.org/administrator/components/com_jresearch/files/publications/Kuipers%20et%20al%202012.pdf
Thanks for the link
Great find that last paper! Some of the same ground covered in the video talk but the paper goes further back into istroical migrationss, encephalisation and the dietary requirements of growing a large brain.
I have IBS and when I went two weeks to a gluten free diet I had the most energy I felt in years. You need to experience it to know the difference.
That’s great – thanks for letting me know your experience
This is absolutely nonsense. You\’re telling people that they don\’t have to eat a very low amount of carbs, but you say that you can\’t eat potatoes, oat meal, bananas… Do you want people to eat 10 pounds of blueberries to get their carbohydrates in? Also, you say that humans don\’t digest gluten as efficent as possible, which is true, but how about fruit and vegetables then? Even gorillas digest fruits much more efficent than humans. Cows can live on grass alone, we can\’t.
Actually I never said that, I said the paleo diet removes foods that many people have problems with, but only find out by their elimination.
Paleo is carb agnostic, you can eat any amount of fruit of root veg that works for you.
I recommend people use paleo as an elimination diet and add foods back in if they wish, but one at a time to test their effect. In this way, I’ve personally discovered that gluten (auto-immune issues) and dairy (eczema) are my biggest problems. I eat legumes with no problems as well as some gluten free grains.
The other reason many get results on paleo is by eliminating highly refined grains, starches and sugars. The effect is decreased blood sugar and insulin. Given around 50% of the population is insulin resistant, this makes a difference for many. If you don’t need to be very low in carbohydrates, there is no ‘paleo’ rule about keeping them very low.
This is a great write up that shows paleo is about much more than bacon and buttered coffee like people think. I’m so tired of hearing people call the paleo diet a “fad” its funny because if we’re honest its our default way of eating so it might be the longest running fad in existence.
Cheers,
Alex
Great article, thanks! Can you please share which study stated that only 8% of people with celiac disease Had changes in their villi after six months?
It was mentioned in one of the papers I looked at – this one I think http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-13-40