Paleo Diet — Nearly Right

Chapter summary

• The Paleo (also “Caveman” or “Stone Age”) diet means eating only foods that pre-agrarian hunters could have eaten.
• Allowed: grass-fed beef and lamb, pastured chicken, fish, vegetables, fruit, nuts, and good fats.
• Avoided: bread, added sugar, potatoes, rice, processed food, and sometimes alcohol and nightshade vegetables such as tomato and eggplant.
• It is more a lifestyle than a diet. The forbidden list closely matches foods that Harvard Medical School tells patients to avoid.
• No long-term studies exist yet, but results for weight loss and diabetes control look promising.

The case for Paleo

• Processed foods and added sugar are removed.
• Followers do not count calories. They eat as much lean meat, vegetables, fruit and good fat as they like, and still lose body fat.
• It favours natural fats and avoids manufactured ones such as canola oil.
• Cooking at home avoids hidden additives and heavy salt.
• It pairs the diet with strength training and short sprints.
• Evidence: In a 29-person trial of type 2 diabetics (Jönsson 2009), a Paleolithic diet improved glucose control and heart risk factors compared with a diabetes diet over three months. It was more satiating per calorie than a Mediterranean diet.
• Appeal to men: It encourages plenty of meat instead of salads.

Mark Sisson’s ten principles

• Eat plenty of animals, insects and seasonal plants.
• Move often at a slow pace, lift heavy things, and sprint now and then.
• Sleep a lot, play, and get daily sunlight.
• Avoid trauma and poisonous things, and use your mind.
• Sisson allows an 80/20 rule: one free day a week helps long-term adherence.

The case against

• History: We do not know what our ancestors ate, including whether they ate grains, nuts or seeds. It depended on place and climate.
• Modern food: Fruit and vegetables have changed over 100 years of agriculture. A 30,000-year-old ancestor would not recognise them.
• Commerce: The diet sells “Paleo” meals and supplements.
• Critics: Many dietitians question cutting out whole grains and legumes, and see health risks in a meat-heavy diet. Supporters point to the lack of processed food.
• Lifespan: Early humans may have lived about 72 years, with early deaths mainly from accidents and poisoning.

Take-away points

• Paleo works because it takes out sugar and simple carbohydrates, not because of the history.
• A trendy diet that makes people feel special can support the behaviour leg of the three-legged stool.

References

• Sisson, M. (2013) The Primal Blueprint. Primal Nutrition.
• Durant, J. (2013) The Paleo Manifesto. Harmony.
• Jönsson, T. et al. (2009) Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovascular Diabetology 8:35.
• Nichols, G., Hillier, T. and Brown, J. (2008) Normal fasting plasma glucose and risk of type 2 diabetes diagnosis. Am J Med 121(6):519-524.