Did Cavemen Have it Right? A Dietitian Examines the Paleo Diet


This post is a guest post from Katie Sullivan Morford and originally appeared here.
I’ve heard rumblings about the Paleo Diet for years, but the trend towards eating like a caveman appears to be gaining traction of late.  Friends are following the program, new books appear every time I turn around, and Paleo recipe sites dominated the recent “best healthy food blog” contest on the popular website The Kitchn (far outpacing little old Mom’s Kitchen Handbook).  It’s clear that Paleo is here to stay, so I thought I’d weigh in, particularly as many of you have asked for my two cents on the topic.

WHAT EXACTLY IS PALEO?

Paleo is based on what is believed to have been the diet during Paleolithic times: meat and fish acquired through hunting and fishing, and nuts, fruits, and vegetables, acquired through gathering. This translates in modern day to a diet that includes meat, preferably grass-fed, game, poultry, preferably pastured, wild seafood, eggs, fruits, vegetables, seeds, nuts, certain oils including olive, coconut, and walnut oil, and for some Paleo followers, honey and maple syrup in moderation.

Foods that are not “Paleo-approved” include grains, legumes, potatoes, dried beans, dairy foods, refined sugar, salt, processed foods, artificial ingredients.

 THE UPSIDE 

The Paleo approach to eating offers much to be desired from a health standpoint. Indeed, it would be a very good thing if a few of the fundamentals were to rub off on the American public.  Here’s where I applaud the diet:

  • Reliance on whole foods without processed ingredients.
  • Eschewing refined sugar, something we eat far too much of in this country.
  • Emphasis on high-quality animal protein: grass fed beef, pastured chickens, and wild seafood. These foods tend to be higher in nutrient content and gentler on the environment than conventionally raised beef and poultry, as well as farmed fish.
  • High intake of fruits and vegetables. Because the diet eliminates grains and beans, it relies heavily on fruits and vegetables, which are low calorie, nutrient-rich, and far too inadequate in the typical American diet.
  • Innovative approach to cooking. Many foods traditionally used in recipes are not part of the Paleo lifestyle. This, by default, has give rise to some pretty  inspired food and use of ingredients.

 SOME DRAWBACKS

On the flip side, though, there are a number of sticking points:

  • The idea of knocking out entire categories of nourishing ingredients just doesn’t stack up: Quinoa, farro, oats, lentils, chick peas, peanuts, and yogurt. Mountains of research demonstrate the health benefits of all of these foods and their role in disease reduction.
  • Eliminating affordable ingredients such as grains and beans, and prescribing grass fed meat and pastured chicken makes this diet an expensive proposition that is, frankly, out of reach for much of the country, not to mention the world at large, most of which subsists on these forbidden foods.
  • Animal protein, even when sustainably raised, is more taxing to the environment than plant-based proteins such as beans and grains. Many animal proteins are high in saturated fat, which we know to be linked to high cholesterol and heart disease.
  • The adverse effects of salt are associated with an excess intake largely  from processed food. Used in moderation in home cooking, salt is perfectly compatible with good health.
  • Meeting all the important nutritional requirements could prove challenging on the Paleo diet, most notably calcium and vitamin D.

THE DEEPER ISSUE

Nutrition data aside, here’s where I get really stuck:

Any diet that claims to be the cure-all for what ails us, quite simply, gives me hives. I don’t espouse a “one-size fits all” approach to eating, so the statement by self-proclaimed Paleo founder Dr. Loren Cordain that his is “the healthiest diet in the world,” doesn’t ring true.

Travel abroad and you’ll discover pockets of the globe where inhabitants know little of the diseases that afflict modern society; all eat vastly different diets. This notion is the basis for Dr. Daphne Miller’s acclaimed book, The Jungle Effect. Consider for example, the Tarahumara Indians in Copper Canyon Mexico for whom diabetes and cancer is practically non-existent. They subsist on a foundation of beans and corn, foods considered off limits to Paleo followers. Or look at the traditional cuisine of Crete, a Greek Island with a remarkably low rate of heart disease. Theirs is a diet that includes barley and yogurt, with very little meat. Again, a significant departure from the Paleo approach.

Aren’t these possibly  some of the “best diets in the world,” too?

Perhaps as important as any of the nutrition, environmental, or economic arguments is what I think of as the flavor quotient. Following a Paleo diet means that many delicious, nourishing dishes that find their way to my dinner table would be off limits: braised farro with winter greens and mushrooms, slow cooked white bean soup with a smoky ham hock, apple slices topped with peanut butter and homemade granola, and a luscious raspberry smoothie boosted with Greek yogurt.

That, from a purely, “this is my grandma talking” standpoint, just makes no sense to me.

I have friends who swear by Paleo and have both lost weight and feel terrific on it.  And I say, good for them. But for now, I’ll stick with my own “best diet” by making a salad on a bed of quinoa with greens and chick peas, topping it with crumbled feta, tossing it with a yogurt dressing, and enjoying it with a slice of hearty, whole grain bread with a swipe of salty butter.

You?

Katie is a freelance food and nutrition writer, registered dietitian, and cooking teacher. She has been published in the New York Times, the San Francisco Chronicle, Cooking Light, Bon Appetit, Self, and Parenting, among others. Katie is currently hard at work on a cookbook for Chronicle Books, due out summer 2013.

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  • Erin

    “which we know to be linked to high cholesterol and heart disease.” I’d like to see the research she is referencing here. It’s my understanding through lots of research and reading that this has never ACTUALLY been shown or proven.

  • Liv Marie

    I’m so glad you have brought this topic up! I have been following a paleo diet for about 6 months now and even have my own business that provides paleo meals for people on a weekly basis. It is defiantly not for everyone , and it has been a learning process for sure! Thanks for all the info!

  • Lili

    Never trust a skinny dietician.

    • Guest

      That doesn’t make sense.

  • The Nutrition Nanny

    @ Erin: Great point. Unfortunately, “which we know to be linked to high cholesterol and heart disease” has become part of “the script” for many health professionals. And while, sure, you can ultimately link saturated fat with heart disease, what is conveniently unspoken of are the risks that sugar – now ubiquitous in our Standard American Diet of highly processed foods – has on hyperlipidemia, heart disease, dm, obesity …. I could go on and on ….. As far as this author’s assessment of the Paleo diet, she brings up some valid arguments both pro and con. Being a registered dietitian myself, I believe the key to health and wellness is eliminating highly processed foods (including CAFO-raised animal meats), wheat, GMO crops (“conventionally grown” corn, soy, potatoes), and moving closer to an organically grown, whole foods-based diet. Yes, it’s expensive (now), but so is shopping in specialty shops for XXXL pants, filling prescriptions for multiple medications and loss of pay due to obesity-related absenteeism in the workplace. Food costs for healthier products will fall once consumers demand it. Food makers want to move towards better-for-you products, but need a conduit – and that is “us”. As far as other regions and health outcomes, I believe our genetic profile does favor the diet closest to our ancestral heritage. It only makes sense, and for reasons that would require my own blog post. ;)

    • http://nutritionstripped.com/ McKel | Nutrition Stripped

      Agreed :)

  • http://twitter.com/CarleneRD Carlene Thomas RD

    Great to see such a comprehensive yet easy to read post on this diet. Well done.

  • Brian Klein

    Actually, grass-fed meat production is much better for the environment than any grain production. There is much more fossil fuel use with grain production (fertilization, planting, harvesting, transportation, topsoil run off.) See: http://www.ted.com/talks/allan_savory_how_to_green_the_world_s_deserts_and_reverse_climate_change.html

    And just a few thoughts on a couple of your cons.

    1. Losing wheat is not necessarily a problem when the individual is either allergic or intollerant. There are no nutrients found in those foods that you cannot find somewhere else.

    2. So where are people supposed to get vitamin d from then. As the supplement that manufacturers add in milk?There are many ways to get enough vitamin d: get enough sun, or to take supplements such as cod liver oil, or eat cold water fatty fish. When vitamin d is supplemented in your food, you might as well just take a supplement.

    3. The need of calcium is WAY overstated. And if you are eating greens and veggies, you will get plenty. Many paleo folks also make their own bone broth, another source of calcium. More importantly, if they are following a paleo diet, they are probably getting the nutrients that work with calcium to to provide for healthy bones. Something most Americans do not know about.

    A final word, many people who pracitce paleo eliminate those foods to begin with, and then reintroduce them to see how they feel and what the effects are. The diet isn’t necessarily the end state, it’s the beginning state. A reset, if you will. They draw inspiration from traditional diets all over the world, and many are members of the Weston A. Price Foundation, whose work studied traditional diets all over the world.

    • Devyn

      You make a lot of really good points. Thank you for this.

  • MrBillWest

    My problem with paleo is that it makes some assumption about what our ancestors would eat. For example, where are the bugs? Any good caveman would not pass on a juicy grub!

    Also, it assumes that our bodies stop evolving and adapting in the 10,000 years since agriculture started. Or the 9,000 years were stared domesticating “milk” animals. We evolve for millions of years and then stop? Humans have succeeded as a species because we can adapt.

    I like the idea of more nuts, better meats, and more veggies. But I will keep my yogurt thanks.

    • Brian Klein

      Most paleo authors suggest that we have “evolved” to a smaller framed weaker, more diseased species. But if you are familiar with Chris Kresser’s work, he talks quite a bit about how we have evolved to be able to eat dairy and grains, and how evolution can happen in quick bursts when it’s necessary for avoiding species extinction. And many do talk about the insects, but don’t really suggest eating insects, since many people would be grossed out by it. Doesn’t mean we shouldn’t or couldn’t. In the end, critics get too bent on thinking about what our diet was 10,000 years ago. All they are suggesting is that we are approximating what that diet is as best as they can from what we know about that time period. The results are in a large number of people living healthier lives.

    • http://www.healthy-lifestyle-trainer.com/ Mike Luque

      More than that, the idea that our paleolithic ancestors ate the way Paleo adherents claim isn’t necessarily true. Actually, it isn’t. As was outlined way back on Sept 10, 2010 in the Proceedings of the National Academy of Sciences, that vegetable processing, including flour, happened as far back as 30,000 years ago! That’s 20,000 years before the supposed advent of agriculture. So perhaps the Paleo Diet folks don’t even have the right basis.

      And where did the Paleo people get the idea that “cavemen” didn’t eat legumes? It’s scientifically accepted that legumes were a staple to some of our Paleolithic ancestors.

    • Jeremy

      The consumption of dairy changes from person to person within groups of people I know that follow a paleo way of eating, but the purpose of avoiding dairy would be because it is likely to be from an animal not eating its natural diet, pasteurized, and or factory farmed. These three together or any of them alone have damaging effects to the milk the dairy product is made of, and subsequently, the consumer.

  • Devyn

    This wasn’t quite what I was looking for. I was hoping for more of a science based answer. Of course different diets work differently for everyone. I don’t think anyone’s debating that. For me, paleo has changed my figure and my energy levels, as well as my craving for certain food. What I want to know is what the long term effects of the diet are…how does the paleo diet effect the body on a biological scale?

  • April

    EXCELLENT article!

  • Marlene

    Just one more dietitian that doesn’t know what she is talking about -.-’ I am a dietitian too, I learned just the same as she did. But I open my mind to the Paleo Diet instead of rejecting it before studying it. My colegues disappoint me so much! Saturated fat bad? Seriously? My lovely beef and bacon <3 Katie Morford, with all respect, go home study, please, for your patients health (and all the dietitians against paleo diet). Cheers

  • Jill Richardson

    I invite you to check out my recent article on this here: http://www.alternet.org/food/popular-paleo-diet-bunch-baloney – if nothing else, read the end, where I caught bestselling paleo book author Loren Cordain distorting the truth in a pretty bad and obvious way. I was really shocked about that. It required no more than 2 seconds of fact checking on the internet to find that he was misrepresenting the results of a study. The study found that vegetarians are 24% less likely to die of ischemic heart disease than meat-eaters. Cordain cited it as “proof” that being vegetarian is NOT healthy… and then selectively quoted from the abstract, leaving out the bit where it found that vegetarians fare better than meat-eaters. Oops. That makes me really question EVERYTHING he says unless I have personally fact checked it myself.

  • http://gigieatscelebrities.com/ GiGi Eats Celebrities

    The Paleo Diet has been working for me for the past 10 years, so I am sticking to what works for me! But… Everyone is different so… What works for me, may not work for you!

  • SuperMom101

    Terrific article! And rings so true…America (and her children) have never been fatter or sicker and strangely we can’t seem to figure out why. Meanwhile, we have entire cultures that live disease free (even to this day).

    The paleo “diet” discourages processed foods and dairy which I both agree with – however, after experiencing breast cancer at the age of 38 I now follow a more traditional rural chinese diet – zero dairy and “limited” amounts of “organic” meat. That’s were I part from the Paleo – beans, root vegetables, etc. are now a huge part of my daily sustenance. (Thankfully weight has never been an issue.) I too accepted all the scientific studies and had no idea about America’s nutritionally void, highly processed, genetically engineered, antibiotic and arsenic feed, growth hormone administered, genetically modified, chemically laden, artificially flavored and dyed, franken-fake, factory farmed food supply – and I thought I was eating healthy.

    Maybe it’s me… more than a few posts here seems to be (ahem) industry supported?

  • http://www.facebook.com/bluecrush777 Sonja Ramos

    AMEN for this article!!! So tired of cross fitters and their paleo obsession. The world does NOT need to eat more animals…totally unsustainable and unrealistic and not healthy. I know people who have lost weight on this diet, but it just doesn’t seem sustainable and too many restrictions which is a hallmark of unsustainability . Plus, we aren’t living in caves anymore, we are driving to cross fit, then to the store to get meat in shrink wrap. Doesn’t get much more removed from the source does it? No chasing animals down with spears, feast or famine, scrounging for whatever you could get. Thank you for this article! i’ll be sharing it with many people.

    • Brian Klein

      You really do need to watch the video I posted above. The way animals are farmed today, yes totally unsustainable, but there is a way to increase animal production and at the same time help our environment.

      For those that use paleo as an excuse to eat meat… they are not following the paleo diet. It’s a very vegetable centered diet as well. If you were to really think about it, it is unlikely that the paleolithic ancestors would have been able to eat meat at every meal. It was likely a very vegetarian based diet, and in the case of hunting down some game, they would eat nothing but that meat until it spoiled. Then go back to vegetables until the next big kill.

      • Karen Callahan

        I agree. Been paleo for 3 years and eat 3 to 5 oz of meat/poultry at 2 meals. Generally eggs for breakfast. MOSTLY vegetables – lots. And low sugar fruits.

  • The Candid RD

    Ugh, diets like this give me hives too!!! Great post.

    I can see how this “diet” or “lifestyle” might benefit some people because it gets them motivated to eat healthy and make changes in their lifestyle, but any lifestyle change that includes giving up entire food groups, and especially ones that are known for their health benefits, is just ludicrous. I definitely think a Paleo-like lifestyle would be more appropriate (eat meat, fish, poultry, nuts, fruits, vegetables, and FEWER grains and legumes…I guess, especially the grains part, because it’s clear that Americans get way too many grains). I actually wrote a blog post about my “paleo-like” diet. I eat more protein foods, and fewer grains, but do I avoid grains altogether? Never! And legumes? I couldn’t live without them.

    • Jeremy

      What health benefits come with the consumption of grains if I may ask?

  • Carol H.

    Great post. Rational and well presented.

  • Jimmy

    Oh this is so great. I’ve been following this cookbook for a long time:

    http://cooklikeacaveman.com/paleo-cookbook-review/

    It has been very wonderful, the recipes are easy and it tastes great that’s main thing for me because I don’t want to give up good food just to lose weight.

    But I think it’s time I add some more recipes into the mix. Thanks!

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  • http://twitter.com/DareYouToBlog Meredith

    This seems like a fairly neutral assessment, but I do take several issues with these “drawbacks”….

    1. Saturated fats are NOT “known” to be linked to high cholesterol and heart disease. There is faulty research that is being uprooted over and over. Science is changing! See this NYTimes post: http://well.blogs.nytimes.com/2013/03/07/eat-your-heart-out/ and THIS video: http://www.youtube.com/watch?feature=player_embedded&v=v8WA5wcaHp4

    2. Is it really fair to evaluate a healthul eating framework based on its affordability? (Plus, it arguably pays for itself in reduced healthcare costs.) Even more, grass-fed beef and organic poultry and not required, but suggested for ideal. This is true for anyone, whether eating ‘paleo’ or not. The junk in conventional meats is atrocious.

    3. Paleo dieters DO use salt, just not the refined kind and not on top of french fries.

    4. Calcium is not an issue: http://balancedbites.com/2011/10/faqs-paleo-diet-calcium.html, and Vitamin D comes from sunlight and fatty fish.

    5. Proponents don’t claim outwardly that it cures everything, but there are too many individual testimonials to ignore. Most proponents and book-writers encourage you to do an “experiment of 1″, where you try it for yourself, see how YOU feel, re-integrate the non-paleo foods and basically find your own real-foods diet that works for you.

    • http://consideringyou.com/ Considering You

      Agreed in every single way.

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  • http://twitter.com/Wordfiend84 Ashley Sargent

    Dear Katie, the minute you used junk science to espouse cholesterol being linked to heart disease, you completely lost all credibility. Find me one study that supports this. ONE. Oh wait, you can’t cause it doesn’t EXIST.

  • Joe Garma

    Katie, IMHO you are so spot on!

    Committed Paleos often cite a few places in the world where meat and saturated fat eaters thrive, but as you mention, the opposite is also true.

    Although I’m not a vegetarian, what occurs to me about meat vs veggie eating is this: If I had to harvest either meal from scratch, which would I rather do — go in a field, shoot a cow in the head and butcher it, or go onto a farm and pull some tomatoes and squash off their vines?

    My bet is that if meat eaters were required to harvest their meat, fewer would do so.

    Yep.

    -Joe

  • http://www.bestsimplediets.com/ Brian

    Juts eat real food. The diet doesn’t matter. IF we all ate real food we would be a lot healthier. Whether it’s paleo, vegan, Mediterranean, and so on it really does not matter. Our poor health is from our processed crap we eat day in and day out.

  • PeaCat

    Dr. Davis’s “Wheat Belly” explains why eating foods based on wheat products is indeed very bad for you. In a nutshell, wheat used for bread today is a “Frankenfood”, the product of genetic tinkering that began about fifty years ago. This “Franken wheat” was not developed for its nutritional value, but for higher and higher yields. It is now very, very high in gluten (rise in celiac spectrum disorders seems to coincide with the new wheat) The modern wheat based products are also high glycemic – meaning when one consumes a bowl of cereal a person gets a sugar high followed by a sugar dump even if the cereal has no added sugar. Carbohydrate is carbohydrate whether it is in the form of honey, sugar in your coffee, or that plain “healthy whole grain” bread or cereal with no added sugar. It’s all pretty bad and Dr. Davis makes a strong case for eliminating wheat based food from your diet.

    Since the beginning of the year I have eliminated wheat (and related grains) from my diet and have lost fifteen pounds. I do not get the mid-morning or mid-afternoon “crash” I would get when eating so-called “healthy whole grain” based foods. I have doubled up on veggies and salads at dinner, and forage for nuts and yogurt at lunch. I’m a much happier camper now….Plus the size eights and sixes in my closet are now fitting again!

  • William

    Thank you for saying what’s on all of our minds in such a concise and detailed manner. As you said, diets aren’t one size fit all.

  • Jodi

    I would like to state first that I am adhering to the Paleo diet right now, and so is my young family (although they are eating a lot more potatoes, quinoa, and low-glucose breads to keep them out of ketosis.) But all along (I’ve only been on it two months) I continue to think: this is just *one* way. I totally agree with you. But I do think that Paleo has a lot of merit. I’ll be getting my blood test results in a week and am very curious about the cholesterol etc.! The reason I went Paleo is because I was tired of being a slave to gluten and sugar. My energy levels were terrible (they still need some work). I wanted to enjoy food again without being a slave to it! This fits the bill for me right now. I’m 43, and here’s hoping.