Is Paleo the new Mediterranean?
Just last week, for example, I noted a study finding that the Mediterranean diet helped diabetics lose more weight and use fewer medications than a low-fat diet.
But I sense a shift of power (or at least of focus) in the works. The "Paleo Diet" has been garnering a larger and larger share of popular attention and support as the latest Solution To All Our Problems. And now the research community is beginning to test the theory, designing studies that pit the Paleo diet against other dietary prescriptions.
The caveman versus the shepherd
The two went head to head in a small study of patients with heart disease. Paleo pinned Mediterranean to the mat, yielding greater improvement in glucose tolerance and greater decrease in waist size. Have the cavemen knocked the shepherds off the hill? Not yet.
Studies are one thing; real life is another
For one thing, I wonder about the long-term practicality of the Paleo diet. Diets which depart dramatically from the cultural norm often lead to dramatic weight loss. This may be partly due to the metabolic "magic" put forth by proponents. But I think it's also at least in part behavioral and practical: when whole categories of food are off limits, you tend to eat less and weight loss ensues.
Paleo and other dietary theorists have compelling stories to tell, but what are the realities on the ground? What are the subjects in the study going to eat when the study is over? History has shown that, while purists and zealots may succeed in renouncing grains, carbs, dairy, etc. for life, mere mortals eventually find these diets too difficult to maintain and lapse back into prior eating habits.
And while cutting fat and calories and getting more exercise may seem
hopelessly old-fashioned in an era of "good calories, bad calories,"
let's not ignore the fact that millions of people continue to lose
weight and keep it off doing nothing more exotic than that.
Do what works
A change in diet only really improves health outcomes if it's sustainable. And sustainability involves practicality, logistics, economics, personal preferences and beliefs, as well as social conditioning and cultural norms. By all means, let's use what we're learning in the research lab to to nudge our social and cultural norms and public health and food policies in the right direction.
But changing cultural norms takes time. Right now, I think the Mediterranean diet may have a practical advantage over the more extreme Paleo approach. Fortunately, we don't all need to agree on the same solution. If what you're doing isn't producing results, try a different approach. If you've found what works for you, keep doing it. But don't assume that what works for you is the (only) solution for everyone.
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Posted by: daveb | Dec 23, 2009 4:04:44 PM
Steve,
Your question about life expentancy shows very little knowledge of anthropology, or what i think, you have been confused intentionally by many interests. Yes, in the Pleistocene, there was a high infant mortality rate. Yes, upto 1/3 men died in warfare. blah, blah blah. But a remarkable thing is preserved in the fossil record as well. There was no shortage of people who lived into their eighties and these people were healthy up to the end. No ostoporosis, no arthritis, etc. These findings are born out with modern day hunter gatheres (except the Eskimos). The life expentancy of 30 was all in. Expectancy from age 15 was well into the 70's and health expectancy was better than now. Dump the grains and the milk. Eat your veggies!
Posted by: Alex | Oct 28, 2009 5:42:21 PM
Well, of course, humans didn't just suddenly out of the blue start growing and eating grain 10,000 years ago. But, humans have been around for 190,000 years, and during most of that time, humans did eat a paleo diet. And, I'd wager that in the late paleolithic, before the advent of agriculture, grains were an insignificant source of calories, and certainly not the dietary staples they've become during the agricultural age.
As for the environment, large scale mechanized agriculture loses topsoil faster than it is created, so seed crop monocultures, in the long run, are not sustainable, regardless of whether people or animals will be eating them. And, rice production vents huge quantities of methane gas into the atmosphere. With respect to meat and the environment, raising animals on seed crops is wastefully resource intensive. It also produces inferior quality meat, which is why paleo foodists tend to focus on eating meat raised naturally on pasture.
Posted by: elninotheblog | Oct 28, 2009 4:35:06 PM
Agonzales. - cool post. I have said it like this to people : Eliminating these modern foods (grains, milk, beans, refined sugar) lowers and stabilizes your blood sugar and consequently ELIMINATES: psoriasis, athletes foot, jock itch, rigning in the ears, acne, joint pain, fatigue AND BODY FAT!
The thing is, not all people have those problems and may think that they are just fine - of course those people are probably not looking for health advice. Much later in life however, more of these seemingly unaffected people will develop those and other problems: arthritis, OSTEOPOROSIS, heart disease, cancer,
Posted by: elninotheblog | Oct 28, 2009 4:23:36 PM
Aww Denise, C'mon back :) were just talking. I dont recall you expressing an opinion on this information.
Posted by: greg | Oct 22, 2009 11:41:42 PM
@AGonzalez
You are correct, there are 2 independent issues: 1) what our ancestors ate, and 2) what would be best for our genetic make-up to be fed.
It turns out, 1) we don't know what our ancestors ate other than the fact that they ate many different things, in different times, in different places; the people selling the Paleo Diet have created a convincing marketing story about their diet, but it is just a story;
and 2) we are genetically capable of eating a very wide range of things and being healthy. There is nothing uniquely healthful about the diet pattern certain authors are selling as the Paleo Diet. What is worse, the Paleo Diet being sold has very high environmental and social costs associated with it.
Posted by: AGonzalez | Oct 22, 2009 7:04:16 PM
I apologize for my lack of correct expression. Thanks in advance.
With much respect towards all, I think that many people write here confuse the focus of the discussion.
One thing is that possibly our ancestors ate, and another is our genetic biochemical and physiological digestion capacities of the human species (logical independence and of context).
A thing is that our ancestors ate food (beyond the limited evidence), and another thing is the genetics and proper capacities of digestion of the human species, without importing his antiquity.
It is obvious that the capacities didn't change, only the food that are consumed. These are customs modified and imposed socially.
Therefore, the most healthy thing is always to pair the feeding that joins, with the capacities.
Therefore it is healthier; align the capabilities of the human digestive system with our food digestion.
This is independent from the "diets", since it is basic and elementary. The most important thing for any species is to survive and as efficiently as possible.
It is interesting to me to know the opinions about this conclusion and his refutations.
What food digests more eficiently human machine?
Which is the food with the lowest consumption of our energy reserves for other reasons (repair cell, for example)?
I do not think these things are hard to learn.
There are economic interests that are not disclosed feeding these premises?
The universal genetic, diet is somewhat adapted to time, place and people (as the sufies would say).
For the Taoist two thousand years ago advised not to eat cereals (subject covered in depth by several specialists) in order to "kill certain parasites” intestines.
Mawangdui medical manuscripts translated by Donald Harper, indicate with precision that suggests the Taoist dietary feeding withdraw 5 cereals (http://www.keganpaul.com/product_info.php?cPath=39&products_id=153) abstention from grains
There is an interesting article on this located in http://sites.google.com/site/delawareteasociety/yoked-to-earth-a-treatise-on-corpse-demons-and-bigu- and soon to publish books on the subject .
"There are more things in heaven and earth, Horatio, than they ever dreamed your philosophy" but everyone has the right to question everything.
It is the right scientific and critical thinking.
One who doubts and does not investigate, becomes not only unhappy, but also unjust. Blas Pascal
Posted by: greg | Oct 21, 2009 9:30:51 PM
@Dawn,
Actually, it is NOT true that "grains came into humans' diets with the invention of agriculture."
There is fossil evidence of homo sapien cereal consumption at least 23,000 years ago, 13,000 years before agriculture. There is also fossil evidence that neanderthals consumed cereals; given that he disappeared 25,000 years ago, it is a good bet homo sapiens were consuming them earlier as well. There are stone tools from 45,000 years ago that may have been used for cereals; there is no way to know because we don't have any plant fossils to go with them.
To put these dates in perspective, our most recent common male ancestor, "Y-chromosomal Adam," is 70,000 years old. So for at least a third of the time since we have had a common ancestor (and perhaps two-thirds or longer) we have been eating grains.
The paleo diet sounds like a compelling idea, but when you look into the details of what we know (and how much we don't know) about paleolithic man, it makes no sense. There is no such thing as a paleolithic diet. This is little more than a new marketing twist low-carb dieting (Cordain's protestations to the contrary not withstanding.) What is worse, its disregard for grains, legumes and dairy and its unfortunate emphasis on meat consumption makes it environmentally very burdensome and unsustainable: we would never be able to feed a significant fraction of the population on this diet because we can't produce that much meat.
Posted by: Dawn | Oct 11, 2009 5:29:09 PM
DS asks why grains are off the table and the answer to this is that Paleo diet is pre-agriculture. It is a hunter-gatherer diet. Grains and dairy came into humans' diets with the invention of agriculture. And, as Ross stated Paleolithic man most likely ate meat "once in a while in bulk when a kill was made." Meat was not a daily dietary staple.
Posted by: Dawn | Oct 11, 2009 5:17:36 PM
I'm wondering how RB can claim to be eating a Paleo diet. He admittedly eats dairy (cheeses and ice cream), chocolate, vinegar, olive oil, and artificially sweetened beverages. Were these things really in the diets of our Paleolithic ancestors? I think not. Nice try RB.
Posted by: DS | Oct 11, 2009 12:02:32 PM
Why would grains be off the table for the paleo diet? I would imagine that OG ate anything he could catch that didnt eat him first, or that he found that didnt kill UG when UG ate it.
"Paleo" sounds like a repackage of "South Beach". And it sounds like a war between MEAT industry and GRAIN industry for a larger portion of your plate.
Maybe high protien low carb is good for those with diabeties, but the fact still remains folks, high intake of meat is accociated with heart disease.
These diets always place fruits and veggies as secondary to the carb or the protein, and this is misleading. The studies show that in terms of health and disease prevention, a diet should promote micro-nutrient density, meaning lots of fruits and veggies, some grain and legumes and nuts, and limited meat intake. Ironicaly, this is also the most sustainable diet that man could produce.
Posted by: Denise | Oct 8, 2009 3:35:21 PM
So, I've been subsribing to this newsletter for several months, and while I have found much information that is quite helpful and enlightening, I must say that I've gotten very put off by the superior, holier-than-thou, preachy attitudes put forth by several contibutors (I will not point fingers). If a specific dietary plan works for you, that's great. But HOW DARE YOU put forward a lecture claiming to know better than I do what is best for MY body! Monica, I enjoy reading the information that you share with people, but until some of the regular contibutors are better moderated to ensure that the more "zealous" among them are reigned in, I won't be back.
Monica's Response: I agree, the diet evangelists do get tiresome! But there's a fine line between "moderating" and "censoring." In the interests of fostering an open exchange of ideas, I tend to err on the side of letting things stand unless they are clearly inappropriate (i.e. abusive, profane, etc.) I hope you'll stick around. May I suggest that you simply don't read the comments from people you don't feel merit your attention?
Posted by: Alex | Oct 7, 2009 8:46:17 PM
The China Study is junk science. For one thing, epidemiological studies prove nothing because correlation does not prove causation. And, the actual data from China, which were published in a different book, show no correlation between meat intake and disease. The study on rats that were fed huge quantities of casein proves nothing about human physiology, and it is not scientifically valid to extrapolate the results from casein as being valid for all animal protein. Similar rat experiments using whey protein produced exact opposite results. The China Study is vegan propaganda, not science.
Posted by: RG | Oct 6, 2009 3:44:09 PM
Posts here have made mention of significant nutritional or "diet comparison" research.
A treasure-trove of nutrition research regarding animal-based and plant-based diets is The China Study, a book by Dr. Colin Campbell. His compilation of research studies over the past 30 years indicates very powerfully that animal-based high-protein diets can trigger and progress cancer and heart disease, while whole food plant-based low-protein diets can inhibit cancer development and reverse cancer progression. Paleo, Mediterranean, whatever the diet: we all have our own stories of how a certain diet has helped us to lose weight, temporarily or permanently. It seems that all "diets" seems to work for some people. The question is, what evidence is there that a certain nutrition approach can impact a human's ability to not only lose weight, but to improve overall health, vitality, and protect you from disease? There is very compelling evidence that a whole food plant-based low-protein nutritional approach not only helps to lose weight. More importantly, it may also save lives and help avoid significant pain and suffering from desease.
How ironic that after spending billions of dollars looking for "cures" for cancer and heart disease, that the "cure" might have been discovered years ago..simply maintaining a lifestyle focused on plant-based, low protein, whole foods.
That's food for thought.
Posted by: Moses | Oct 6, 2009 12:47:30 AM
Did not take the time to read all the comments but wondering what the general thought on the Blood type diet by Peter D Adamo
Monica's Response: I did a podcast episode on the blood type diet. You can read the transcript (or listen to it) here: http://nutritiondiva.quickanddirtytips.com/blood-type-diet.aspx
Posted by: Amy | Oct 6, 2009 12:38:25 AM
When I completely cut out ALL grains and ALL dairy in an attempt to relieve my hot flashes, it worked like a charm, within 5 days. As long as I stay off those two food groups, I don't have hot flashes. Of course, I'd already given up sugar, wheat, caffeine and alcohol for other reasons. But here's the kicker - this new diet also cured my decades long chronic sinusitis! Who knew rice could be problematic for sinuses?!
I think that some of this is about the processing of the foods - dairy is pasteurized and that must change some things, and grains are stored in elevators for years at a time, which might leave them open to all sorts of fungi and bacteria. Mycotoxins? Who knows.
I'll keep avoiding these foods, without making myself crazy. It's just common sense. I feel better. BTW, my weight is normal and I'm a 56 year old white woman of German and Welsh descent. The hot flashes had just started a couple of weeks before I found the cure. I tested it out, went back on the rice and dairy, and they came back with a vengeance. So, if dairy free and grain free is the definition of Paleo, then count me among the yeays.
Posted by: Alexa Fleckenstein M.D. | Oct 5, 2009 9:38:17 PM
Paleo is fine - as long as we are aware that our ancestors had very divergent diets then, depending on from which climates they came, if their lived at lakes and seashores, in mountain valleys, in dry zones - and so on.
Another problem is that we can't even get the foods anymore they had then - our carrots, greens, fruit are very different from theirs (just try to enjoy crab apples...). We can only do approximations.
The basic idea is to eat as much grown food as possible - as opposed to processed food. And don't forget: cavemen had no cows for milk!
Alexa Fleckenstein M.D, physician, author.
Posted by: Leigh | Oct 5, 2009 9:04:05 PM
I ate paleo for several months according to the guidelines of Cordain's "The Paleo Diet," but ultimately I found it too limiting because of the restrictions on salt, vinegar, soy products and pretty much any condiment you can think of. I love veggies, but come on! Most of them need a flavor kick, and I can only take so much lemon juice and garlic.
Anyway, my point is that the grains and dairy weren't the hard part for me.
To those of you who are eating "Paleo" but have cheese in your diet, what gives? Also bacon? Pickles? Chocolate? I'm sure you're still getting *most* of the benefit of being on the diet, but you must admit you've adapted it a little to make it something you can live with.
Posted by: Perry | Oct 5, 2009 8:21:38 PM
It was facminating to read so many posts by people be claiming this or that. Remember a couple of things. There is no quick fix and listen to your mind and body. Nobody ever says, "Oh I wish I didn't go for that swim I feel lousy now," or "If only i hadn't eaten that salad." We all understand we need to use our muscles, eat fresh, in season, locally grown, real food, that isn't formulated by Nestle of General Mills. Eggs should be orange not almost yellow. Fat should come from grass fed cows, coconuts, and non vegatble sources. Sugar and flour and salt* are the white death. Salt would be okay if you don't eat processed foods, but thet put seventeen pounds of it in everything canned to perserve it.
Eat grass fed beef, organic chicken, pigs grown on farms; whatever. Be prepared to pay 5 dollars for a dozen real eggs. That's only fifty cents an egg - suck it up. Farmers are needed so we don't need to import 'Europe's Best' from China.
Canadians and Americans spend so much less money on food than the rest of the World. We do not eat better. We eat cereal and other sugar laden crap. The NA food pyramid told to us by the food producers is Sugar, Flour, and Fat. It should be Protein, Fat, Carbs. And, Carbs should be plants.
Posted by: elninotheblog | Oct 5, 2009 4:33:09 PM
The problem is not with the human body but with the foods that have been called STAPLES in our elementary school classrooms. The elimination of these so-called staples in a healthy diet has been revealed and published before, long ago. Approximately 140 years ago William Banting wrote about it. You can download his "Letter on Corpulence" published in 1864 at my blog:
http://www.elninotheband.com/?p=70
The fact that this understanding has not been fully illuminated by our medical professionals worldwide is a testament to the fact that processing and selling WHEAT AND CORN AND SOY AND MILK AND SUGAR AND OILS is more important to our governments than improving the health of our populations.
Posted by: elninotheblog | Oct 5, 2009 4:12:50 PM
Monica! Get Hip! Putting the paleo diet into the context of other fad diets is really kind of dumb. Diets are society's attempt to learn what it is they are eating - because they dont know. Just because a principle like 'eat less, exercise more' works for the majority of people, that doesn't mean we have learned anything. If you really want something to write about, write about the fact that the modern foods that are eliminated in the paleo diet are absolutely NOT ESSENTIAL FOR SURVIVAL OR EVEN NUTRITION AND ARE BADLY IMBALANCED IN THEIR RATIO OF NUTRIENTS TO ENERGY. The foods you mentioned in your article; "grains ,dairy, legumes and oils" are foods that were discovered and used to provide a supplement to real, fresh food. People don't eat wheat or corn or rice products because its nutritious, they eat it because its there. As a bed, vessel, holder, handle, wrap, sourdough bowl, disguised with icing after the main meal.... its just TAKING UP SPACE AND DISPLACING NATURAL SOURCES OF CARBS LIKE FRUIT AND VEG. Eating modern foods on a daily basis makes most people fat if we're talking about people with a propensity to gain fat in a way that makes them unhealthy and/or unattractive to potential mates. Paleo is the REAL ALL NATURAL DIET - it is sustainable and continually effective in its maintenance of human health because there is nothing consumed that is full of energy and lacking in the nutrients needed to utilize the energy. YOUR PANCREAS WILL THANK YOU!
Monica's Response: Actually, I HAVE written about the fact that grains aren't necessary. http://blog.nutritiondata.com/ndblog/2009/08/are-grains-necessary-to-a-healthy-diet.html
Posted by: Mark | Oct 5, 2009 2:54:38 PM
The problem is everyone wants the fast result, low effort fix. No one diet is better than the other because all diet types are healthy when they're done in the proper moderation. The problem is people don't get enough activity anymore, but still eat the amount of food they used to. That's why we tend to pu ton weight when we get older: same food, less exercise. Too much time and effort is spent trying to find that one-size-fits-all cure when all you need to do is figure out how many calories you burn each day and then eat less. People don't like that answer because it makes those who lose weight on a specific diet feel less special and makes everyone else face the fact they're friggin' pigs when it comes to food.
Posted by: dave in NJ | Oct 5, 2009 2:20:25 PM
COW MILK IS FOR BABY COWS!!
and studies show they DIE on Pasteurized milk
Posted by: Carolyn | Oct 5, 2009 2:05:31 PM
For anyone looking for some good science to back up the health effects of a "carbivore" diet, I highly recommend the book "Primal Body, Primal Mind" by Nora Gedgaudas. She also has a great website: www.primalbody-primalmind.com
Posted by: Dean Romano | Oct 5, 2009 1:49:12 PM
Five years ago I was a VERY SICK man. I had High Blood Pressure 240/1, High Cholesterol, 288, High LDL's 225, Triglycerides 345. I also suffer from Psoriasis and Psoriatic Arthritis and Spondyoitis, an almost impossible combination of pain and discomfort which you can only barely imagine if you don't suffer from them.
I began an All Natural, Unprocessed Food Diet Regimen three years ago. It took about three months to acclimate myself to eating only fruits, vegetables, nuts, seeds, and animal proteins,but, once I did, it is easier than the horrific diet I consumed my whole life.
I DO NOT EAT: Processed Sugars including honey and maple syrup, Grains of ANY type including rice, Dairy Products of ANY type, and for almost one year I ate no additional oils, but now use moderate amounts of olive oil.
My cholesterol dipped at one point to 126, my LDL's to 65 and my triglycerides to 60. My blood pressure, once controlled by FOUR different maximum strength medications is now averaging 118/72 with one remaining medication. My weight has gone form 247lbs. to 167lbs. and my doctor told me at my last visit that if I lose the additional 7lbs. I plan to lose that I will be able to come off of the last of my blood pressure medications.
Prior to this diet change I had open, bleeding psoriasis plaques all over my body and horrific joint and muscle pain that prevented me from doing just about anything physical. I used to bake in a UVB light booth three days a week for fifteen minutes which would tire me out and used five different lotions for my psoriasis. NOW...NOW...my skin is virtually clear and I have STOPPED all of the UVB treatments (I took my home UVB booth apart two weeks ago) and have eliminated the lotions and creams.
Anyone that doubts the value of eating a Paleolithic or All Natural, Unprocessed Diet is selling themselves short. Their minds have been poisoned by the same companies that produce the food that is poisoning their bodies and cutting into their life span.
Last year I read a book by Loren Cordain, Ph.D. "The Paleo Diet" and learned some of the science behind my All Natural, Unprocessed Eating Regimen. Dr. Cordain is a distinguished nutritionist and scholar from the University of Colorado, not some quack. EVERYONE SHOULD READ THIS BOOK AND FOLLOW THE ADVICE IN IT.
This is NOT the unsafe, unbalanced Atkins Diet. I REPEAT...this is not "THE ATKINS' DIET."
Save you life and your health. Do it immediately.
dpromano@hotmail.com
Posted by: missmoo61 | Oct 5, 2009 1:47:47 PM
I'm not as educated as most of you about this Paleo diet, nor the atkins either; but eating healthy is one that needs to eat from the earth and only the earth. That is to say, fresh raw vegetables and fruits and whole raw grains (as much as possible. Man made carbs, processed foods and dairy products (with the exception of eggs)are high carb and high glycemic as well as acidic. It is very important to keep a well balance PH level and keep a well maintain metabolic rate by following a low glycemic diet. I have been educated and followed a low glycemic diet and finally had a substantial weight loss along with getting rid of all my medications for various illnessess. I have never felt better in my life. You need to eat what our bodie were made to eat from whole natural foods. It was difficult at first to adapt (lucky me - I love vegetables), but eating whole grains and fruits were more difficult. But after 3 months all cravings for the processed foods were gone, even the chocalate !! I will never go back to my old ways as my body seems to urge the natural foods. Although once in awhile, an occasional taste of a cookie or cake for those celebrate occasions is not all that bad, though the urge to have more has deceased. You'll be amazed of how your body processes or even better yet, doesn't process all the external foreign additives to our foods. Remember, that you just need to follow a well balanced meal with whole natural protein, and good natural carbs won't harm you, MAN WILL !!!!
Posted by: Travis | Sep 30, 2009 5:45:04 AM
Though this article is regarding the Atkins diet, a lot of the information applies to the Paleo diet and any diet that is low in carbs, especially in regards to not being able to lower your cholesterol level below 150.
http://www.drfuhrman.com/AtkinsRev.html
This is one paragraph from the article:
"Never forget my recurrent motto: do not be satisfied with mediocrity. Nutritional mediocrity might just cause your death. Only a cholesterol level below 150 and an LDL below 100 are satisfactory. Atkins diet plan devotees never reach these desirable levels, on a regular diet of beef, cheese, and butter. Those following my recommendations routinely achieve these recommended levels"
If you research into practitioners that have reversed type 2 diabetes (ie. Joel Fuhrman) you will find that they are done on plant based diets that are high in carbs. This goes to show that the high carb plant based diets when done correctly are the best diets to prevent and cure diabetes.
Ornish's patients with heart disease have managed to clear plaque from their arteries, reverse heart disease and come off of all medication. As far as I am aware, there are no good long term studies that have proved heart disease can be reversed by following the recommendations made in the Paleo diet.
You should be very concerned and unsatisfied with your current diet if your cholesterol level is not under 150 as this is the cholesterol level in parts of the world where heart disease is extremely rare.
Posted by: shel | Sep 29, 2009 2:04:59 PM
if one looks at diet through the eyes of a paleoanthropologist, within an evolutionary paradigm, the answer starts to become clear.
500 generations is simply not enough time to adapt properly to a neolithic diet.
i'm a 44 year old male in better shape now than in the past. since adopting a paleo diet (c. 75 gms carbs, c. 130 gms protein, c. 200 gms fat, incl. plenty of sat.), i have more energy, more stamina for my backpacking and mountaineering, and am cut and no longer "skinny fat".
a recent visit to the doctor with a full checkup tells me everything is better than before.
"The two went head to head in a small study of patients with heart disease. Paleo pinned Mediterranean to the mat, yielding greater improvement in glucose tolerance and greater decrease in waist size. Have the cavemen knocked the shepherds off the hill? Not yet."
nice try. Ornish and Keys are about to get trounced as more people become less fooled by the diet dictocrats.
"History has shown that, while purists and zealots may succeed in renouncing grains, carbs, dairy, etc. for life, mere mortals eventually find these diets too difficult to maintain and lapse back into prior eating habits."
i am a mere mortal with absolutely no craving for starchy or sugary food. i eat more whole veggies than most people. 75 gms of carbs is a lot o' veggies when one cuts out starchy and cuts down on sweet. fat satisfies quite well, thanks. a high carb diet spikes insulin, drives hunger intolerably, and makes "dieting" miserable and obsessive. there is no lapsing "back into prior eating habits" for me.
this is my eating habit, just like inhaling and exhaling are my breathing habit.
Posted by: Felicia | Sep 29, 2009 1:10:44 PM
I'm going to go out on a limb here and say the humans have always eaten whatever we found that was edible and palatable. I would agree that our culture eats far too much white flour and sugar. Corn syrup is right out as a main component of any healthy diet. We also don't use nearly the number of calories that men once used just to live. We can look back as recently as the old west and see evidence of people ate massive amounts of food, both bread and fats and were pretty darn lean because they worked so hard.
Eat a diet that works well for you. I for one, do not want to live my whole life devoid of the occasional cake or cookie, and I LOVE milk. I do not want to get rid of dairy from my diet, I see no benefit in it. Life is to be enjoyed. To each his own.
Do as you wish, but let's not start seeing every ailment as the fault of our food. We live in an imperfect world and there are many things that can cause ailments. Eating the right diet will not lead to immortality. Nothing will, Life is terminal.
Posted by: greg | Sep 29, 2009 3:09:28 AM
@Alex,
Actually, I'm not really advocating for any particular diet pattern. And I concede that a diet devoid of milk, grains & legumes, done correctly, could be healthy. My points are:
1) there is no such thing as a paleo diet. I've made the point a few times in prior posts; here is an excerpt from "Human nutrition in the context of evolutionary medicine" that makes the same point for me. "...there was neither specialization in certain foods, nor a typical plant-animal ratio nor a defined macronutrient distribution [among our paleolithic ancestors]. Correspondingly, it is impossible to justify details given by representatives of evolutionary medicine on "the Paleolithic diet" empirically." Here is a link to the whole abstract (unfortunately only the abstract is in English; the article itself is in German.)
http://www.ncbi.nlm.nih.gov/pubmed/19412746?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
2) One doesn't have to give up dairy, grains & legumes to be healthy. There are a great number of healthy diets for humans. Monica makes this point for me in another context. Here again is the link to Monica's post:
http://blog.nutritiondata.com/ndblog/2008/04/is-a-varied-die.html
3) A paleo diet is usually interpreted as a high meat consumption diet. Such a diet pattern has very high social/environmental costs and is ethically suspect. I've put several references in posts below.
Everyone must evaluate these issues for themselves. And of course the sick may need special diets. But it seems to me that if one can achieve a healthy diet in a way that doesn't impose large social and ethical costs, it makes sense for most of us to consider it.
Posted by: amanda | Sep 29, 2009 1:40:51 AM
I think Dave's nailed it...you've simply got to try it...
Posted by: hs | Sep 28, 2009 4:13:14 PM
How can a diet based on Olive oil which has so much fat been seen as being healthy?..One might lose weight, but is that health; why not lose weight and be friendly to your heart and arteries by getting rid of oils..
Posted by: dots | Sep 27, 2009 11:14:48 PM
After a life of the SAD food pyramid, gaining weight, trying to read books by 'smart' doctors (Dr. Ornish), gaining more weight (not liking meat, so never read Atkins), being diagnosed with celiac disease, I've embraced Paleo, the opposite of my pre-diagnosis life. I've for the first time in my life experienced satiety (grains made me malabsorb nutrients) with meat and fats. Glory be. The basis of all diets should be MORE vegetables or alkaline to acid foods. Vegans, vegetarians don't have a corner on that market. Whether paleo or not, my gut likes plain yogurt. My cholesterol is lower eating about a dozen eggs a week, fish, some buffalo and grass fed beef. I wish I could care less about sustainability for the masses, but I'm concentrating on keeping myself alive. JMHO.
Posted by: Eni | Sep 27, 2009 10:06:04 PM
What people are really after is "paleo health," not a "paleo diet," and unfortunately that comes with nearly impossible cultural and behavioral changes, as well. Changing your diet to a more natural and "paleolithic" one will certainly cause some changes, but we live in an utterly different time under completely different circumstances, and cannot expect the same results.
Posted by: Kurt G Harris MD | Sep 27, 2009 9:18:29 PM
One approach to paleonutrition is to focus on metabolism instead of paleolithic food re-enactment.
We can simply look at everything novel in our current diets that we did not have access to as we evolved, and simply ask "for which of these is there evidence of harm that might be due to evolutionary discordance?'
When I ask this question, the answer I get is three neolithic agents of disease:
1) Wheat and other gluten grains
2) Fructose
3) Linoleic acid
Note that the last 2 of the 3 were available in pre-agricultural times, but the amounts we eat now are an order of magnitude higher due to "food technology".
Avoiding neolithic agents results in a diet that happens to be low in carbohydrate, unless you purposefully seek out paleolithic sources of carbs. I've found no reason to believe we should do that, however.
For more information go to:
Posted by: Chris G | Sep 27, 2009 6:29:15 PM
I adopted the paleo diet in mid-may and have lost 79 pounds in less than 4 & 1/2 months. It's not extreme, and I find it very easy to maintain. I walk for an hour every day and go to the gym twice a week to lift weights for about 35-40 minutes. Other than that, I have a rather sentary job & life.
I see a lot of social policy discussions about sustainability & the like, but I'll leave that to others & decide for myself how to live as best works for me. And for me, that's the Paleo Diet.
Posted by: Alex | Sep 27, 2009 2:02:13 PM
@Greg
Your suggested diet is basically the Indian (India) type diet I foolishly ate for 20+ years, letting my belief in "spiritual" nutritional concepts override my body telling me in no uncertain terms that the concepts were not applicable to my own physiology.
When whole grains and beans are staples of my diet, I'm lethargic, I have huge blood sugar swings and sugar cravings, and I overeat. Six years ago, when I dropped my grain and bean consumption to just two slices of sprouted grain toast with hummus per day, and ate more meat and veggies, I effortlessly lost 30 pounds in five months because I was eating foods that would sate my appetite for many hours. It also did away with the lethargy, blood sugar swings, and cravings. Above a certain intake threshold, grains and beans (grains especially) exert a powerful anti-satiety effect on me that leaves me feeling utterly famished after 1-2 hours. For me, the less agrarian food I eat, the better I feel.
Posted by: Richard Nikoley | Sep 27, 2009 12:38:18 PM
It certainly has worked for me. Also many of those who read my blog.
It should also be pointed out that, unlike many other diet protocols, the emphasis is more on principle (pre-ag) and not on specific macronutrient ratio.
For example, Kitvans get 60-70% energy from carbs, starchy tubers, mainly. At the other extrme, you had the Inuit who got 80% of their energy from animal fat and almost zero carbs.
Both populations sport[ed] excellent health, as did others with different ratios. And take the Tokelauans: 50% of energy from saturated fat (highest in the world).
http://freetheanimal.com/2009/01/saturated-fat.html
Personally, I tend to practice 'lacto-paleo," which is to say I include some dairy, mainly raw & fermented, like yogurt. I also practice high fat.
In addition, many of us attempt to exercise in a way that models a more primitive existence. For me, that's walking and brief bouts of very intense sprinting and resistance exercise. I walk about an hour per day and work out only twice per week, 30 minutes each.
Finally, primitive hunter gatherers didn't have refrigerators and didn't do three squares. I'm rarely every hungry enough to eat more than twice per day, and hunger n paleo for many is such that food is pretty unappealing until you're hungry. So, the other thing we try to simulate is random periods of hunger via intermittent fasting.
The most remarkable thing to me, at just about 60 pounds weight loss in the nearly two years I've been pretty strict about diet is the way hunger is so different. If you don't find a way that takes care of the hunger, you're very unlikely to succeed long term.
Good article.
Posted by: Bonnie | Sep 27, 2009 9:27:42 AM
The "Paleo Diet" has been working for me! Without knowing that is what it is called, I have been eliminating dairy, gluten and sugar with great results [working with a nutritionist]. I have environmental allergies, but never diagnosed with food allergies. However, eliminating these commonly allergic foods has dramatically improved my health. I have also effortlessly lost 10 lbs. I eat fish, meat, poultry, fruits, vegetables, and potatoes subsitute for grains and starches. I only sparingly have rice or other gluten-free grains, and avoid sugar with rare exceptions. I feel better, rebound from illness better, look years younger -- best of all, when I eat, I am satiated -- I no longer have the endless cravings for sugar. Other people can eat grains, dairy and sugar without a problem -- but I am convinced that my body reacts negatively to them. As far as sustainability -- I have been doing this for more than 6 months and have become accustomed to the changes in shopping and cooking habits. I remember how ill I felt when I ate those foods and have no desire to go back...
Posted by: greg | Sep 26, 2009 12:45:10 AM
Rebekka –
I'll come to HF's defense here. You are correct, Homo sapien neanderthalensis are thought to be distinct from Homo sapiens sapiens but they are very close relatives. In fact, some experts think the reason they disappeared is because Homo sapiens in Europe interbred making us a hybrid and the Neandertal diet entirely relevant. A NYTimes article "Discovery Suggests Man Is a Bit Neanderthal" reviews this conjecture. If you don’t have a Times account, a copy of the article is at
http://cogweb.ucla.edu/ep/Neanderthal.html
But in any event, there are other archeological finds that indicate that paleolithic man did in fact eat grains. One paper finding such evidence is “Grinding flour in Upper Palaeolithic Europe (25000 years bp) by Aranguren, Becattini, Lippi and Revedin. The point of all this is we don’t know what Paleolithic man ate, and the evidence points out that different peoples in different places ate different things at different times. The Paleolithic diet is a chimera.
As for your comment @Greg (to me) I find it curious you chose that one sentence to pull out of my long post. I made that point (only-half seriously btw) to express that even the strictly self-interested have something to gain by eschewing a paleo diet, but the point of my post is that the social and ethical costs of this diet pattern are too high to adopt it. If you have money to burn, then considered going ahead and consuming grains, legumes & dairy but choosing only organic products: going organic and paleo have about the same amount of evidence for their relative healthfulness but organic is good for the world while paleo has serious negative consequences for the planet.
Jesting aside, I’ll say again: give up paleo and embrace a diet including healthful grains and legumes and dairy. You lose nothing but it will be better for your wallet, better for the environment, better for society, and better for your soul.
Posted by: Rebekka | Sep 25, 2009 10:52:12 PM
@HF, Neanderthals were not our ancestors, so whether they ate grains or not is about as relevant as whether a gorilla eats grains or not.
@Greag
"Meat, fruits and vegetables typically have the highest cost-per-calorie so this diet will waste money"
Yes, we should save our money to buy yet more useless junk, plasma screens, big cars, unnecessary gadgets... oh wait. Perhaps eating better is not actually a waste of money. In historical terms, we spend a ridiculously small proportion of our income on food. I'd rather "waste" my money on healthy eating than "save" by buying cheap refined foods and spending more on doctors.
Posted by: Travis | Sep 24, 2009 11:15:10 PM
It is also absurd to says that unrefined carbohydrates (whole grains, beans etc.) cause heart disease and diabetes, as the areas of the world that do not suffer from these disease such as rural china consume very large amounts of these foods, and the diets that have proven to reverse these diseases are very high in complex carbohydrates.
Posted by: Travis | Sep 24, 2009 10:50:38 PM
We do not want a slightly better diet, we want to have the best diet.
Improving heart disease and type 2 diabetes is not what we want, we want to reverse these diseases. Therefore it is probably better to follow diets recommended by practitioners who have had 100% or close to 100% success in reversing these diseases with compliant patients as well as coming off of all medications. Practitioners such as Joel Fuhrman and Caldwell B. Esselstyn have provided long term studies proving that their recommended diets reverse ADVANCE HEART DISEASE.
And YES, only diets which have the data to prove the reversal of advance heart disease have always been predominantly or exclusively plant based (as well as being whole food). The meat and dairy industry, Atkins etc. with all their money have never provided data proving that consuming their recommended foods in any substantial quantity has reversed advanced heart disease, despite the amount of economic gain that would be possible by providing such data.
Posted by: daniel defoe | Sep 24, 2009 1:53:47 PM
in terms of weight gain, it has been demonstrated and it makes sense that quantity of consumption is the culprit far more so than quality.
with this in mind, i have experienced a lot of success by simply eating vegetables, sweeds, nuts, and fruit. but eliminating dairy and bread is out of the question; these items can still be consumed but in much smaller quantities. and meat? maybe once a month. why more?
the paleo diet is smart and is in line with our evolutionary history.
Posted by: Schnoodle | Sep 24, 2009 11:58:37 AM
I think that this is just another extreme wish diet. With 30 years of being an RN and a degree in nutrition under my belt - I have recently regained control of my post menopausal body. I never had weight problems until then. Now I control blood sugar by eating every 3 hours. 9:30 am, etc for 5 BALANCED meals of 300 to 325 cals each. I exercise twice a day for 15 minutes each. The excess weight (seriously - nearly 100 pounds) has melted off. If I try all carbs or all protein, I get very hungry. If I try eating every two hours as many have suggested over the years - I get hungry. I learned the 3 hour trick from Jillian Michaels.
I hope that that this helps someone. After weighing 128 pounds from 12 yrs to 45 yrs - it took me many trial and errors to reach my goal at age 60!
Posted by: greg | Sep 23, 2009 2:29:45 AM
@Dave Moss, you correctly identify my three-fold concerns with the paleo diet but to be clear, my objection inter-relates all three: the paleo diet has very high associated costs including social (“practical policy”) and ethical costs – perhaps so high that prima facie it is an objectionable diet pattern; in any event, given such high costs, since the efficacy of the diet isn’t demonstrably and substantially superior to other diet patterns, it really should not be adopted at all – the benefit isn’t worth the cost.
First, some points of agreement. I agree that an individual might get along just fine on this diet. Done correctly, I don’t think one loses anything nutritionally by going on it. (I will say that many of the posters here that are “going paleo” are not in fact doing so but that is another issue.) And I agree that idea motivating paleo – taking advantage of our evolutionary tuning – is intriguing.
But the first problem with paleo is defining what it is. (See HF’s post below.) When we look at the archeological evidence of Paleolithic man’s diet we find that 1) we can’t know the details of what he ate based on fossil records - we can only make generalizations and guesses, 2) different peoples in different places ate different things at different times. So which one is the “correct” paleo diet? We can’t possibly know. Averaging (or concatenating) the diets across all Paleolithic archeological sites (or 13th century hunter-gatherer societies which is what Cordain actually does) is highly artificial.
The diversity of actual diets of Paleolithic man points to another reality: there is tremendous diversity in healthful diets for humans! And those healthful diets can easily include foods that are paleo “no no’s” and include far less meat. Monica has actually made this point before (not in reference to paleo but it is on point) so I will just point you to her post. http://blog.nutritiondata.com/ndblog/2008/04/is-a-varied-die.html
This brings me to the other half of my argument: the high cost of the paleo diet. Meat, fruits and vegetables typically have the highest cost-per-calorie so this diet will waste money. But of greater concern are the social and ethical costs. You can go to nearly any vegetarian website and get an education on the problems with meat consumption. Sometimes (dare I say often) they get a bit strident and preachy and may overreach in their arguments but they do tend to raise all the right issues. For a comprehensive (and more even-handed) study of the environmental impacts of meat production I’d recommend United Nations, FAO publication “Livestock’s Long Shadow – Environmental Issues and Options.”
Finally, a couple of direct responses to your comments:
Dave Moss wrote: “I think protein is a red herring (pardon the pun). We can't derive more than 35% calories from meat and few people go below 15%, so there's limited room for alteration in habits, paleo or no.” That is not even close to true: every vegan/vegetarian is a counter-example. South India is an entire society of vegetarians – sort of the anti-paleo culture. FYI global average calorie intake from livestock is 17%, but about 8% of that comes from dairy! Clearly we can (and most of the world does) get along on a lot less meat.
Dave Moss wrote: “Provision of calories for the world, while excluding grains, dairy and vegetable oil is eminently plausible and provision of nutrition just as easy.” Again this is just not the case. Today 58% of the earth’s surface is dedicated to grazing or feed crop cultivation. It is not possible to touch 25% of global calories from meat with no dairy let alone doing it with low-efficiency (yet sustainable) pastoral grazing. The earth isn’t large enough.
(The global calories and earth surface statistics are from the United Nations, FAO.)
In short, give up paleo and embrace a diet including healthful grains and legumes and dairy. You lose nothing but it will be better for your wallet, better for the environment, better for society, and better for your soul.
Posted by: greg | Sep 23, 2009 2:23:33 AM
@Dave Moss: one comment that I am going to address separately because it doesn’t fit the flow of my longer answer to you:
Dave Moss wrote: “I see you and Dave have crossed swords about satiety… In any case, I find hunger-as-physiological (pace Taubes) a far more convincing model than the more psychological models of folk wisdom.” Really? I find incredible the suggestion ala Taubes that something as enormously complex as human behavior is going to ultimately reducible to… insulin response? Your really think the brain (among other things) has nothing to do with how much we chose to eat? Just a few counter-examples: we know we eat more when given larger plates than smaller – our eyes help regulate food intake; we know we eat different amounts in the presence of the opposite sex, or in the presence of obese and thin people, or if we are served rather than serving ourselves – food intake is socially regulated. The list of factors that influence food intake is enormous. I suspect our current obesity epidemic has a lot more to do with socio-economic factors than insulin… but who knows?
Posted by: HF | Sep 17, 2009 11:21:01 PM
The problem with the "paleo diet" described is that it makes incorrect assumptions about what our ancestors actually ate. Pre-agricultural societies *did* eat grains and legumes. They turned to agriculture to protect this valuable food source in the face of climate change. In fact there is even direct evidence of grains in the plaque on the teeth of Neanderthals. http://news.softpedia.com/news/Neanderthals-Ate-Plants-84569.shtml
Also, for those of us who are tolerant of lactose, milk was such a valuable food source to our ancestors that they evolved the ability to digest it well into adulthood. It's silly to consider it a foreign substance now.
Finally, human diet is highly variable. We can exploit the plant and animal resources of whatever landscape we find ourselves in -- from high-fat high-meat in cold climates to high starch in lower latitudes, and our ancestors diets would have likely been equally varied. The only difference is they got crazy amounts of exercise compared to the quanity of calories they took in, and we don't.
Posted by: David Moss | Sep 17, 2009 3:19:18 PM
Greg, thanks for the thorough and articulate response. You seem to have three concerns: whether we should want to switch to a paleo diet (health-wise), whether we could go paleo (as practical policy) and whether we should do so (ethically).
The main argument for “paleo” is genetic adaptability- that humans are biological organisms and better suited to the foodstuffs we evolved eating (or physiological analogues). That strikes me as convincing for starters, but we'd need to debate the precise mechanisms of each (un)paleo food to be clear on matters. For grains and dairy though, the provisional evidence is good- large swathes of the population have full intolerance of them and many others measurable intolerances. So prima facie there are good reasons for this sort of paleo-shift and little to be lost nutritionally. I see no reason to consider the western model you describe as particularly “balanced” (balanced relative to what?): far more “balanced” and “well tested” is surely the purely meat + veg diet we evolved on!
I agree that the epidemiological data is inconclusive either way, so I won't press the matter much. To my mind the fact that most people fail to adhere to recommendations detracts from arguments for the “tested” success of the recommended diet: muesli might be healthy relative to a largely sugar + white flour + veg oil combination, but that's little commendation for it. I'm sceptical that more calories come from meat than any other source. Americans are estimated to eat 5-8 ounces per day, that's only 300-500calories by a generous estimate. The other 5/6ths of calories can only plausibly be coming from refined carb and (mostly vegetable) fat, rather than piles of fruit and veg. Personally I'm not convinced by “too many calories” but I'm a low-carber as well as a paleoite.
I see you and Dave have crossed swords about satiety. My argument was that protein produces satiety because of specific metabolic effects (largely due to glucagon)-i.e. it combats hunger by ensuring cells are efficiently fueled with energy. Fibre conversely may be “filling” in the way that gallons of water are, but you can still feel weak and search for food however full of water/fibre/cotton wool you are. There's a significant difference: directly experienced back when I tried to fuel my workouts by stuffing chickpeas! In any case, I find hunger-as-physiological (pace Taubes) a far more convincing model than the more psychological models of folk wisdom.
I think protein is a red herring (pardon the pun). We can't derive more than 35% calories from meat and few people go below 15%, so there's limited room for alteration in habits, paleo or no. High fat on paleo isn't obligatory, despite the common convergence with low carb, so fruit and starchy tubers (potatoes etc) can easily make up a high carbist's paleo calories. Also getting calories from animals, if not from meat is easily doable via animal fats (if one has overcome lipophobia), which made up most of our fat intake in the early 20th century (pre obesity/heart disease/diabetes crises, pointedly).
This feeds directly into the question of practicality and sustainability: potatoes or lard as staple calories don't present much of an ecological crisis, nor much of a clash with western culture. I don't view provision of current levels of meat as unsustainable, certainly in the UK/EU a huge bulk of what we produce is literally just thrown away. Provision of calories for the world, while excluding grains, dairy and vegetable oil is eminently plausible and provision of nutrition just as easy. Meat may be inefficient compared to beans, but given that most western calories are gained from essentially zero-nutrient foods the point is a minor one, practically. Pointing to the relative costs of producing grain vs beef is misleading given so many of our resources are poured into producing nutrient-free foods, expensive/exotic foods purely for enjoyment (importing bananas from overseas is certainly ecologically unsustainable en mass) and indeed (in the developed world) on non-food items. Purely in terms of caloric-efficiency, feeding the world on fruit and vegetables is equally implausible, yet these are not cited as unsustainable indulgences.
As to the intrinsic potential for feeding our population on reasonable meat levels (25% calories, let's say), I can't see any reason to consider paleo meat production capacity to be so limited, even 50% of Africa is covered with grassland. Raising meat on grassland is not merely preferable to raising meat on grain, in many ways it's more sustainable that grain per se. Grazing makes use of non-agricultural land without exhausting it, unlike grains etc which require large scale artificial fertilisation.
As to the ethical qualms, if you're a vegetarian fair enough. If your objection is concerned with food shortage in the developing world, then you can stop worrying about sheer lack of food: the world has ample food production capacity, we just have an economic-political system that quite positively keeps food out of the hands of the starving, but that's an ethical objection for another day...
Posted by: Bob | Sep 17, 2009 8:27:31 AM
Since when is it so hard to eat what we have been eating for 2 million years?
Just eat meat, with a little fruit, veg and nuts. Pretty simple really.
@RB - You don't eat paleo. Dairy is not paleo.
Calories in do not equal calories out. Read 'Good Calories Bad Calories' by Gary Taubes and you might start to understand...
Posted by: greg | Sep 16, 2009 7:29:16 PM
@Dave (sorry for one last, awful long post)
First, legumes are NOT generally toxic. I live in the Southwest, one of those cultures thriving on beans, and let me assure you we and our neighbors south of the border do not go to any great lengths to make our beans edible – we boil them in a pot.
There is a kernel of truth in your claim: raw red kidney beans can make one ill because they contain a large amount of hemagglutinin aka kidney bean lectin. To remove the lectin one must… (drum roll)… boil them in a pot. 10-15 minutes is all it takes.
Food poisoning from pathogens in meat (can be deadly) is far more dangerous than the threat in red kidney beans (can induce nausea). So what? All food has to be handled and prepared properly; this isn’t much of an argument against any particular food.
Returning to your first point, (you and I have been down this road before) there is substantial evidence for health benefits of whole grains and legumes including: they reduce blood cholesterol and lower the risk of CHD; they improve bowel function and reduce diverticular disease – an extremely common affliction; they provide satiation with fewer calories assisting with weight control; they may reduce the risk of colon cancer.
“Health benefits of dietary fiber” Nutr Rev. 2009 Apr reviews these benefits and more. I have posted in the past studies regarding CHD. A short visit on pubmed will find lots of studies, but I know that no study meets your threshold of proof. The study it would take to convince you that fiber is healthful – putting thousands of people on high- vs low-fiber carbs for years at a time in a controlled setting to see what happens – is not realistically going to be conducted. So I don’t think we can move this discussion any further.
(I will say your comment about Metamucil and McDonalds is funny)
Sorry I am being stubbornly adamant about this too. I think it is an important point that as a community we each make choices that are sustainable for our community. With regard to food, that means incorporating healthy cereals and legumes into our diets when we are able. At one level, we are talking about different things. I am discussing diet choices made by the (more or less) healthy public at large while your focus seems to be on the sick. By all means, the sick may need special diets: most of us don’t.
On that note, you write: “the subjective feeling of satiety is linked to overall metabolic regulation. If satiety is failing to regulate food intake properly, something is broken in the metabolism.” That claim certainly is not true a priori. Other reasons why people might regulate food intake poorly besides a physiological explanation that your statement assumes include biological, environmental, and socio-economic factors. (That is a great segue to Monica’s post today on obesity and genetics - I made the first comment there.)
@Monica,
you and Dave are invited to my place for dinner anytime. I’ll make my famous vegetarian chili and cool it off with some homemade yogurt ;)
Posted by: Alecu | Sep 16, 2009 10:40:54 AM
Low-carbohydrate diets improve insulin sensitivity for people with type 2 diabetes and glycemic control. I have read on http://www.projectweightloss.com some doctors compared the benefits of a low-fat diet with low-carbohydrate diet for diabetics. For non-diabetics a low-carbohydrate diet has the same effect as other diets – weight loss, but in diabetics’ case we can add the improving of glycemic control and insulin sensitivity. Of course, medication was adjusted to avoid any weight gain.
Posted by: Monica Reinagel | Sep 16, 2009 10:19:04 AM
Greg and Dave, you two should definitely get together for dinner sometime. And when you do, I want to be there!
Dave, I find the estimate about 1/3 of food poisoning cases being due to improperly prepared beans highly suspect. Also, not sure if you saw my response to your Paleo challenge, which I inserted into your comment rather than posted as a new comment, just to try to keep the threads organized.
Posted by: Dave | Sep 16, 2009 10:07:36 AM
@Greg,
"the weight of the evidence seems to make clear that whole grains and legumes can be part of a healthy diet and adding more whole grains and legumes makes sense for the diet of most people."
To what evidence are you referring? I've had a lot of people tell me this, and zero who can supply said evidence (or at least any beyond comparisons with the generally poor SAD, over which just about anything is an improvement). And I think you need to qualify this statement with "properly prepared". Raw grains and legumes are generally toxic. Were you to eat raw wheat, it would give you a stomach ache. Raw kidney beans can kill you, and I read an estimate somewhere that something like 1/3 of food poisoning cases are suspected to be due to improperly prepared beans. There are cultures that thrive on these foods, but they go to some lengths to make them edible (soaking, sprouting, fermenting).
My point about fiber (which I'm making badly) is that the subjective feeling of satiety is linked to overall metabolic regulation. If satiety is failing to regulate food intake properly, something is broken in the metabolism. If you want to fix that problem, you need to understand the root cause. The root cause of metabolic syndrome is very likely not lack of dietary fiber.
I'm being annoyingly adamant on this point because I think it represents a key gap in treatment recommendations for metabolic syndrome. The fiber thing appears in a lot of soundbites, but I doubt any nutrition professional would recommend you just pound large glasses of Metamucil on top of your McDonald's meal.
Posted by: greg | Sep 16, 2009 12:50:08 AM
@Dave,
I see we are having a semantic difficulty. I’m not claiming that fiber promotes “long-term satiety.” Other than some conjecture around this blog, I’m not aware of any food having been demonstrated to promote “long-term satiety.” I’m just talking about regular-old satiety, the full feeling you get after a meal that provides the pleasant, satisfied, subjective experience and helps to reduce consumption. Protein promotes that subjective experience; so can fiber from whole grains and legumes.
Monica has already devoted an entire blog post to your suggestion that one can live without grains. I don’t think anyone posting around here disputes that grains may not be essential to health. But from a public policy perspective, we cannot get along without most people consuming a significant portion of their calories from grains and legumes. From a personal nutrition perspective, the weight of the evidence seems to make clear that whole grains and legumes can be part of a healthy diet and adding more whole grains and legumes makes sense for the diet of most people.
All that said, it is true, there may be no sustainable way to support today’s population levels. Estimates of Earth’s sustainable carrying capacity vary widely, from a low of 2 billion people to a high of 40 billion. That is a discouragingly large range because such estimates are extraordinarily complex and depend heavily on what level of per capita consumption is maintained. If current US levels of consumption of food, water and energy are to be the norm, then you may be right and even current levels of consumption may not be sustainable. On the other hand, if the developed world can find ways to lower demand for these necessities, we may be just fine. For a constructive, detailed look at these issues, I might recommend “Feeding the World: A Challenge for the Twenty-First Century” by Vaclav Smil.
I think we have taken this blog a LONG way off from nutrition… so I’m going to sign off here.
Posted by: Joseph Gentzel | Sep 15, 2009 4:16:51 PM
I thought I sent this already, so sorry if this is a repeat.
I am going to keep this short as these are getting way too long to be meaningful.
With all due respect, I believe some of you are mostly debating the wrong set of postulates or at best symptoms and reactions IMHO the most important aspect of the diet is how the food interacts with the body i.e. does it cause inflammatory, neutral or anti inflammatory reactions in the body. At first this does not make much sense, but it falls into place physiologically. An anti inflammatory diet takes care of most of the rest of these dietary aspects by its nature, i.e. being the nutrients the body can use most effectively for optimum health. Check it out. I think you will be happy that you did.
If that postulate is correct, the Paleo diet is somewhat superior to the Mediterranean diet, but still is not ideal.
Posted by: Dave | Sep 15, 2009 4:14:00 PM
@Greg,
The point of the experiment is to show that fiber content by itself cannot exert a major effect on long-term satiety. And I know of no evidence that "whole grain foods" are particularly healthy when considered in the whole spectrum of foods, only when compared against highly refined foods.
I'm not arguing that paleo is particularly sustainable. I have the increasing feeling that there exists no sustainable solution for feeding six billion people. Current large-scale agriculture of grains and soy is clearly not sustainable, relying heavily on petroleum products, irrigation, and topsoil destruction. This is further exacerbated by the fact that both wheat and soy are toxic in their raw form, and require considerable processing to even be edible. I'm interested to hear your views on the topic.
Posted by: Joseph Gentzel | Sep 15, 2009 4:05:25 PM
I am going to keep this short as these are getting way too long to be meaningful.
With all due respect, I believe some of you are mostly debating the wrong set of postulates or at best symptoms and reactions IMHO the most important aspect of the diet is how the food interacts with the body i.e. does it cause inflammatory, neutral or anti inflammatory reactions in the body. At first this does not make much sense, but it falls into place physiologically. An anti inflammatory diet takes care of most of the rest of these dietary aspects by its nature, i.e. being the nutrients the body can use most effectively for optimum health. Check it out. I think you will be happy that you did.
If that postulate is correct, the Paleo diet is somewhat superior to the Mediterranean diet, but still is not ideal.
Posted by: greg | Sep 15, 2009 3:51:26 PM
@Dave
I don't follow the point of your post or your proposed experiment. I don't think it matters to the consumer of food why high fiber foods promote satiety - mechanical, GL-effects, whatever. My point is only that if the paleo diet is lauded because it promotes satiety, there are other (more environmentally sustainable, perhaps ethical) ways to get that benefit and among them are to eat more high fiber foods including whole grains.
As you point out, there is already enough literature on what does & doesn't impact satiety that we can rely on.
Posted by: Dave | Sep 15, 2009 2:44:42 PM
@Greg,
Fiber affects satiety only via added mechanical distension of the stomach, with a possible minor contribution coming from the short-chain fatty acids manufactured from fiber by intestinal flora (no idea how much this is in terms of calories). The mechanical effect clearly cannot be the primary driver of satiety, since then an animal could eat an indigestible substance, feel satisfied, and starve to death. Try the experiment yourself: eat very low calorie and high-fiber, and see how long satiety lasts.
There's a whole bunch of hormonal signals related to the energy and macronutrient content of food which affect satiety, see links below for mind-numbing details.
http://sparkofreason.blogspot.com/2008/06/energy-regulation-1-do-calories-count.html
http://sparkofreason.blogspot.com/2008/07/energy-regulation-2-appetite.html
Anticipating your next comment, there have been studies showing that eating higher fiber foods leads to lower caloric intake. But remember that higher fiber generally means lower glycemic load, thus lower insulin response, and less chance of postprandial hypoglycemia. If fiber has an independent effect on satiety as relates to overall energy regulation, the experiment I proposed above should illustrate this.
Posted by: greg | Sep 15, 2009 2:26:42 PM
@Dave Moss. You points are all well taken but on balance I don’t find them are convincing that the paleo diet is a good idea. Let me explain (sorry for the long post).
D Moss wrote: “…In the US people have been eating less meat and animal fat (proportionate to calories), more vegetable oil and more carb (and more calories from carb), while obesity and chronic disease have been increasing…” That is true but a little misleading. From 1970 to the present in the US, people are eating more (300-550 cal/person/day depending on what data series you look at). They have been eating more of every food category. You are right, they highest growth in that time period has been in fats (for clarity that is both vegetable & animal fats) and grains (with very little whole grains), but from the start of the series to today we consumed more our calories from meat than any other major food source. America has the highest per capita consumption of meat of any country in the world. I really don’t think this data set is an indictment of current food recommendations that are not followed nor supportive of a high meat consumption diet. (But to be clear, I think data at this level of aggregation is not really indicative of anything other than on average we consume way too many calories.)
D Moss wrote: “Anecdotally people find a high fat paleo diet eminently filling and sustainable, whereas calorie restricted high carb diets are notoriously and demonstrably difficult. Crucially there are plausible biological mechanisms for why this would be so.” I agree there are “plausible biological mechanisms” behind the paleo diet, but that is a long way from saying they are demonstrated. More important I suspect one can get all the hypothesized benefits of the of paleo diet by consuming a diet of (healthy) fats, (low-GI, high fiber) carbs, and (lean, sustainable including vegetable sources like legumes) protein. Such a diet can easily incorporate whole grains. We have many years of study and data that demonstrate the effectiveness and health benefits of this balanced diet approach.
Specifically with respect specifically to satiety, yes, protein is generally the most satiating macronutrient so we could expect a very-high protein diet to be filling. But fiber is also highly satiating so you can achieve the same result with respect to fullness without foregoing grains if you choose whole grains. To give our sponsors a plug, the Fullness Factor tool they provide is excellent at identifying more satiating choices and they need not all be meat.
D Moss wrote: “Paleo doesn’t require 50% calories form meat…” I’d agree (which is why I tried to hedge in my post) that what exactly it means to “eat paleo” is not well defined. My strawman definition is 50% of calories from meat, 50% from fruits and vegetables, 0% grains, dairy, legumes & oils. If we let the meat-to-fruit & vege ratio vary, I would still think it difficult (though possible) to get 30% of your calories from non-meat fats…
D Moss wrote: “… In all other respects though, paleo is highly sustainable.” Yes well, it can be, but not at the scale required to feed the current population. It was a sustainable diet choice for hunter/gatherers because such societies had population densities of ~1 person/sqr mile. You could not feed 300 million Americans (~80/sqr mile) let alone a world population of 7 billion (~115 person/sqr mile) on such a diet sustainably. Frankly, it is not at all obvious that we can provide the current level of meat in our diets sustainably.
You mention “India” and “African pastoralists” as examples of sustainable meat producers. I can’t speak to that specifically, but I can say that if the paleo diet supposed we ate the amount of meat that Indian or Africa produces per capita, there would not be an issue. The problem is that you can’t produce the volume of meat the paleo diet prescribes by such methods for our sized population. It is true that optimal land use almost certainly does include some meat fed by grazing (or growing feed crops) on marginal lands, but to produce enough calories to feed our populations, those calories are going to have to be provided by cereals. We cannot un-ring the bell and return to a Paleolithic diet without also returning to Paleolithic populations sizes; given that, the paleo diet is public policy non-starter and ethically questionable.
Posted by: Rosmerta | Sep 15, 2009 2:20:15 PM
The "paleo" diet cannot be sustainable or attainable unless you are eating only wild game and plants which have not been exposed to modern soils. Even grass-fed livestock is not "paleo" becuase those grasses did not exist in prehistory. It's just another gimmick which sounds very appealing unless you realize that both we and the plants and animals have changed irrevocably since the inception of the Neolithic and the cultivation of grains, and especially in the last century.
Posted by: Dave | Sep 15, 2009 10:39:26 AM
Oops, my hypothetical answer should have been "yes", not "no" to your second question. Otherwise I'm arguing with myself.
Posted by: Dave | Sep 15, 2009 10:36:41 AM
@Monica,
"But if I'm willing to exercise my capacity for conscious choice and self-control ( e.g., selecting appropriate portion sizes rather than eating until my lizard brain tells me to stop), couldn't I enjoy non-Paleo foods and still maintain a healthy body and weight? (Anecdotally: yes)"
To some extent, that's probably true, though there's obviously many other variables. There are plenty of people who eat a "healthy" Western diet and exercise, and still wind up with diabetes, cancer, heart disease, etc. And all that thinking and exercising seems like a hassle just to be able to eat bagels :-)
"Furthermore, if one of the goals is to return us to a more natural, instinctive state in which we don't have to exercise conscious control over our calorie intake or weight: doesn't avoiding all grains, dairy, oils, and legumes in this modern age require the same capacity for self-control as simply regulating intake of these foods?"
That's an interesting question. I will hypothesize the answer is "no", based both on the anecdotal experiences of myself, along with a hypothesis on the nature of addiction, which I'm about to bore you with. First, here's a nice NYT article on a part of the brain called the insula (annoying sign-up possibly required):
http://www.nytimes.com/2007/02/06/health/psychology/06brain.html
The insula is a small part of the "lizard" brain, but projects to many other parts of the brain, including the cerebrum. It's job seems to be to reinforce and drive learned behavior that are deemed beneficial, e.g., see bright colored spheres (fruit) hanging off plant, eat, repeat. The insula is powerful, and also can be usurped for evil, i.e. addictions like smoking appear to be driven by the insula (smokers who damage their insula, e.g. via a stroke, can often go cold turkey).
The insula contains receptors that respond to many substances, amongst them nicotine, opioids, cocaine, and insulin. The latter is probably the most important in an evolutionary context, since food raises insulin, particularly those containing available sugar, like fruit (there's a reason why plants expend the energy to make their fruit sugary). Fruit is a good source of energy and micronutrients, and generally doesn't last long, so it makes sense to reinforce the behavior of eating it.
Now take that mechanism and expose it to the sorts of insulin stimuli resulting from even a "healthy" modern diet. One would expect an addictive cycle, and this has been observed in animal models. In her book "The Vegetarian Myth" Lierre Keith discusses the possible role of opioids in wheat as an additional driver of this addictive cycle. I don't think there's much clinical evidence for this, but an intriguing thought nonetheless. I've certainly encountered plenty of people who have no problem giving up sugar soda, but ask them to skip their morning bagel? Run for cover.
So yes, kicking grains etc. definitely requires willpower, as does kicking cigarettes, cocaine, or heroin. If grains and sugar weren't addictive at some level, this wouldn't occur. Nobody needs willpower to leave Brussels sprouts out of their diet (well, maybe there's a few "sprout-heads" out there).
BTW, this whole business about the insula is the kind of thing I mean when I say "biology drives behavior". People are very good at rationalizing their addictions. The insula projects to the reasoning centers of the brain, and will make you come up with a "reason" to persist in the behavior. We like to think that our rational brain (about 200,000 years old) drives the bus, but it is more likely a passenger with majority of actual control being exerted by deeply ingrained survival mechanisms (which have been evolving for billions of years).
There's a couple of key questions. One is if there is sufficient health reason to kick grains and other refined carbohydrates. Clearly if you have coeliac disease, the answer is "yes". I claim it is also "yes" for the major "epidemic" of modern times, Type II diabetes and broader metabolic syndrome. And yes, I know you can normalize metabolism in some people without carbohydrate restriction, but it's very likely easier if you remove external sources of glucose and other foods that induce insulin resistance (like fructose). See e.g.
http://www.springerlink.com/content/v57212m331741w24
But for an healthy person with a normal metabolism and genetic tolerance to grains (assuming that exists)? It's an open question, though frankly there seems to be absolutely no nutritional upside to grains, so the only reason to eat them seems to be "because I want to" (hello insula).
The other question has to do with sustainability. Quitting cigarettes for life is hard, with recidivism occurring even after decades of being "on the wagon". I think the good news is that there are many whole foods that one can use to replace grains sugar, e.g. sweet potatoes or fruit (assuming your metabolism isn't so broken it can't handle this). Anecdotally, many people (myself included) seem to find that once you get over the hump, leaving out refined carbs isn't so hard. There's not much you can do to replace cigarettes, but you can certainly eat an apple or an egg instead of having a bagel and at least keep the hunger part of the equation in check.
So here's a challenge for you: kick all refined foods for 8 weeks. I'm sure your readers would be interested in your experiences, positive or negative, and it would give you some mileage in someone else's shoes, so to speak.
Monica's Response: But what's my motivation for taking that challenge? Yes, I LIKE my current diet (hello insula), but you haven't convinced me that it's hurting me in any way. I mean, we've descended to the level of individual case histories, right? By all measures (weight, body composition, lipids, hormone levels, bp, glu, etc.) my diet seems to be working pretty darned well for me. Why fix what's not broken?
Now, maybe I'm the exception to the rule. Let's talk about public health policy, seeing as the word "epidemic" is being hauled out so regularly. In terms of public policy, it doesn't really matter whether its behavior or biology driving, does it?
Let's say we could amass definitive evidence that the majority of heart disease, diabetes, and obesity is caused by inclusion of grains in the diet--and that includes explaining away all the evidence supporting other dietary patterns as healthful, such as lower rates of obesity and disease in vegetarians.
What should our next move be? Should we take the same measures we used to motivate people to stop smoking? Heavy taxes on grains? Massive public education campaigns? Skull and crossbones warnings on bread wrappers? Higher health insurance premiums for grain eaters? Shut down Italian restaurants? Outlaw consumption (or sale) of certain foods (maybe we could start by banning them from schools)? How about eight week in-patient detox programs to break the spell of addiction--(hey, I see a business opportunity!)
Let's say you're right. What next?
Posted by: Monica Reinagel | Sep 15, 2009 8:00:49 AM
Great discussion on this topic, everyone, with many valuable and thought-provoking contributions. Thank you for keeping the tone civil and respectful as well!
Posted by: Monica Reinagel | Sep 15, 2009 7:59:36 AM
@Dave
One of the arguments seems to be that if I eliminate all non-Paleo foods from my diet my appetite, intake, and metabolism will all regulate themselves to sustain my ideal body weight without me having to exercise any conscious control or choice. In other words, I can eat as much as I want. If I were to indulge in non-Paleo foods, however, that self-regulating system would break down and I'd end up eating (and storing) too many calories and gaining weight.
But if I'm willing to exercise my capacity for conscious choice and self-control ( e.g., selecting appropriate portion sizes rather than eating until my lizard brain tells me to stop), couldn't I enjoy non-Paleo foods and still maintain a healthy body and weight? (Anecdotally: yes)
Furthermore, if one of the goals is to return us to a more natural, instinctive state in which we don't have to exercise conscious control over our calorie intake or weight: doesn't avoiding all grains, dairy, oils, and legumes in this modern age require the same capacity for self-control as simply regulating intake of these foods?
Posted by: Monica Reinagel | Sep 15, 2009 7:44:14 AM
@Dave @CD @ChrisB @DavidMoss
My comments about "norms" and "extremes" are not comments on the nutritional merits of the Paleo diet (or the so-called norms), but merely speaking to the issue of practicality.
Posted by: David Moss | Sep 15, 2009 3:07:16 AM
Greg:
Even though most people miss food pyramid recommendations, there's some reason to the claim that people are following guidelines and failing. In the US people have been eating less meat and animal fat (proportionate to calories), more vegetable oil and more carb (and more calories from carb), while obesity and chronic disease have been increasing rapidly.
Also the fact that people fail to follow recommendations is pertinent to the paleo perspective. Anecdotally people find a high fat paleo diet eminently filling and sustainable, whereas calorie restricted high carb diets are notoriously and demonstrably difficult. Crucially there are plausible biological mechanisms for why this would be so.
-
A practical point: the paleo diet doesn't require 50% calories from meat, (cf the kitavans). Even low carb paleo only requires sufficient meat for protein and satiety (20% calories for me personally), the bulk of calories can come from fat.
As to the ethical question: as a paid up Peter Singer disciple I'm open to animal liberation arguments against meat. In all other respects though paleo is highly sustainable. Grain fed industrialised meat is very energy inefficient, but if you compare livestock energy efficiency in India or a fortiori African pastoralists, meat compares far better to grains (since animals eat vegetable that's inedible to humans.) There is a crippling food crisis at present, but not for wont of calorie-production, but rather due to distribution. It's also inconsistent to criticise meat for squandering food energy, by the same token producing nutrition-free lettuce would be ethically indefensible.
Posted by: greg | Sep 15, 2009 1:45:32 AM
O wrote: “…what people have been eating - the low fat high carb diet recommended by the government - has not been producing results.”
Steve Parker wrote: “…the "eat less fat and exercise more" philosophy dominant over the last 30 years has had many short-comings, as evidenced by increasing rates of overweight. So, it makes sense to examine the alternatives.”
Explicit by O and implicit by Steve is that people are following conventional recommendations. That simply is not the case: fat consumption is >50% and sugar consumption is >150% of Food Pyramid recommendations (to use the USDA as the standard of conventional recommendations.) Total grain consumption matches the Pyramid but the mix is wrong: the Pyramid would have us increase our whole grain consumption by 300% and cut our refined grains in half. The current obesity epidemic wouldn’t seem to be an indictment of diet recommendations if there isn’t compliance to the recommendations in the general population.
But perhaps more important from a public policy perspective, the paleo diet – if that means getting 50% of our calories from meat – just is not an available diet pattern for us: we cannot produce enough calories for the world to eat if that is the diet we are all going to be on. It is also unlikely that we could we sustain the environmental impacts of wide-spread adoption of such a diet.
Monica has in the past has alluded to “cultural & ethical” factors reasonably influencing food choices. The paleo diet arguably fails the ethical smell test: it likely isn’t sustainable for the planet for mankind to live on that diet.
Posted by: Chris McNeil | Sep 14, 2009 11:23:11 PM
Interesting article.
I'm a big fan of the energy equation, and in 20+ years in the fitness business I've seen little to dispute that calories in vs. out is what counts more than what kind of calories.
So, maybe the question really is what is the easiest way for a person to cut calories and stay with their new patterns. The Peleo diet gives some interesting alternatives that seem to work for some.
Chris McNeil, founder
http://www.fitmenu.net
Posted by: Dave | Sep 14, 2009 9:56:23 PM
I'm curious how far outside of the social norm one has to fall to become a "purist" or "zealot". Cutting grains from the diet hardly seems "zealous", particularly when you consider that something like 10% of people have a clinically detectable problem with grain consumption. I expect there was a time when not smoking would have been considered "zealous" as well (and no, I'm not suggesting that the evidence against grains comes even close to that against tobacco, just
making the point that social norms are extremely poor indicators healthy behavior).
Here's a more recent paper on the same topic, also a small study.
Posted by: greg | Sep 14, 2009 8:45:49 PM
O wrote: “The economics of paleo is what is [sic] is because of the huige [sic] government agricultural subsidies (corn, soy). Once these subsidies are gone, the prices of paleo foods and grains will be comparable.”
Dave has made a similar suggestion (in a comment on another post) and even Monica has acknowledged this alleged effect in a past post. Perhaps others have as well. I know this is a nutrition blog and I don’t want to take us too far afield, but I think this is an oft repeated claim which is highly unlikely to be true.
First, understand that farm subsidies impact prices directly only at the commodity level but the cost of farm commodities is a small part - generally less than a quarter - of the retail cost of food. Second, in the US, farm subsidies take many different forms that impact supply and prices both positively and negatively so the mere fact of their existence is not evidence of the magnitude or direction of the impact on these programs on retail prices or supply.
In addition, it is not at all clear that farm subsidies impact meat prices adversely vis-à-vis grains: livestock producers get subsidies too. Farm subsidies go directly to dairy as well as to feed crops which impacts of livestock costs. Ranchers also get non-cash subsidies by being able to graze animals on federal land as well as benefit from tariffs on foreign products. (And for completeness sake, I’ll point out that about 20% of our farm subsidies go to non-food products including cotton, wool and tobacco.)
It is difficult to conclusively establish what the net effect of all this is on consumer prices but it generally thought by economists to be very small, certainly well less than 5% of the consumer price for most products. O’s suggestion that prices of “paleo foods” and grains would be comparable in a world without subsidies is almost certainly false (assuming "paleo foods" means "meat"). If there is any exception to this general claim that farm subsidies do not materially impact consumer prices it is going to be for sugar: our policies are substantially increasing the consumer price of sugar - by keeping foreign sugar out of the US market - rather than decreasing it as might be supposed.
Posted by: O | Sep 14, 2009 8:10:27 PM
It is indisputable that what people have been eating - the low fat high carb diet recommended by the government - has not been producing results.
I see these people everywhere, including my gym. They exercise as much as I do, and yet, still carry excessive body fat.
Now, if someone is eating a mediterannean diet and is happy with the results, they are free to continue what they are doing. This is a free country.
But I will go one step further and say that many people are happy with mediocrity. If they were obese, and they lost and kept the weight off on a mediterannean diet, then they are happy and will continue with it.
I have never been happy with mediocrity. I wanted my 6-pack abs I had in my 20s back (I am now 43). I wanted perfect lipids. I wanted a perfect CT heart scan calcium score of 0. And I achieved all that with the paleo diet.
Posted by: Stacey Baker | Sep 14, 2009 7:20:05 PM
If what you're doing isn't producing results, try a different approach. If you've found what works for you, keep doing it. But don't assume that what works for you is the (only) solution for everyone.
That is fantastic advice in sooo many contexts.
You rock.
Posted by: O | Sep 14, 2009 6:25:43 PM
I am also a paleo eater and have been for about a year and a half. I used to be a low fat high carb diet. Since I started paleo my weight has gone down about 10 lbs, and my lipids have become spectacular: triglycerides = 40, HDL = 88 (double what it was). Testosterone also doubled to a healthy 606.
I find the diet extremely easy to follow, and very tasty. It is hard to overeat on paleo, as the high fat content of meals satiates you well.
I exercise 4x week, 2 hrs each session which includes very intense weights as well as cardio. Paleo gives me endless supply of energy, and at the same time maintains my 6 pack abs flawlessly.
Monica, as far as practicality is concerned, many years ago, it wasn't practical to be a non-smoker either as smoking was everywhere and people were unaware of how damaging to their health it was. But the people in the know fought and claimed a victory. Today, if you are a smoker, you are just plain stupid and ignorant.
Further, I don't feel at all like the paleo diet is all that limiting. It may seem so if you focus on what you don't eat: grains (cereal, bread, crackers), potatoes, rice, pasta, and desserts. I eat every possible kind of meat, fatty or not, bacon, eggs, all kinds of cheese, nuts, olive oil, coconut oil, and just about any vegetable and fruit you can imagine. Limiting?
It is limiting in a same way that a smoker would say it is limiting to not be allowed to smoke.
The economics of paleo is what is is because of the huige government agricultural subsidies (corn, soy). Once these subsidies are gone, the prices of paleo foods and grains will be comparable.
I don't find too many societal obtacles to following a paleo diet. I do live in LA where asking to replace potatoes or rice with veggies in a restaurant is completely normal. Or even ordering "naked burgers" (without the bun).
Given all that, Monica, let me give you the real reason why people are slow to even try paleo despite all the positive evidence. It is the same reason we have people passing judgement without even having read the bible. It is the same reason we have people being ignorant and impolite at these health care town hall meetings, without having read and understood what really is in the health care bill. It is the same reason people buy gym memberships, only to stop going after a few weeks.
Yes, a lot of people lack motivation, discipline, basic education, and it appears to me, basic intelligence.
Posted by: Paleo Man | Sep 14, 2009 5:39:25 PM
I am 45 years old and have familial hypercholesterolemia (genetically high cholesterol of 340 or so on a Ornish-style low-fat mostly vegan diet with daily exercise.) I am a lean, fit distance runner. I started on a paleo diet 18 months ago.
Starting in the mid-1990s, my doctor tried to control my cholesterol through statins without success due to my intolerance of the medications. (See the 2004 study on "Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems." http://www3.interscience.wiley.com/cgi-bin/fulltext/118777654/HTMLSTART
While I am not a professional athlete, I am a very active runner, bicyclist, and weight lifter. Recently, I was able to raise my HDL levels to 85 from 45 due to dietary changes resulting from a strict adoption of the Paleo diet. My fasting glucose levels were also reduced from 102 to 90 and my weight dropped to 132 from 140, despite my eating huge portions. I also consume extra fiber in the form of psyllium and guar gum and would recommend that to other statin-phobic individuals. My total cholesterol has now fallen to 280. Still high, but much better.
On my previous low fat, high carb vegetarian diet, my HDL levels were as low as 35. I discovered the Paleo diet on my own as a way to solve my creeping glucose levels. Its dramatic affect on HDLs confirms its utility for individuals like me! I have never felt better and am now winning races for my age class for the first time in my life.
Posted by: Joseph Gentzel | Sep 14, 2009 4:29:53 PM
There is no data to even suggest that "millions of people" take of weight and "keep it off" by simple calorie restriction without looking at the foods that cause adverse reactions to the body upon ingestion. The data says that the obese epidemic continues to esculate geometrically. And yes long term data is needed in many places before the jury is in on any of these, but it has to start somewhere. My sence is that the paleo diet is close. The Mediterranean diet is also good as long as one pays close attention to the grain content of the diet.
Posted by: RB | Sep 14, 2009 4:04:10 PM
I've been doing paleo for three years now. I eat roughly the same calories now as I did before. However, the calories in the two soft drinks, the four slices of bread and 3-4 cookies I used to eat in a day have been replaced by olive oil, nuts and cheese. I'll still eat a few dried mango slices and other sweet things here and there, but I try to limit that to less than 50 gms per day.
My weight is down 10-12 pounds and my lipids are far, FAR superior to what they used to be when I started out.
My typical diet:
B: Two fried eggs and 3 pieces of bacon
L: 1/3 pound cheeseburger (no bun) with 3 pickle quarters on a bed of lettuce - OR - ~3/4 pounds salad including 2 eggs, loads of celery, loads of broccoli and cauliflower, lots of sunflower seeds and blue cheese, cheddar cheese and parmesan. EV Olive oil and a little balsamic.
S: 1/3 lb meat or fish, green apple, loads of green beans with melted cheese.
Dessert: 1 oz 75% dark chocolate - OR - heaping tablespoon vanilla ice cream -OR- 1 oz of dried fruit.
Drink: Zevia cola or stevia sweetened Kool-Aid.
The times I've measured calories, I'm hitting pretty close to 2200.
My blood sugar, lipids and blood pressure are very firmly in the healthy range.
Posted by: ChrisB | Sep 14, 2009 3:41:08 PM
I am a Paleo eater and have been for close to 6 months. The only changes I made were to cut out grains, tubers and legumes in exchange for an equal amount of calories from fruits and veggies and cut out refined oils for an equal amount of animal fats, yes lard and tallow. I removed sodium. Never ate dairy.
I am an athlete so there has been no effect on exercise other than that my recovery rates have significantly improved and I am training harder. Oh, and I am 100% symptom free of exercise induced asthma, something I have struggled with all my life.
I find the Paleo diet very easy to follow and far from "extreme". I have lost bodyfat with little weight loss (gained muscle) and dropped close to 3 waist sizes. I eat A LOT OF FOOD!!!!
Pre-Paleo I struggled with cravings for sugars and treats. Cravings have been no issue since week #3 of 100% Paleo. MY GF is a pastry chef. I am often surrounded by amazing cakes and pastries.
Pre-Paleo I had to carry food with me everywhere I went to prevent crashes in energy. Now I can go out on 20+mi. hikes with no snacks and have great energy all day. I live in the mountains!
Paleo is the way to go for me! I wish my girlfriend and my other friends ate Paleo so they had enough energy to keep up with me now.
Posted by: ross | Sep 14, 2009 3:27:32 PM
The behavioral aspect is too important to be overlooked or just passed off as "unsustainable". I would love to see the parameter of time factored into some of these studies more.
I have been experimenting for a while with a paleo technique where I cut down the amount of fatty red meats that I eat during my regular meals. However, once a week or so I will cook a large 3-4lb roast and will feast on it for the days following. I started doing this to approximate the way our paleo ancestors more likely ate meat (once in a while in bulk when a kill was made).
I have found that doing so has encouraged unexpected behavioral and dietary modifications:
1 - I eat less meat intrinsically.
2 - I save money because I eat less meat and because I buy it in bulkier portions.
2 - I focus on more variety in my protein sources such as eggs or complete protein carbs like quinoa.
3 - I find it EASIER to maintain because I only have to cook the meat once in a while.
4 - I find it EASIER to maintain because the emotional satisfaction that comes from biting into the first piece of delicious meat is savored since I only eat it once in a while. This prolonged expectation and satisfaction helps me to always "look forward" to my weekly roasts and never "get tired of it". If I ate it once a day, this psychological aspect would likely yeild VERY different results.
Ultimately, whatever works for an individual is the best choice because any choice is better than none at all. However, finding personal, creative ways to balance the societal and behavioral aspects of "meal making" with the scientific/nutritional foundations of food quality is a powerful concept for boosting any individual's dietary success and sustainability.
Posted by: David Moss | Sep 14, 2009 3:19:28 PM
Monica: "millions of people continue to lose weight and keep it off doing nothing more exotic than [cutting fat and calories]."
Let's keep things neutral in the carb vs fat slugfest! Cutting calories [and fat] can produce weight loss, as can cutting calories [and carbs] or calories and [any type of calories you care to name]; ignoring metabolic "magic" it's the calories that count.
There's a similar bias inherent in calling low grain, low carb or low dairy diets "extreme." Fat and carbs are both macronutrients, prima facie low carb is no more extreme than low fat [notwithstanding that there aren't any essential carbs...]. As to grains or dairy: there's clearly no nutritional need for them, many cultures have thrived without them; indeed most humans, most of the time have thrived without them! Cutting grain, dairy and vegetable oil can hardly be called extreme, just because they've recently become a cheap, hyper-subsidised staple in our culture.
The 'cutting whole categories of food = lower calories' argument is one explanation, certain non-paleo foods driving hyperphagia is another.
As for sustainability: not eating grain and dairy seems pretty straightforward, especially given the huge numbers of people who are acutely intolerant of both gluten and lactose (and arguably casein) and so do just that! The fact that eating bread is really tempting for most seems a reason to suggest that avoiding it might be a good thing, rather than so inconceivable that it would be better not to mention the possibility.
Posted by: Dave | Sep 14, 2009 2:41:03 PM
@B
The study you cite has significantly different carbohydrate content, potentially influencing insulin response. The central role of insulin in appetite regulation (directly and indirectly) means that the difference could be due to the expected smaller insulin response from the Paleo diet. The question is one of causality (is the difference in calorie intake by choice or as a result of metabolic regulation), and you need to fix as many variables as possible to interrogate this.
@Steve,
I think the average Paleolithic lifespan is skewed by high infant and child mortality. I don't have the exact reference at hand (one of Cordain's papers?) but I believe it is known that post-puberty, Paleolithic humans had about the same chance of hitting 70 as modern humans. That is, the mortality distribution is bimodal, peaked both at young and old. I'll try to dig up the reference.
Posted by: B | Sep 14, 2009 1:40:24 PM
Monica said: "But I think it's also at least in part behavioral and practical: when whole categories of food are off limits, you tend to eat less and weight loss ensues."
Dave said: "Have there been any animal studies confirming this belief? It would be very strange if behavior trumped biology, especially in an area as critical for survival as managing energy."
Yes Dave, it has been shown. In the study I am about to cite, which compared Paleo vs Diabetes Diet, it was about 300 Calories less.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2724493&rendertype=table&id=T5
Which makes sense. If a paleo dieter went out to eat, their salad can't have salad dressing, their steak can't have a side of fries like it normally does and instead has to opt to something like raw/steamed veggies. This person can no longer graze on the biscuits/chips/breadsticks that are often given to the table. How many Calories did that person just save?
Overall though, I agree with Monica - "Do what works for you."
Like Steve, I am interested in hearing that answer.
Posted by: Steve Parker, M.D. | Sep 14, 2009 12:47:44 PM
You make a lot of sense, Monica.
Neverheless, I have increasing interest in the paleo diet and look forward to learning more about it. Why? Well, the "eat less fat and exercise more" philosophy dominant over the last 30 years has had many short-comings, as evidenced by increasing rates of overweight. So, it makes sense to examine the alternatives.
Cutting calories (regardless of macronutrient percentages) and physical activity HAVE indeed helped many people control their weight. Visit the National Weight Control Registry for success stories.
In the interest of science, the paleo community should get together and decide early on, if they can, exactly what IS a paleo diet. For example, which insects are included? [Google "mark sisson"]
In that vein, Mediterranean diet scores have been very helpful in research efforts.
My recollection is that average lifespan of Paleolithic Man was about 30 years, due to infections, trauma, lack of medical care, harsh living conditions, etc. If you're going to die at 30, it may not matter too much what you eat, as long as it's not too contaminated with germs. Most of the lifestyle-related disease we see now (e.g., cancer, heart disease, type 2 diabetes) don't appear until after age 30.
The paleo advocates must have an answer to that. I just don't know what it is.
-Steve
Posted by: CD | Sep 14, 2009 12:03:28 PM
I thought the post was helpful until I got to the end where you add the label Extreme to the Paleo approach. I think using the Extreme label will discourage people from giving it a try.
We have seen an "extreme" increase in obesity, diabetes and heart disease. Could it be that the eating habits associated with existing cultural norms are the "extreme" diet to be avoided?
Posted by: Dave | Sep 14, 2009 12:01:43 PM
"And while cutting fat and calories and getting more exercise may seem hopelessly old-fashioned in an era of "good calories, bad calories," let's not ignore the fact that millions of people continue to lose weight and keep it off doing nothing more exotic than that."
These "millions of people" must be living somewhere else. The experience of those I know is that cutting fat and increasing exercise works short term, but not long.
"But I think it's also at least in part behavioral and practical: when whole categories of food are off limits, you tend to eat less and weight loss ensues."
Have there been any animal studies confirming this belief? It would be very strange if behavior trumped biology, especially in an area as critical for survival as managing energy.
Out of curiosity, have you ever tried a paleo-ish diet?
