Paleo

I am a recovering breakfast cereal addict. For most of my adult life I would end my day with several large bowls of cereal. Usually Raisin Bran. What could be better? Whole healthy grain, fruit, plenty of fiber and low fat skim milk. There’s even the “Heart Healthy” seal of approval on the package. In the back of my mind I worried that this might not be the best thing to be doing but old habits die hard.

My wife is always interested in losing a few pounds (even thought she really doesn’t need to) so she ended up trying the Ideal Protein diet. I had been recommending this diet to my patients because I had several patients who had achieved significant weight loss on this program. It’s a commercial program with some up-front cost then pay-as-you-go snacks and meal replacements. In addition there are weekly accountability weigh-ins. She lost 10 pounds then stopped the program. The weight came back. She repeated this cycle two more times. Because it is a very low calorie diet it is difficult to maintain, not to mention expensive. Eventually we gave up.

Our CrossFit coach recommended looking at either the Zone diet or the Paleo diet. We read The Zone Diet by Barry Sears. He presents elaborate mechanistic arguments as to why the diet is effective. I didn’t find these arguments particularly compelling but we tried it anyway. The breakdown of macronutrients was somewhat confusing. Ultimately it just didn’t resonate with us so we didn’t stick with the diet for very long.

I read Robb Wolf’s book The Paleo Solution. This argument made more sense. Eat the diet of our Paleolithic hunter-gatherer ancestors. The diet on which humans evolved before the advent of agriculture. Agriculture has only been around for about 10,000 years which, in terms of human evolution is a blink of the eye.

No processed food. No sugar, grain, beans, dairy or starchy vegetables. I liked the logic of the approach but for me there would be a huge hurdle. I’d have to do the unthinkable and forgo the cereal.

After a lot of soul searching I decided to give up cereal for lent and try the Paleo diet. My wife was on board as well. It was tough at first but we never looked back. We followed it to the letter and both lost weight with no loss of muscle mass. We got leaner and felt better.

For years prior to this I had taken daily Prilosec for indigestion. Without it I had terrible indigestion. The indigestion resolved completely on Paleo. I discontinued the Prilosec haven’t needed it since.

We stuck with Paleo for about two years without any difficulty so I can attest to its sustainability. We’ve since “graduated” to a ketogenic diet but I still believe that the Paleo diet is an excellent framework for healthy eating. The “rules” are straightforward and there are plenty of resources both in print and online.

Eliminate sugar and processed foods.

No grain, beans or starchy vegetables (eliminate high carbohydrate foods).

No dairy.

Nuts are fine (no peanuts, they’re legumes).

Fresh fruit and non-starchy vegetables are encouraged.

Plenty of beef, pork, fish, chicken, eggs, seafood, essentially any meat.

Lots of healthy fat.

Why these restrictions?

We can’t really know what our Paleolithic ancestors ate but there’s some scientific archeologic evidence and there have been studies of contemporary hunter-gatherer cultures that provide some insight. Plant foods were obtained by foraging. Fruit, tubers, leafy greens, mushrooms, for example but not beans or grains. Cultivation is required for the latter to have any meaningful nutritional impact.

Another argument for elimination of grain and legumes is interesting. From an evolutionary perspective how do plants defend themselves as a species? Plants can’t run away like a rabbit or a squirrel. But what if the plant produced a toxin that discouraged consumption of the plant by animals? Everyone knows that some plants produce deadly poison. Perhaps some of these toxins aren’t lethal but rather, unpleasant.

A well known example of a plant toxin is gluten. Gluten is a protein found in grain (wheat flour) that clearly causes gastrointestinal pathology in some people. Gluten-sensitive enteropathy or celiac disease is a well described condition. The primary manifestations are usually GI symptoms such as diarrhea, malabsorption, weight loss, vitamin deficiencies, etc… The manifestations are not limited to GI symptoms. Dermatologic, neuropsychiatric, autoimmune, pulmonary and even cardiac conditions can result from gluten sensitivity. It’s likely that there’s a huge spectrum of illness severity from full-blown clinically diagnosed disease to subtle but bothersome symptoms that go undiagnosed.

The rationale for elimination of dairy is slightly problematic for me. There’s the lactose argument. Many adult humans lose the ability to digest lactose. They are lactose intolerant and this leads to gastrointestinal symptoms. I don’t see this as a reason to eliminate dairy for everyone. The other argument against dairy is that some milk proteins are potentially irritating to the lining of the intestine. The theory is that this irritation can lead to autoimmune problems. If your dietary goal is to heal an autoimmune or inflammatory disorder then it might make sense to eliminate dairy.

A word about fruit. Don’t overdo it. The Paleo diet allows/encourages fruit consumption. In today’s supermarkets there is a year round abundance of fresh ripe fruit. This was not the case for Paleolithic man. Fruit was only available occasionally when in season. Most people will insist that fruit is “healthy”. True, but remember that most fruit is essentially pure sugar. I’ve heard dietitians give the sugar a pass because it’s “natural” sugar. Give me a break. Sorry, that doesn’t make biological sense.

Meat likely made up a very large part of the cave man’s diet. There is considerable evidence of this in the archeological record. Weapons, butchering marks on bones, cave paintings, etc…It has even been argued that meat in our diet led to the development of our large brains. From an efficiency perspective meat makes sense. You get much more nutritional value from a mammoth than you do from a handful of berries. For reasons I won’t go into at the moment, meat has gotten a “bad rap”. ‘Red meat causes cancer’. ‘Meat is bad for the environment’. The result has been a popular push to promote a “plant based” diet. No other food has the nutrient density of meat. On a plant based diet you’ll have a lot of catching up to do.
In general fat is encouraged on a Paleo diet. Natural fats as opposed to many of the polyunsaturated “seed oils” on the market today (corn, canola, vegetable, soybean, etc…) There is no mandate against saturated fats like coconut oil, lard, ghee, tallow. I must admit that at the time my wife and I adopted the Paleo diet we initially had trouble with the fat issue. It’s a topic that’s so ingrained in our culture that we’ve been taught to be afraid of fat both as a cause of heart disease and as a food that will make you fat. We sometimes struggled when a recipe called for full fat coconut milk. After a considerable amount of research we’ve come full circle on this issue but for many it remains a significant obstacle.