Tag Archives: ancestral diet

My Critique of the Joslin Critique of the Paleo Diet

Posted on March 16, 2013 | 3 Comments
paleo diet, Paleolithic diet, hunter-gatherer diet

Huaorani hunter in Ecuador

The Joslin Diabetes Blog yesterday reviewed the paleo diet as applied to both diabetes and the general public.  They weren’t very favorably impressed with it.  But in view of Joslin’s great reputation, we need to give serious consideration to their ideas.  (I don’t know who wrote the review other than “Joslin Communications.”)

These are the main criticisms:

  • diets omitting grains and dairy are deficient in calcium and possibly B vitamins
  • you could eat too much total and saturated fat, leading to insulin resistance (whether type 1 or 2 diabetes) and heart disease
  • it’s not very practical, partly because it goes against the grain of modern Western cultures
  • it may be expensive (citing the cost of meat, and I’d mention fresh fruit and vegetables, too)

Their conclusion:

There are certainly better diets out there, but if you are going to follow this one, do yourself a favor, take a calcium supplement and meet with a registered dietitian who is also a certified diabetes educator  to make sure it is nutritionally complete, isn’t raising your lipids and doesn’t cause you any low blood glucose incidences.

Expense and Practicality

These take a back seat to the health issues in my view.  Diabetes itself is expensive and impractical.  Expense and practicality are highly variable, idiosyncratic matters to be pondered and decided by the individual.  If there are real health benefits to the paleo diet, many folks will find work-arounds for any expense and impracticality.  If the paleo diet  allows use of fewer drugs and helps avoid medical complications, you save money in health care costs that you can put into food.  Not to mention quality of life issues (but I just did).

Calcium and B Vitamin Deficiencies

This is the first I’ve heard of possible B vitamin deficiencies on the paleo diet.  Perhaps I’m not as well-read as I thought.  I’ll keep my eyes open for confirmation.

The potential calcium deficiency, I’ve heard of before.  I’m still open-minded on it.  I am starting to wonder if we need as much dietary calcium as the experts tell us.  The main question is whether inadequate calcium intake causes osteoporosis, the bone-thinning condition linked to broken hips and wrists in old ladies.  This is a major problem for Western societies.  Nature hasn’t exerted much selection pressure against osteoporosis because we don’t see most of the fractures until after age 70.  I wouldn’t be surprised if we eventually find that life-long exercise and adequate vitamin D levels are much more important that calcium consumption.

With regards to calcium supplementation, you’ll find several recent scientific references questioning it.  For example, see this, and this, and this, and this, and this.  If you bother to click through and read the articles, you may well conclude there’s no good evidence for calcium supplementation for the general population.  If you’re not going to supplement, would high intake from foods be even more important?  Maybe so, maybe not.  I’m don’t know.

If you check, most of the professional osteoporosis organizations are going to recommend calcium supplements for postmenopausal women, unless dietary calcium intake is fairly high.

If I were a women wanting to avoid osteoporosis, I’d do regular life-long exercise that stressed my bones (weight-bearing and resistance training) and be sure I had adequate vitamin D levels.  And men, you’re not immune to osteoporosis, just less likely to suffer from it.

Insulin Resistance

Insulin resistance from a relatively high-fat diet is theoretically possible.  In reality, it’s not common.  I’ve read plenty of low-carb high-fat diet research reports in people with type 2 diabetes.  Insulin levels and blood glucose levels go down, on average.  That’s not what you’d see with new insulin resistance.  One caveat, however, is that these are nearly all short-term studies, 6-12 weeks long.

If you have diabetes and develop insulin resistance on a high-fat diet, you will see higher blood sugar levels and the need for higher insulin drug doses.  Watch for that if you try the paleo diet.

Are High Total and Saturated Fat Bad?

Regarding relatively high consumption of total and saturated fat as a cause of heart or other vascular disease: I don’t believe that any more.  Click to see why.  If you worry about that issue, choose meats that are leaner (lower in fat) and eat smaller portions.  You could also look at your protein foods—beef, chicken, fish, eggs, offal, etc.—and choose items lower in total and saturated fat.  Consult a dietitian or online resource.  Protein deficiency is rarely, if ever, a problem on paleo diets.

In Conclusion

I think the paleo diet has more healthful potential than realized by the Joslin blogger(s).  I’m sure they’d agree we need more clinical studies of it, involving both type 1 and 2 diabetics.  I appreciate the “heads up” regarding potential vitamin B deficiencies.  My sense is that the Joslin folks are willing to reassess their position based on scientific studies.

I bet some of our paleo-friendly registered dietitians have addressed the potential adverse health issues of the paleo diet.  Try Amy Kubal, Franziska Spritzler (more low-carb than paleo) or Aglaée Jacob.  I assume the leading paleo diet book authors have done it also.

If you’re worried about adverse blood lipid changes on the paleo diet, get them tested before you start, then after two months of dieting.

Steve Parker, M.D.

PS: The paleo diet is also referred to as the Stone Age diet, caveman diet, Paleolithic diet, hunter-gatherer diet, and ancestral diet.

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Ideas For A Paleo Diabetic Diet

Posted on February 3, 2013 | 6 Comments
Sirloin steak, salad, cantaloupe, 3 raspberries

Sirloin steak, salad, cantaloupe, 3 raspberries

I’ve been thinking about a paleo-style diabetic diet for over a year.  Here are some miscellaneous ideas for your consideration.

A paleo diabetic diet will have the following major food groups:

  • vegetables
  • fruits
  • nuts and seeds
  • proteins (e.g., meat, fish, eggs)
  • condiments

A paleo diabetic diet could (should?) emphasize salads and low-carb colorful vegetables and only (?) low-carb or low-glycemic-index fruits.

Calories

Total calories?  Probably in the range of 1,800 to 3,000 calories daily with an average of 2,000.  Remember that 85% of type 2 diabetics are overweight or obese. Calorie restriction—regardless of macronutrient ratios (% carb, protein, fat)—tends to improve or normalize blood sugar levels.  Weight loss will likely entail some caloric restriction, whether consciously or not.

Type 1 Versus Type 2 Diabetes

Type 1 and type 2 diabetics have many pathophysiologic differences.  Could a single paleo diabetic diet serve both populations equally well?  That’s the goal.

Carbohydrates

Diabetics have trouble metabolizing carbohydrates, so a paleo diabetic diet should probably be lower-than-average in digestible carbs.  100 g/day?  30 g/day?  I’m leaning toward 60 g ± 25%, so 45–75 g.  Smaller, less active folks could eat 45 g/day; larger, more active guys eat closer to 75 g.

Is there a role for very-low-carb or ketogenic eating patterns?  For most folks, that’s less than 50 g of digestible carbohydrate daily.  Under 30 g for some.  Use that only for those needing to lose weight?  Start everybody at  very low carb levels then increase carbs as tolerated?  On the other hand, there’s a lot to be said for simplicity.  It might be best to avoid very-low-carb (ketogenic) eating entirely.  Anyone not losing the desired amount of fat weight could cut portion sizes, especially carbohydrates.

Fish

I encourage fish consumption twice a week, diabetes or no.  Cold-water fatty fish have more of the healthy omega-3 fatty acids than other fish.

Nuts

I’d encourage 1–2 ounces (28–56 g) of nuts or seeds daily.  Any more than that might crowd out other healthful nutrients.  Nuts are protective of the heart.

Proteins

Protein-rich foods can definitely raise insulin requirements and blood sugar levels, but not in an entirely predictable way, and not to the extent we see with carbohydrates.  Should insulin users dose insulin based on a protein gram sliding scale?  I’m leaning towards simply recommending the same amount of protein at each meal, perhaps 4–8 ounces (113–229 g).

Fruit and Starchy Vegetables

Could a paleo diabetic diet even be “paleo” without fruit?  The problem with classic fruits is that they spike blood sugars too high for many diabetics.  To prevent that, Dr. Richard Bernstein outlaws all classic fruits (and other starchy carbs), even limiting tomatoes and onions to small amounts.  E.g., a wedge of tomato in a salad.  He doesn’t allow carrots either, unless raw (lower glycemic index than when cooked).  A paleo diabetic diet eater may be able to get away with eating lower-carb, lower-GI (glycemic index) fruits such as cantaloupe, honeydew, strawberries and other berries.  Some paleo diabetic dieters will tolerate half an apple twice a day.

Different diabetics will have different blood sugar effects when eating starchy vegetables and higher-carb fruits.  Type 1 diabetics will tend to be more predictable than type 2s.  Both may just need to “eat to the meter”: try a serving and see what happens to blood sugar over the next hour or two.

Starchy vegetables—potatoes and carrots, for example—may well have to be limited.  Again, eat to the meter.

Gluten

This is looking to be gluten-free.  How trendy!  It’s a paleo celiac diet.

Use “natural” stevia as a sweetener?  If you read about how the product on your supermarket shelf  is made, it’s not at all natural.

Omega-6/Omega-3 Fatty Acids

A strict focus on omega-6/omega-3 fatty acid ratio will not appeal to many folks, even if it’s important from a health viewpoint.  Reserve this for advanced dieters who have mastered the basics?  Modern Western diets have an omega-6/omega-3 ratio around 10 or 15:1.  Paleolithic diets were closer to 2 or 3:1.  So we have an over-abundance of omega-6 fatty acid or deficiency of omega-3 that may be unhealthy.

Implementation

To get dieters started, I’d design a week of meals based on 2,000 to 2,200 calories.  If still hungry, eat more protein, fat, and low-carb vegetables (and fruits?).

What do you think?

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.  

PS: See Dr. Bernstein’s “no-no” foods on page 151 of his Diabetes Solution book.

PPS: The paleo diet is also known as the Paleolithic diet, Stone Age diet, caveman diet, hunter-gatherer diet, and ancestral diet.

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Two Month Recap of the Parker Paleo Diet Trial

Posted on December 9, 2012 | 1 Comment
soup, home-made, potato, chicken, paleo diet, meal, Stone Age diet, recipe

Potato chicken soup

I’ve completed my two-month paleo diet trial.  I’m proud to say I’ve been fairly compliant with it, although certainly not 100%.  Perhaps 95%.

My major transgressions have been:

  • three diet sodas
  • a bottle of wine around Thanksgiving holiday
  • two or three pies around Thanksgiving (I couldn’t stand throwing them out)
  • other grain and refined sugar products around Thanksgiving
  • four servings of salad dressing made with industrial seed oils when I had no good alternative
  • a Blizzard (thick milk shake) from Dairy Queen
  • on 10–15 days I’ve exceeded my 2-ounce (60 g) limit on nuts

Results and Overall Impressions of Paleo Eating

It’s fairly easy, even when dining out or away from home.  Nevertheless, it requires some discipline and willpower.

My sense is that my meat, poultry, egg, and nut consumption stayed about the same as my baseline, pre-paleo levels.  I eliminated cheese and didn’t miss it much.  I ate more vegetables and fruit.

paleo diet, paleo meal, recipe, stone age diet, paleo food, hunter-gatherer food

I took my lunch meals to the hospital

My wife says paleo eating is at least a little more expensive than my prior eating habits, mostly related to fresh vegetables and fruit.  Grain products like bread, pasta, and rice are cheaper calories.  On the other hand, we saved money by not buying wine even though I don’t drink expensive wine.

I don’t miss grain products much at all.  I had already cut back on them over the last couple years as part of my experimentation with low-carb eating.  I do enjoy whole grain breads but could live a happy life without them if necessary.

I miss sweet items like cinnamon rolls, other pastries, cake, pie, ice cream, diet soda, and candy bars.  I don’t care for sugary soda pop and fruit juices.

I didn’t do this to lose weight, yet went from 171 lb (77.7 kg) down to 164 lb (74.5 kg).  So an unexpected loss of 7 lb (3.2 kg).  I hovered between 162 and 166 lb for the last few weeks so I don’t think I’ll keep losing weight if I stay with the program.

Do I feel any different eating this way?  No.  I’m blessed with good health, so wasn’t looking for any upgrades.  I have noticed more sweetness in a few foods, such as nuts and carrots.

I take nothing away from those who report more energy, better sleep, improved digestion, increased strength, less joint pain, etc., from paleo-style eating.  Undoubtedly, some of those apparent improvements are placebo effect, some are coincidental, and some are bona fide results of the paleo lifestyle.

Steve Parker, M.D.

PS: The paleo diet is also called the Paleolithic diet, hunter-gatherer diet, Stone Age diet, caveman diet, or ancestral diet.

Update December 16, 2012:  I wondered if lack of alcohol for the last two months had any effect on my weight loss.  For the last week I ate my usual paleo diet but added 3 fl oz (90 ml) of whiskey daily.  Weight today 163 lb (73.9 kg), so no real change over the short run.  That’s enough whiskey for a while.

Update December 27:  After three days of unrestrained Holiday eating, my weight is up 8 lb to 171 lb (77.7 kg).  Mostly thanks to pie, cookies, and candy.  I’m sure some of that extra weigh is glycogen, water, and intestinal contents, rather than fat.  Back on the paleo diet today, a low-carb version.

Update December 29:  Weight is down 5 lb to 166 lb (75.5 kg).  Amazing.

Pace salsa, paleo diet, Parker paleo diet

The contents of this salsa jar are all paleo-compliant

paleo diet, Parker paleo diet, canned pumpkin

Pure paleo contents unless there’s BPA in the can liner

pumpkin pie, paleo diet, Parker paleo diet

Definitely non-paleo pumpkin pie

wine bottle, red wine, paleo diet, meal,

Wine is not “paleo” by most definitions

paleo diet, paleo food, hunter-gatherer diet, macadamia nuts

L. Cordain likes the low omega-6/omega-3 ratio of macadamia nuts

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Classic Australian Aborigine Study on Return to Ancestral Diet and Lifestyle

Posted on March 10, 2012 | 18 Comments

Did you know kangaroo is edible?

The scientific article I review today is often cited by those who favor a Paleolithic diet for diabetics.  Cordain and Stefanson have written about it, for example.

Background

Urbanized Australian Aboriginal communities have a high prevalence of type 2 diabetes.   Kerin O’Dea writes:

The change from an urban to a traditional lifestyle involves several factors that directly affect insulin sensitivity: increased physical activity, reduced energy intake and weight loss, and changes in the overall dietary composition.  All of these factors improve insulin sensitivity and should, therefore, be of benefit to the insulin-resistant diabetic.

Methods

Ten urban type 2 diabetic and four nondiabetic full-blood Aborigines agreed to revert to their traditional lifestyle as hunter-gatherers in an isolated region of Australia for seven weeks.  Average age was 53.  Half of them were moderate to heavy alcohol drinkers.  Average diabetic weight was 82 kg (180 lb); nondiabetics averaged 77 kg (169 lb).  There were equal numbers of men and omen.  None of the diabetics was on insulin, and only one was on an oral diabetic drug (a sulfonylurea). 

Ayers Rock, Uluru National Park, Australia

The study was carried out at Pantijan, the traditional land of these Aborigines.  It’s a day-and-a-half drive in a four-wheel vehicle from Derby.  At least it was in 1984.

For seven weeks, the participants ate only what they hunted or collected.  Diet composition was dependent on whether they were travelling to the homeland (1.5 weeks), at the coastal location (2 weeks), or inland on the river (3.5 weeks). Protein sources were mainly beef, kangaroo, fish, birds, crocodiles, and turtles.  Carboydrate content ranged from under 5% to 33%.  Protein content varied from 50 to 80%.  Fat was 13 to 40%.  So, very high protein and low-carb.  Carb sources were yams, honey, and figs.  Yams were the predominant carb source.  They also eat yabbies (shrimp or crayfish (“crawdads” in Oklahoma)).  Average energy intake was a very low 1,200 calories a day. 

The author implies this was the traditional Aboriginal diet.

What did they eat back home in the city? 

The main dietary components were flour, sugar, rice, carbonated drinks, alcoholic drinks (beer and port), powdered milk, cheap fatty meat, potatoes, onions, and variable contributions of other fresh fruit and vegetables. 

O’Dea estimates a macronutrient breakdown of 50% carb, 40% fat, and 10% protein (similar to the Standard American Diet, then).

What Did O’Dea Find Out?

Everyone lost weight, a group average of 8 kg (18 lb) over the seven weeks.

Fasting blood sugars fell in the diabetics from 11.6 mmol/l to 6.6 mmol/l (209 to 119 mg/dl).  After-meal blood sugars also fell dramatically.

Fasting insulin levels fell from 23 to 12 mU/l.

Fasting triglycerides fell drastically. 

HDL cholesterol fell significantly, whereas LDL cholesterol tended to rise.

So What?

How often do you see a scientific article with just one author?  Rarely, these days.

The investigator wrote that, “Under the conditions of the study it is difficult to separate out effects of dietary composition, low energy intake, and weight loss.”

O’Dea estimates that experimental activity levels were probably higher than in the urban setting, but not dramatically more so.  (He was with the participants throughout the experiment.)

The main carbohydrate sources in this ancestral diet were yams, honey, and figs.  Modern Australian honey is probably similar to the honey of 100,000 years ago.  But what about yams and figs? 

These folks had to have been eating twice as many calories, at least, back in their urban environment.  O’Dea didn’t comment on how well the participants tolerated calorie restriction.  Did they complain?  Did they eat to satiety?  They had no access to food other than what they could hunt and gather.  Was food in short supply?  It’s not documented.  You’d think O’Dea would mention these issues if they were a problem. 

This particular ancestral diet was extremely high in protein: 50–80% of calories.  (Eaton and Konner suggest that an average ancestral diet provides only 25–30% of total calories from protein.  A typical modern high-protein diet derives about 30% of calories from protein, compared with 15–18% in the standard American diet.)  Protein helps combat hunger.  But halving caloric intake for seven weeks is extreme.  Don’t believe me?  Just try it.  This degree of caloric restriction by itself would tend to lower blood sugar levels and body weight in most humans, regardless of macronutrient ratios and ethnicity.

I know nothing about Australian Aborigines as an ethnic and genetic group.  Is their diabetes similar to European diabetes?  Pima Indian diabetes?   

O’Dea never called the study diet Paleolithic, because it wasn’t. It was a modern hunter-gatherer diet eaten by rural, isolated Australian Aboriginal communities.

This calorie-restricted, very-high-protein, natural diet was very effective for weight loss and blood sugar control in this tiny, seven-week study on a specific ethnic population.  I bet the caloric restriction was the most effective component of the lifestyle change.  Restriction of refined sugars and starches also helped. 

This ancestral diet was beneficial for a few Australian Aborigines.  Are the lessons widely applicable?  Not yet.  As they say, “further studies are needed.”  You can’t just cite this study to say that paleo diets are healthy for diabetics.

It does jibe with plenty of other research that shows severe calorie restriction leads to weight loss and lower blood sugar levels.

Steve Parker, M.D.

Reference: O’Dea, Kerin.  Marked improvement in carbohydrate and lipid metabolism in diabetic Australian Aborigines after temporary reversion to traditional lifestyle.  Diabetes, 33 (1984): 596-603.

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Random Thoughts On Paleo Eating For People With Diabetes

Posted on February 18, 2012 | 15 Comments

Not really pertinent, but I like buffalo

I was interviewed  yesterday by Amy Stockwell Mercer, author of Smart Woman’s Guide to Diabetes.  All I knew beforehand was that she was interested in my thoughts on the paleo diet as applied to diabetes.

In preparation, I collected some random thoughts and did a little research.

What’s the paleo diet?

Fresh, minimally processed food.  Meat (lean or not? supermarket vs yuppiefied?), poultry, eggs, fish, leafy greens and other vegetables, nuts, berries, fruit, and probably tubers.

Non-paleo: highly processed, grains, refined sugars, industrial plant/seed oils, legumes, milk, cheese, yogurt, salt, alcohol.

Is the paleo diet deficient in any nutrients?

A quick scan of Loren Cordain’s website found mention of possible calcium and vitamin D deficits.  Paleoistas will get vitamin D via sun exposure and fish (especially cold-water fatty fish).  Obtain calcium from broccoli, kale, sardines, almonds, collards.  (I wonder if the Recommended Dietary Allowance for calcium is set too high.)

What About Carbohydrates and Diabetes and the Paleo Diet?

Diabetes is a disorder of carbohydrate metabolism.  In a way, it’s an intolerance of carbohydrates.  In type 1 diabetes, there’s a total or near-total lack of insulin production on an autoimmune basis.  In type 2 diabetes, the body’s insulin just isn’t working adequately; insulin production can be high, normal or low.  In both cases, ingested carbohydrates can’t be processed in a normal healthy way, so they stack up in the bloodstream as high blood sugars.  If not addressed adequately, high blood glucose levels sooner or later will poison body tissues .  Sooner in type 1, later in type 2.  (Yes, this is a gross over-simplification.) 

Gluten-rich Neolithic food

If you’re intolerant of lactose or gluten, you avoid those.  If you’re intolerant of carbohydrates, you could avoid eating them, or take drugs to help you overcome your intolerance.  Type 1 diabetics must take insulin.  Insulin’s more optional for type 2′s.  We have 11 classes of drugs to treat type 2 diabetes; we don’t know the potential adverse effects of most of these drugs.  Already, three diabetes drugs have been taken off the U.S. market or severely restricted due to unacceptable toxicity: phenformin, troglitazone, and rosiglitazone. 

Humans need two “essential fatty acids” and nine “essential” amino acids derived from proteins.  “Essential” means we can’t be healthy and live long without them.   Our bodies can’t synthesize them.  On the other hand, there are no essential carbohydrates.  Our bodies can make all the carbohydrate (mainly glucose) we need.

Since there are no essential carbohydrates, and we know little about the long-term adverse side effects of many of the diabetes drugs, I favor carbohydrate restriction for people with carbohydrate intolerance.  (To be clear, insulin is safe, indeed life-saving, for those with type 1 diabetes.)

That being said, let’s think about the Standard American Diet (SAD) eaten by an adult.  It provides an average of 2673 calories a day (not accounting for wastage of calories in restaurants; 2250 cals/day is probably a more accurate figure for actual consumption).  Added sugars provide 459 of those calories, or 17% of the total.  Grains provide 625 calories, or 23% of the total.  Most of those sugars and grains are in processed, commercial foods.  So added sugars and grains provide 40% of the total calories in the SAD.  Remember, we need good insulin action to process these carbs, which is a problem for diabetics.  (Figures are from an April 5, 2011, infographic at Civil Eats.)

Anyone going from the SAD to pure Paleo eating will be drastically reducing intake of added sugars and grains, our current major sources of carbohydrate.  Question is, what will they replace those calories with? 

That’s why I gave a thumbnail sketch of the paleo diet above. Take a gander and you’ll see lots of low-carb and no-carb options, along with some carb options. For folks with carbohydrate intolerance, I’d favor lower-carb veggies and judicious amounts of fruits, berries, and higher-carb veggies and

Will these cause bladder cancer? Pancreatitis?

tubers.  “Judicious” depends on the individual, considering factors such as degree of residual insulin production, insulin sensitivity, the need to lose excess weight, and desire to avoid diabetes drugs.

Compared to the standard “diabetic diet” (what’s that?) and the Standard American Diet, switching to paleo should lower the glycemic index and glycemic load of the diet.  theoretically, that should help with blood sugar control.

A well-designed low-carb paleo diet would likely have at least twice as much fiber as the typical American diet, which would also tend to limit high blood sugar excursions.

In general, I favor a carbohydrate-restricted paleo diet for those with diabetes who have already decided to “go paleo.”  I’m not endorsing any paleo diet for anyone with diabetes at this point—I’m still doing my research.  But if you’re going to do it, I’d keep it lower-carb.  It has a lot of potential.

Are There Any Immediate Dangers for a Person With Diabetes Switching to the Paleo Diet?

It depends on three things: 1) current diet, and 2) current drug therapy, and 3) the particular version of paleo diet followed. 

Remember, the Standard American Diet provides 40% of total calories as added sugars and grains (nearly all highly refined).  Switching from SAD to a low-carb paleo diet will cut carb intake  and glycemic load substantially, raising the risk of hypoglycemia if the person is taking certain drugs.

Drugs with potential to cause hypoglycemia include insulin, sulfonylureas, meglitinides, pramlintide, and perhaps thiazolidinediones.

Who knows about carb content of the standard “diabetic diet”?  Contrary to popular belief, there is no monolithic “diabetic diet.”  There is no ADA diet (American Diabetes Association).  My impression, however, is that the ADA favors relatively high carbohydrate consumption, perhaps 45-60% of total calories.  Switching to low-carb paleo could definitely cause hypoglycemia in those taking the aforementioned drugs.

One way to avoid diet-induced hypoglycemia is to reduce the diabetic drug dose.

A type 2 overweight diabetic eating a Standard American Diet—and I know there are many out there—would tend to see lower glucose levels by switching to probably any of the popular paleo diets.  Be ready for hypoglycemia if you take those drugs.

Paleo diets are not necessarily low-carb.  Konner and Eaton estimate that ancestral hunter-gatherers obtained 35 to 40% of total calories from carbohydrates.  I’ve seen other estimates as low as 22%.  Reality likely falls between 22 and 65%.  When pressed for a brief answer as to how many carbohydrate calories are in the paleo diet, I say ”about a third of the total.”  By comparison, the typical U.S. diet provides 50% of calories from carbohydrate.

Someone could end up with a high-carb paleo diet easily, by emphasizing tubers (e.g., potatoes), higher-carb vegetables, fruits, berries, and nuts (especially cashews). Compared with the SAD, this could cause higher or lower blood sugars, or no net change.

A diabetic on a Bernstein-style diet or Ketogenic Mediterranean Diet (both very-low-carb) but switching to paleo or low-carb paleo (50-150 g?) would see elevated blood sugars.  Perhaps very high glucoses.

Any person with diabetes making a change in diet should do it in consultation with a personal physician or other qualified healthcare professional familiar with their case.

Steve Parker, M.D.

Fun Facts!

  • A typical carbonated soda contain the equivalent of 10 tsp (50 ml) of sugar.
  • The typical U.S. adult eats 30 tsp  (150 ml) daily of added sweeteners and sugars.
  • U.S total grain product consumption was at record lows in the 1970s, at 138 pounds per person.  By 2000, grain consumption was up by 45%, to 200 pounds per person.
  • Total caloric sweetener consumption (by dry weight) was 110 pounds per person in the  1950s.  By 2000, it was up 39% to 150 pounds.
  • Between 1970 and 2003, consumption of added fats and oils rose by 63%, from 53 to 85 pounds.  [How tasty would that be without starches and sugars?  Not very.]
  • In 2008, “added fat” calories in the U.S. adult diet were 641 (24% of total calories).

Fun Facts provided by the U.S. Department of Agriculture. 

(The paleo diet is also referred to as the Paleolithic, Old Stone Age, Stone Age, Ancestral, Hunter-Gatherer, or Caveman diet.)

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