Tag Archives: caveman diet

Anthropologist Debunks the Paleolithic Diet

paleo diet, paleolithic diet, caveman diet

Not Dr. Warinner

Christina Warinner has a new TEDx talk on the paleo diet.  Dr. Warinner has a Ph.D. in anthropology from Harvard, so I’ll call her an anthropologist. The written TEDx intro mentions she is a paleontologist, and she mentions “archeologist” in her talk.  Anyway, I’m sure she’s very bright and put much thought into her presentation.  She spoke at my old stomping grounds, the University of Oklahoma in Norman.

Click to view video.

Dr. Warinner is probably addressing the smarter half of the general population, who holds the idea, at least superficially, that the paleo diet is meat-based.  (The dumber half of the public isn’t watching TEDx videos.)  Dr. Warinner doesn’t define “meat-based.”  Is half the plate filled with meat, fish, or eggs?  75% of the plate?  Half of total calories?

I’m not familiar with all the popular modern versions of the paleo diet.  Perhaps some are in fact meat-centric, whatever that means.  But the ones I’m more familiar with, like Dr. Cordain’s and mine, prominently feature vegetables, fruits, and nuts.  You could easily fashion a plant-based paleo diet, filling 80 or even 90% of your plate with plants.  (A vegan paleo diet isn’t realistic.  Cultures not eating animals would die out from B12 deficiency.)

I’d swear I heard Dr. Warinner say “we’re not adapted to eat meat.”  Surely she mis-spoke.

She mostly debunks popular misconceptions of the paleo diet.  Most of us deeply familiar with the paleo diet would have little to disagree with her about.

Here are some of Dr. Warinner’s major points:

  • It’s nearly impossible for most of us to eat a true Paleolithic diet.  Selective breeding has altered nearly all our foods to the point of unrecognizability by cavemen.  Examples are bananas, broccoli, carrots, and tomatoes.
  • There is no single paleo diet.  It depends on regional geographic variations in rainfall, latitude, temperature, etc.  Local populations ate what was available, in season, and often migrated seasonally to find food.

Dr. Warinner suggests we all incorporate three concepts from the paleo diet:

  1. Eat a great variety of foods.
  2. For the highest nutrient content, eat fresh food when ripe, in season.
  3. Eat whole foods.

Steve Parker, M.D.

PS: Miki Ben-Dor, a Ph.D. candidate, had many more objections to Dr. Warinner’s speech.  Paul Jaminet made a few comments about it, too (see middle of his post, after the comments on Marlene Zuk’s PaleoFantasy).  Wendy Schwartz weighs in, too. Angelo Coppola does a good job countering most of Dr. Warriner’s criticisms.

Paleo Diet Advocates Fear Modernity

…according to David Gorski at Science-Based Medicine.

Gee, I hadn’t noticed that fear.  Maybe it’s subconscious.

Dr. Gorski makes some good points along with others I disagree with.  I expect the commentators at SBM will address many of the controversial points.  They’re a smart readership.

One uncommon observation of his is that the “complementary and alternative medicine” believers tend to embrace the paleo diet and lifestyle.  I’ve noticed that also.  To the extent that the CAM folks are often unscientific or anti-scientific, those of us examining the paleo diet from a scientific viewpoint have to be wary of “guilt by association.”

A major point that Dr. Gorski didn’t address is that living hunter-gatherers studied over the last century or two don’t have nearly as much cardiovascular disease and death as modern Western societies.  That’s a common meme in the paleosphere, started by the prominent paleo book authors.  (I’ve not reviewed the original sources.)  I’m talking about lower rates of heart attacks, strokes, hypertension, peripheral arterial disease, and premature death.  Note that the mere presence of atherosclerosis may not correlate with these hard clinical endpoints.

My Critique of the Joslin Critique of the Paleo Diet

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 KubalFranziska 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.

Low-Carb Research Update

Grain-based high-carb Neolithic food

Grain-based high-carb Neolithic food

The paleo diet averages about 30% of total calories from carbohydrates, with a range of about 22 to 40%.  That 30% average is much lower than the standard 50–60% in the developed world.  Is that lower percentage healthy or not?  It depends on the quality of the carbs and the remainder of the diet.  It most certainly can be healthy.

As much as possible, I base my nutrition and medical recommendations on science-based research published in the medical literature.  In the early 2000s, a flurry of scientific reports demonstrated that very-low-carb eating (as in the style of Dr. Robert Atkins) was safe and effective for short-term weight management and control of diabetes.  Eighty hours of literature review in 2009 allowed me to embrace low-carbohydrate eating as a logical and viable option for many of my patients. The evidence convinced me that the relatively high fat content of many low-carb diets was nothing to worry about long-term.

I’d like to share with you some of the pertinent low-carb research findings of the last few years.

Low-Carb Diets

  • Low-carb diets reduce weight, reduce blood pressure, lower triglyceride levels (a healtlhy move), and raise HDL cholesterol (another good trend).  These improvements should help reduce your risk of heart disease.  (In the journal Obesity Reviews, 2012.)
  • Dietary fat, including saturated fat, is not a cause of vascular disease such as heart attacks and atherosclerosis (hardening of the arteries).  (Multiple research reports.)
  • If you’re overweight and replace two sugary drinks a day with diet soda or water, you’ll lose about four pounds over the next six months.  (American Journal of Clinical Nutrition, 2012.)
  • United States citizens obtain 40% of total calories from grains and added sugars.  Most developed countries are similar.  Dr. Stephan Guyenet notes that U.S. sugar consumption increased steadily “…from 6.3 pounds [2.9 kg] per person per year in 1822 to 107.7 pounds [50 kg] per person in 1999.  Wrap your brain around this: in 1822 we ate the amount of added sugar in one 12-ounce can of soda every five days, while today we eat that much sugar every seven hours.”
  • A very-low-carb diet improves the memory of those with age-related mild cognitive impairment. Mild cognitive impairment is a precursor to dementia.  (University of Cincinnati, 2012.)
  • High-carbohydrate and sugar-rich diets greatly raise the risk of mild cognitive impairment in the elderly. (Mayo Clinic study published in the Journal of Alzheimers’ Disease, 2012.)
  • Compared to obese low-fat dieters, low-carb dieters lose twice as much fat weight.  (University of Cincinnati, 2011.)
  • Diets low in sugar and refined starches are linked to lower risk of age-related macular degeneration in women.  Macular degeneration is a major cause of blindness.  (University of Wisconsin, 2011.)
  • A ketogenic (very-low-carb) Mediterranean diet cures metabolic syndrome (Journal of Medicinal Food, 2011.)
  • For type 2 diabetics, replacing a daily muffin (high-carb) with two ounces (60 g) of nuts (low-carb) improves blood sugar control and reduces LDL cholesterol (the “bad” cholesterol). (Diabetes Care, 2011.)
  • For those afflicted with fatty liver, a low-carb diet beats a low-fat diet for management. (American Journal of Clinical Nutrition, 2011.)
  • For weight loss, the American Diabetes Association has endorsed low-carb (under 130 g/day) and Mediterranean diets, for use up to two years. (Diabetes Care, 2011.)
  • High-carbohydrate eating doubles the risk of heart disease (coronary artery disease) in women.  (Archives of Internal Medicine, 2010.)
  • One criticism of low-carb diets is that they may be high in protein, which in turn may cause bone thinning (osteoporosis).  A 2010 study shows this is not a problem, at least in women.  Men were not studied.  (American Journal of Clinical Nutrition.)
  • High-carbohydrate eating increases the risk of developing type 2 diabetes (American Journal of Clinical Nutrition, 2010.)
  • Obesity in U.S. children tripled from 1980 to 2000, rising to 17% of all children.  A low-carb, high-protein diet is safe and effective for obese adolescents.  (American Journal of Clinical Nutrition, 2010.

Steve Parker, M.D.

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

Ideas For A Paleo Diabetic Diet

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.

Two Month Recap of the Parker Paleo Diet Trial

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

What Do Mainstream Dietitians Think of the Paleo Diet?

Australian Aborigine in Swamp Darwin

I’m curious to know what mainstream dietitians think about the Paleolithic diet, so I read an article entitled “Are diets from Paleolithic times relevant today?”  This one-page article is in the August, 2012, issue of the Journal of the American Academy of Nutrition and Dietetics. The author is Eleese Cunningham, RD, of the Academy of Nutrition and Dietetics Knowledge Center Team.

The Academy of Nutrition and Dietetics is the new name of the American Dietetics Association, “the world’s largest organization of food and nutrition professionals.”

Ms. Cunningham notes that “diet books for modern humans are extremely popular, and the Paleolithic diet, sometimes called the “Caveman Diet” or the “Stone Age Diet,” is one of the latest trends.”  You’d think the author would mention one of the popular paleo diet books, such as Loren Cordain’s, Robb Wolf’s, or Mark Sisson’s.  Think again.  She brings up only another dietitian’s review of Richard Nikoley’s paleo diet book, pointing out his lack of professional health credentials and his advocacy of raw milk consumption.  But milk isn’t even considered a component of most paleo diets.  Ms. Cunningham justifiably points out the infectious risks, however small, linked to raw milk consumption.  (I’ve not read Nikoley’s book, Free the Animal.)

(If you click the link to see the review of Nikoley’s book, scroll to page 30.  Sample: “Based more on science fiction than science fact, Nikoley’s recommendations are misguided and reckless…”)

Ms. Cunningham likes the fact that the paleo diet reduces consumption of salt and added sugars, while promoting fruit and vegetables.  However, she immediately notes thereafter that, “a striking counter to the meat-based Paleolithic diet is the evidence that supports the healthfulness of a vegetarian diet and the benefits it may have in the prevention and treatment of certain diseases.  Another review of this approach . . . questions the exclusion of nutrient-rich grains, beans, and low-fat dairy and the potential nutrient shortfalls associated with the Paleolithic diet restrictions.”

This article appears to be in a regular feature of the journal called, “From the Academy: Question of the Month.”  Are diets from Paleolithic times relevant today?  She never answers directly.  I suspect the average dietitian reading this article will conclude that Ms. Cunningham and the Academy are not in favor of the paleo diet.

Steve Parker, M.D.

Reference: Cunningham, Eleese.  Are diets from Paleolithic times relevant today?  Journal of the Academy of Nutrition and Dietetics, 2012 (vol. 112, issue 8): p. 1296.  doi: 10.1016/j.jand.2012.06.019

Position of the American Dietetic Association: Vegetarian diets.  Journal of the American Dietetic Association, 2009 (109): 1266-1282.

Day 1 of My Paleo Diet

Why do it?

  • Direct experience with implementation obstacles
  • Potential health benefits

My first Parker Paleo Diet meal: sautéed mixed veggies and pan-fried chicken breast

I’m not doing this to lose weight, although I wouldn’t mind losing 10 lb (4.5 kg).  I weigh 171 lb (77.7 kg, BMI 23.4).  Regarding health benefits, I’m just going to monitor how I feel.  No blood work.  My blood pressure’s normal already.

My current version of paleo is not designed for someone with diabetes or prediabetes.  That may come in the future (Dr. Frassetto, when can we see your latest research results?).  By “current version,” I mean I’ll quite likely tweak it over the coming months.  One of my major issues is whether to keep or delete potatoes.

Here’s what I’ll eat (or not) on the Parker Paleo Diet:

FORBIDDEN FOODS: Grains (e.g., corn, wheat, rice), Dairy, Legumes (peanuts, beans, peas, green beans), Industrial Vegetable Oils (soybean, corn, safflower, etc.), Alcohol, Refined Sugars.

PROTEINS: Meat, fish/seafood, eggs, poultry, and wild game.  Bacon OK; minimize other processed meats.

NUTS & SEEDS: Especially walnuts, macadamia, cachews, almonds.  Limit to 1-2 oz/day.

FRUITS: Limit 2 pieces/day?

VEGETABLES:

Lower-Carb: Greens (lettuce, spinach, chard, collard, mustard geen, kale), radicchio, endive, bok choy, herbs, celery, radishes, mushrooms, cabbage, jicama, avocado, asparagus, okra, cucumbers, cauliflower, broccoli, peppers, summer squash, zucchini, Brussels sprouts, green onions, tomatoes, eggplant, tomatillos, eggplant, artichokes, turnips, rutabagas, spaghetti squash, carrots, onions, leeks, water chestnuts (small serving).  This list generally starts with the lower carb items and gradually increases to higher carb grams.  All these have 5 or fewer carbs per serving; most are  much less.

Starchy, Higher-Carb: Beets (6 g, GI 64), winter squashes (acorn, butternut), water chestnuts, parsnips (9 g, GI 97), potatoes (35 g, GI 87), sweet potatoes, (20 g, GI 61), cassava (37 g), taro (21 g), plantains.  Some categorize carrots as starchy.

HERBS & SPICES: Cilantro, parsley, basil, rosemary, thyme, etc.  Salt (minimal), pepper, vinegar.

OILS: Extra virgin olive, canola, flax, avocado.

CONDIMENTS: Olive oil vinaigrettes, mayonnaise from olive oil & egg yolk, and ?

LIQUIDS: H2O, coffee, tea

I’m not counting calories, fat grams, or carb grams.  I’ll eat until full or satisfied, not stuffed.  This is a two-month trial, excluding 24 hours around Thanksgiving.

Steve Parker, M.D.

What Exactly Is the Paleo Diet?

Pure paleo

Let’s be realistic: There’s no way to eat a Stone Age diet these days unless you live off the land, hunting, fishing, and gathering from what’s naturally available in the wild.  Few can do that, although it’s not impossible.  I’m going to specify my version of the paleo diet because I’m starting a paleo diet trial soon—a first for me.

How long has man had fire?  Biological anthropologist Richard Wrangham estimates hominins tamed fire and started cooking with it 1.8 million years ago.  So I’m cooking my paleo foods if I wish.

As with my beloved Mediterranean diet, definitions of the paleo diet vary.  The following guidelines are influenced by my review of blogs or websites by Loren Cordain, Julianne Taylor, Robb Wolf, and Kurt Harris.  The first three are closely affiliated with each other, so expect lots of overlap.  It’s simplest to define paleo by what’s not allowed.

What’s NOT Paleo?

Industrial vegetable oils (e.g., soybean, corn,safflower), legumes, dairy, refined sugars, grains, alcohol, and high salt consumption.

What Is Paleo? 

The focus is on minimally processed, in-season, locally available foods.  Many favor pastured, grass-fed beef, free-range chickens, “organic,” and the like.  I guess that’s fine if you can afford it; I choose to spend my money elsewhere.

Proteins

Meat, fish/seafood, eggs, poultry, and wild game.  Most paleo proponents favor lean meats over fatty ones; it’s debatable. Undoubtedly, our domesticated feedlot animals are fattier than wild game, generally.  Processed meats such as bacon would not be pure paleo, but many paleo advocates allow it.

Nuts and Seeds

Favor those with the best omega-6/omega-3 ratio (2 or 3:1), such as walnuts, almonds, macadamia, and cashews.  Modern humans eat way more omega-6 fatty acids compared to ancient hunter-gatherers.

Fruits and Vegetables

It’s probably best to favor those with lower glycemic index.  Examples are berries, melons, cauliflower, tomatoes, onions, and broccoli.  Most modern fruits and veggies  have been bred for large size and good looks.  Ancient fruits and veggies were smaller and had much more fiber per serving.

Tubers, Roots, Bulbs

These are OK per Cordain, and I agree.  Examples include potatoes, cassava, taro root, onions.  Some paleo proponents exclude potatoes.

Oils

Cordain favors oils such as canola, flax, olive. Others mention avocado oil.  Aim for a good omega-6/omega-3 ratio.  Lard is probably OK although obviously processed.

Herbs and Spices

Many of our favorites should be OK.  Wolf says balsamic vinegar is allowed, although processed, like all vinegars.  Vinegar is “natural,” as you might have noticed if you ever walked through an apple orchard with rotting fruit on the ground; you can smell the vinegar.

Condiments

Undecided.  Note that you can make mayonnaise from olive oil and egg yolk.

Miscellaneous

Olives?  They’re processed, but I’m inclined to keep them in the mix.  Coffee?  Not paleo, but I ain’t givin’ it up.  Consider limiting nuts to one ounce daily since most of them are high in omega-6 fatty acids.  Fresh foods are more purely paleo than canned or frozen, but I’ll not exclude canned and frozen.  Limit fruit?  Probably: in most environments, they’re available only seasonally.  Diet sodas?  Clearly not paleo, but I enjoy one now and then and don’t see any drawbacks to low consumption.

Steve Parker, M.D.

Update October 8, 2012

I learned today that my version of paleo, by coincidence, is similar to the Hartwigs’s Whole30 plan.  But they allow clarified butter or ghee, green beans, and snow peas.  I include potatoes, but Whole30 doesn’t.

Can A Christian Be A Paleo Advocate?

If you’re squeamish about discussions of religion and God, read no further! What follows is controversial and much of it not subject to scientific investigation.

In case you’re wondering, I’m a Christian.  This simply means I believe I was given life by God, that His son Jesus became a man and died for my sins, and that I will have everlasting life in heaven for believing on this.  I strive to live the way God would want me to live, as written in the Holy Bible.  I was brought up in the Catholic faith, even attending parochial school in grades 1-8, but I’m Protestant now.  I went through an agnostic period between the ages of 19 to about 38—I’m glad I made it through that alive!

I’ve been learning more about paleo eating over the last year since it overlaps a fair amount with low-carb eating. (Paleo-style eating is also referred to as ancestral, Old Stone Age, hunter-gatherer, or the caveman diet.) The Paleolithic Era covers about 1.5 to 2 million years of human evolution, admitting that there probably hasn’t been much genetic change over the last 50,000 years (debatable). The cornerstone of paleo eating is that we should eat the things we are evolutionarily adapted to eat. We’ll be healthier that way. We didn’t have corn chips, soda pop, and candy bars 20,000 years ago, so we shouldn’t be eating them now.

Sounds reasonable, doesn’t it? Various species of animals thrive on certain foods and not others. My horses eat three meals a day – all hay; you and I couldn’t survive on that.

I have a college degree in Zoology, so I was thoroughly indoctrinated in Charles Darwin‘s evolutionary theory, at least the version current in the mid-1970s. Darwin’s theory requires no God, or didn’t include a role for God or gods. How Darwinians answer the question of Creation, I don’t know.

Many proponents of evolutionary theory seem to be atheist or agnostic. Natural selection determines who lives or dies, not the hand of God. Some brands of Christianity, but not all, reject the idea of human evolution in its entirety. They believe God created us just as we are about 6,000 years ago. So can a Christian be a paleo diet advocate?

(I don’t know where Judaism, Islam, and other major religions stand on evolution.)

Human evolution is central to paleo diet theory. A religious person may reject the idea of human evolution; can he nevertheless participate in the modern “paleo community”?

I believe God made us and the universe. There’s no proof – it’s a matter of faith. I don’t know if He made us 6,000 years ago or two million.  The bulk of the science speaks clearly against 6,000 years ago.

Our bodies are made to thrive on certain foods and not others.  That’s true for all animals.  If you find an injured bird in your yard and hope to nurse it back to health,  you better find out what it eats naturally and provide it, or you’ll fail.  The range of foods humans can thrive on is pretty broad. Whether the optimal way of eating is determined by godless evolutionary processes or by the intelligent design of a Creator doesn’t matter so much if you’re looking at it from a purely nutritional viewpoint.

From an “everlasting life” viewpoint, it matters.  Big time.

The paleo guys might be right about the best way to eat. Science continues to accumulate evidence one way or the other.

Christianity and paleo diet theory are not mutually exclusive. A Christian can ignore the possiblity of a million years of evolution, believing instead that God made our bodies in such a way that we’d be healthier eating certain foods and not others. Those foods may be the components of the paleo diet, whatever that is.

Steve Parker, M.D.

Further reading:

Carl Drews has written extensively on Christianity and Evolution, including his essay on Theistic Evolution.

Phil Porvaznik’s article on theistic evolution and the Roman Catholic Church.

Wikipedia: Catholic Church and Evolution.

Can a Christian follow a paleo low-carb diet? at Jimmy Moore’s Livin’ La Vida Low-Carb blog.

A few questions for the atheists.  Where did the universe come from?  Was it created? By whom or what?  What if God exists, and he made us for a reason and wants us to live a certain way?

Consider this excerpt from Walter Isaacson’s book, “Einstein: His Life and Universe”:

One evening in Berlin, [Albert] Einstein and his wife were at a dinner party when a guest expressed a belief in astrology. Einstein ridiculed the notion as pure superstition. Another guest stepped in and similarly disparaged religion. Belief in God, he insisted, was likewise a superstition.

At this point the host tried to silence him by invoking the fact that even Einstein harbored religious beliefs.

“It isn’t possible!” the skeptical guest said, turning to ask Einstein if he was, in fact, religious.

“Yes, you can call it that,” Einstein replied calmly. “Try and penetrate with our limited means the secrets of nature and you will find that, behind all the discernible laws and connections, there remains something subtle, intangible and inexplicable. Veneration for this force beyond anything we can comprehend is my religion. To that extent, I am, in fact, religious.”