Tag Archives: paleolithic diet

Free Online Paleo Recipes

Sirloin steak, salad, cantaloupe, 3 raspberries

Sirloin steak, salad, cantaloupe, raspberries (on the Paleobetic Diet)

Or paleo-ish anyway.

Most diabetics eating paleo-style need to know how may grams of digestible carbohydrate they’re eating. Their blood sugars will go too high if they eat too many carbs. “Too many” varies from one person to another. Additional nutrient numbers are just icing on the cake. (Oops! Not a good metaphor for a Stone Age diet website.) Other than this site, I’ve only found three other sites that divulge basic nutritional analysis of their free recipes. Several sites listed are primarily low-carb, so you have to see if the recipe you’re interested in fits your definition of paleo.

Before you go, I just want you to consider financially supporting the owners and writers at the following sites. Many of them have books or services for sale. Some have a Donate button. If they can’t bring home the bacon, the websites go down and the recipes go bye-bye.

Recipes With Nutritional Analysis

Catalyst Athletics

Linda’s Low-Carb Recipes

Hold the Toast (I bet Dana Carpender’s “500 Paleo Recipes” book provides basic nutrient analysis.)

Paleo Diabetic

More Recipes (You can do your own nutritional analysis at places like Fitday.)

The Clothes Make the Girl

NomNom Paleo

The Paleo Diet

Julianne’s Paleo & Zone Nutrition (see drop-down menu under Paleo Links, Recipes, and Meals tab)

Everyday Paleo (see drop-down menu under Food tab)

Paleo Food

Paleo Plan

Stalkerville

Perfect Health Diet

Diabetes Warrior

Whole Life Eating

Nell Stephenson

Paleo Diet Lifestyle

Happy hunting!

Steve Parker, M.D.

Ryberg et al: Effects of Paleolithic Diet on Obese Postmenopausal Women

Sweden's Flag. Most of the researchers involved with this study are in Sweden

Sweden’s Flag

After menopause, body fat in women tends to accumulate more centrally than peripherally. This is reflected in a higher incidence of fatty liver disease, type 2 diabetes, and cardiovascular disease. A multinational group of researchers wondered if a modified paleo-style diet would have metabolic effects on healthy overweight and obese (BMI 28–35) postmenopausal women in Sweden, with particular attention to fat levels in liver and muscle. I’ll call this the Ryberg study because that’s the first named author.

Study Details

Curiously, they never give the age range of the 10 study participants. Were they closer to 52 or 82?

tuna, fishing, Steve Parker MD, paleo diet, tuna salad

Has anyone even bothered to ask why the tuna are eating mercury? —Jim Gaffigan

The five-week intervention diet seems to have been mostly prepared and provided by the investigators, but they allowed for home cooking by providing menus, recipes, and a food list. No limit on consumption. The goal was to obtain 30% of calories from protein, 40% from fat (mostly unsaturated), and 30% from carbohydrate “…together with 40 g nuts (walnuts and sweet almonds) on a daily basis….”

The diet included lean meat, fish, fruit, vegetables (including root vegetables), eggs and nuts. Dairy products, cereals, beans, refined fats and sugar, added salt, bakery products and soft drinks were excluded.

“They were also advised to use only rapeseed [i.e., canola] or olive oil in food preparation.”

A diet like this should reduce average saturated fat consumption, which was a stated goal, while substituting monounsaturated  and polyunsaturated fat for saturated.

These women were sedentary before and during the intervention.

Results

The ladies indeed made some major changes in their diet. Total calories consumed fell by 22% (2,400 to 1,900 cals). The average weight of participants dropped from 190 lb (86.4 kg) to 180 lb (81.8 kg).

Carbohydrates consumption as a percentage of total calories fell from 49% to 25%. Total carb  grams dropped from 281 to 118, with fiber grams unchanged. To replace some of the carbs, the women increased their protein and fat calorie percentages by about a third. The authors don’t make it clear whether the total carb grams included total fiber grams. (I could probably figure it out if I had the time and inclination, but don’t.) “Before” and “after” fiber grams were 25 and 27, respectively.

In other words, “…the ratio between energy intake from the macronutrients protein, total fat and carbohydrates expressed as E% [calorie percentages] changed significantly from 16:33:50 at baseline to 28:44:25 after five weeks.” Total daily fat grams didn’t change, but the contribution of saturated fat grams fell.

Elevated blood pressure is one component of metabolic syndrome

Elevated blood pressure is one component of metabolic syndrome

A 10-point drop in systolic blood pressure over the five weeks didn’t quite reach statistical significance (p=0.057), but the 9% drop in diastolic pressure did.

“Fasting serum levels of glucose, leptin, cholesterol, triglycerides, HDL, LDL, ApoB and apolipoprotein A1 (ApoA1) and percentage HDL also decreased significantly.”

Fat (or lipid) content of the liver dropped by half. It was measured by magnetic resonance spectroscopy. Peripheral muscle fat content didn’t change, measured in the soleus and  tibialis anterior muscles of the leg.

Urinary C-peptide excretion and HOMA indices [HOMA1-IR formula] decreased significantly, whereas whole-body insulin sensitivity, measured using the hyperinsulinaemic euglycaemic clamp technique, was not significantly changed.” See footnote labelled PPS at bottom page for confusing details.

My Comments

The intervention diet was a reasonable version of the Paleolithic diet, with one exception. From what I’ve seen from Eaton, Konner, and Cordain, I think they’d agree. Except for the rapeseed oil. It’s fallen out of favor, hasn’t it?

Here’s what the Jaminet’s wrote about canola:

Canola oil…is rapeseed oil bred and processed to remove erucic acid and glucosinolates. During processing, the oil is treated with the solvent hexane and very high temperatures; it may also be subject to caustic refinement, bleaching, and degumming. [Perfect Health Diet, p.225.]

I can’t quite see Grok doing that.

My fantasy about extra virgin olive oil is that it simply oozes out of the olives when pressure is applied. So easy a caveman could do it.

Eaton and Konner have argued that our ancestral diet would have had at least two or three times the fiber as was provided by this diet. But that would have been at a total daily calorie consumption level of at least 3,000 or 3,5oo back in the day. So this diet isn’t so far off.

10-lb Weight Loss Without Calorie Restriction? I'll Take That.

10-lb weight loss In five weeks without conscious calorie restriction? I’ll take that.

The 10 lb (4.6 kg) weight loss is impressive for an eat-all-you-want diet. Calorie intake dropped spontaneously by 500/day, assuming the numbers are accurate. The satiation from higher protein consumption may explain that. The authors admit that the women lost more weight than would be predicted by the energy balance equation (i.e., a pound of fat = 3,500 calories). They wonder about over-estimations of food intake, thermogenic effects of protein versus other macronutrients,  and loss of glycogen (and associated body water). You can’t argue with those scales, though.

While serum C-peptide didn’t fall, urinary levels did. (My sense from reviewing other literature is that 24-hr urine levels of C-peptide are more accurate indicators of insulin production, compared to a single fasting C-peptide level.) The authors interpret this as increased insulin sensitivity in the liver in combination with decreased insulin secretion by the pancreas. Fasting serum insulin levels fell from 8.35 to 6.75 mIU/l (p<0.05).

Regarding the non-significant change in overall insulin sensitivity as judged by hyperinsulinemic euglycemic clamp technique, remember that insulin sensitivity of the liver may be different from sensitivity in peripheral tissues such as muscle. These investigators think that liver insulin sensitivity was clearly improved with their diet.

Blood lipid changes were in the right direction in terms of cardiovascular disease risk, except for the drops in HDL (from 1.35 to 1.17 mmol/l) and ApoA1.

This study may or may not apply to men. Also note the small sample size. Will these results be reproducible in a larger population? In different ethnicities?

I like the reduction in blood pressure. That could help you avoid the risk, expense, and hassle of drug therapy.

From 97 to 90 mg/dl

Serum glucose fell from 96  to 90 mg/dl

I like the drop in fasting blood sugar from 96 to 90 mg/dl (5.35 to 5 mmol/l). It’s modest, but statistically significant. Was it caused by the weight loss, reduced total carb consumption, paucity of sugar and refined starches, lower total calories, higher consumption of protein and mono- and polyunsaturated fats, or a combination of factors? As with most nutritional studies, there’s a lot going on here. A small fasting blood sugar drop like this wouldn’t matter to most type 2 diabetics, but could diabetics see an even greater reduction than these non-diabetics? Only one way to tell: do the study.

I can well imagine this diet curing some cases of metabolic syndrome, prediabetes, mild type 2 diabetes, and fatty liver disease.

Most type 2 diabetics (and prediabetics, for that matter) are overweight or obese.  If a diet like this helps them lose weight, it could improve blood sugar levels. Nearly all authorities recommend that overweight and obese diabetics and prediabetics get their weight down to normal. (I admit that weight loss and improved blood sugar levels are not always in sync.) Weight loss by any standard method tends to improve insulin sensitivity.

Furthermore, the elevated fasting blood sugars that characterize so many cases of diabetes and prediabetes are usually linked to, if not caused by, insulin resistance in the liver. According to these investigators, the diet at hand improves insulin sensitivity in the liver, and even lowers fasting blood sugars in non-diabetic older women.

This modified Paleolithic-style diet doesn’t include table sugar or refined grain starches. That would help control blood sugar levels in both type 1 and type 2 diabetics and prediabetics. The authors didn’t say so, but this must be a relatively low-glcemic-index diet.

The investigators don’t mention ramifications of their diet for folks with diabetes. Their focus is on ectopic fat accumulation (in liver and muscle) and its linkage with insulin resistance and cardiovascular disease. They’ve put together a promising program to try on diabetics or prediabetics. They just need the will and funding to git’r done.

I agree with the authors that the lower calorie consumption, rather than the paleo diet per se, may have caused or contributed to the reduction in liver fat.

Stockholm Palace

Stockholm Palace

The investigators wonder if a Paleolithic-style diet like this would be beneficial over the long-term in patients with non-alcoholic fatty liver disease (NALFD) and associated metabolic disturbance (e.g., impaired sensitivity sensitivity in the liver). NAFLD tends to predict the development of diabetes and cardiovascular disease. If we can prevent or reverse fatty liver, we may prevent or reverse type 2 diabetes and cardiovascular disease, to an extent. You’ll be waiting many years for those clinical study results.

But you have to decide what to eat today.

A significant number of American women (20%?) need to lose weight, lower their blood pressures, lower their blood sugars, and decrease their liver fat. This Ryberg Paleolithic-style diet would probably do it.

A very-low-carb diet is another way to reduce liver fat, and it’s more effective than simple calorie restriction.

Steve Parker, M.D.

Reference: Ryberg, M., et al. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. Journal of Internal Medicine, 2013, vol. 274(1), pp: 67-76.  doi: 10.1111/joim.12048

PS: See Carbsane Evelyn for her take on this study here and here.

PPS: Urinary C-peptide secretion reflects insulin production. HOMA is a gauge of insulin resistance, much cheaper and quicker than the purported “gold-standard” hyperinsulinemic euglycemic clamp technique. Why HOMA and the clamp technique in this study didn’t move together is unclear to me, and the authors didn’t explain it. School me in the comment section if you can. Click this HOMA link and you’ll find this statement: “HOMA and clamps yield steady-state measures of insulin secretion and insulin sensitivity in the basal and maximally stimulated states, respectively. HOMA measures basal function at the nadir of the dose-response curve, whereas clamps are an assessment of the stimulated extreme.” Maybe that means HOMA is applicable to the fasted state (no food for 8 hours), whereas the clamp technique is more applicable to the hour or two after you ate half a dozen donuts.

History of the “Modern” Paleo Diet Movement

Here’s a timeline, certainly not comprehensive, but probably more than enough to bore you. I’m trying to hit the major developments.

  • 1939 – Nutrition and Physical Degeneration by Weston A. Price’s is published.
  • 1973 – Stephen Boyden’s “Evolution and Health” is published in The Ecologist.
  • 1975 – The Stone Age Diet: Based On In-Depth Studies of Human ecology and the Diet of Man is self-published by Walter L. Voegtlin, M.D.
  • January 1985 – “Paleolithic Nutrition. A consideration of its nature and current implications” by S. Boyd Eaton and M. Konner in the New England Journal of Medicine.
  • 1987 – Stone Age Diet by Leon Chaitow (London: Optima).
  • 1988 – The Paleolithic Prescription: A Program of Diet and Exercise and a Design for Living by S. Boyd Eaton, M. Shostak, and M. Konner.
  • January 1997 – Paleodiet.com established by Don Wiss.
  • March 1997 – The Paleodiet listserv established by Dean Esmay and Donn Wiss.
  • April 1997 – The Evolutionary Fitness online discussion list is created. Art DeVany is its anchor and Tamir Katz is a regular participant.
  • April 1997 – Jack Challem published the article “Paleolithic Nutrition: Your Future Is In Your Dietary Past.”
  • 1999 – Neanderthin by Ray Audette is published.
  • November 2001 – Evfit.com established by Keith Thomas (“Health and Fitness in an Evolutionary Context”).
  • December 2001 – The Paleo Diet by Loren Cordain, Ph.D., is published.
  • April 2001 – Wikipedia’s page on Palaeolithic diet is created.
  • 2005 – Art DeVany’s first paleo blog.
  • 2006 – Exuberant Animal by Frank Forencich is published.
  • 2008 – Art DeVany’s Las Vegas seminar.
  • 2009 – The Primal Blueprint by Mark Sisson is published. Art DeVany announces ‘The New Evolution Diet’.
  • 8 January 2010 – The New York Times features the paleo lifestyle in its ‘fashion’ pages.
  • 26 February 2010 – McLean’s (Canada) publishes a general audience review of the paleo movement.
  • February 2010 – Food and Western Disease by Staffan Lindeberg is published.
  • March 2010 – Paleolithic lifestyle page is created on Wikipedia.
  • September 2010 – The Paleo Solution: The Original Human Diet by Robb Wolf is published.

Contributors to this timeline include Keith Thomas, Paul Jaminet, and Ray Audette (the latter two via blog comments). Any errors are mine.

Of the folks above, my major influences have been Cordain, Eaton, and Konner.

What would you add? I’m tempted to include the Jaminet’s book (Perfect Health Diet) and Dr. Emily Deans’ blog. Paul Jaminet mentioned Jan Kwasniewski’s Optimal Diet of 1990 (or was it Optimal Nutrition?), but is that just “the Polish Atkins,” as some say? Very high fat.

—Steve

Is the Paleo Diet Truly Low-Carb After All?

Lifextension argues that very case in a recent blog post. If the paleo diet is low carb, then it’s going to be heavily animal-based. According to Lifextension:

Diachronic and comparative analysis of the skeletal data of human hunters and cultivators from across the globe has revealed that – prior to the onset of agriculture – carbohydrates must have comprised only a rare and occasional component of ancestral eating patterns. Furthermore, the impact of the introduction of carbohydrates to human diets was almost immediate in its deterioration of human health and biology.

However, paradoxically, many proponents of a ‘Paleo’ (i.e.: pre-agricultural) diet have promoted the use of tubers and other starches as – not only benign – but necessary health foods to consume for the correction of metabolic and endocrine disorders. Potatoes, rice, and other oxymoronically-labelled ‘safe’ starches, are being promoted in spite of the fact that they are exclusively Neolithic foods. Consequently, it is the conflation of starches, safe, and ancestral that I now wish to address, and hopefully correct.

Lifextension concludes:

The intake of plant foods by hominids was most plausibly and conceivably minimal. This is due to their limited, seasonal availability; the physiological ceiling on fibre and toxin intake; the biological evolution of early Homo physiology; along with the technological, spatial and temporal limitations of obligatory pre-consumption preparations. Consequently, evolutionary arguments for the consumption of what are quite blatantly Neolithic foods are rendered paradoxical and absurd. Starches are neither ‘Paleo’; nor does our evolutionary biology sanction them as ‘safe’.

Lifextension neither pulls punches nor takes prisoners. This could get interesting.

Read the rest.

Seminal Article by Loren Cordain, Ph.D.

I have little to say about it. Just wanted it in my database:

The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groupsin Journal of the American Neutraceutical Association,  2002; 5:15-24.

The title of that journal doesn’t fill me with confidence, but it is what it is. Many of the ideas in the article are likely in his popular books.

A Paleo Problem: Calcium

paleo diet, Steve Parker MD,calcium, osteoporosis

I worry about her bones 50 years hence

It appears difficult to meet the Recommended Dietary Allowance (RDA) for calcium while eating most versions of the paleo diet.  That’s because they don’t include milk products.  The Linus Pauling Institute at Oregon State University has a review of calcium as related to nutrition and health, last updated in late  2010. They say that few Americans hit their recommended daily calcium goal.

I see lots of little old ladies with hip and other fractures related to osteoporosis. Trust me, you don’t want to go there. It’s difficult to reverse osteoporosis, an insidious process that’s been going on for decades before the fracture.

Osteoporosis may be related to years of inadequate calcium consumption. Adequate vitamin D is  an important part of the equation, too. Blood calcium levels are strictly regulated, and if they’re too low, calcium is pulled from the bones to fill the blood’s tank.

Broccoli and bok choy are fair sources of calcium, but pale in comparison to milk. Bok choy isn’t a part of my diet; I’m not even sure I’ve ever had it. Below is a video on bok choy cooking. Looks simple enough.  I need to look into kale, too.

Many paleophiles promote bone broth, but I haven’t figured out why yet. Is it high in calcium? (Hat tip to Wendy Schwartz for the word “paleophile”.)

A can of sardines looks like a good source of calcium: 350 mg or 35% Daily Value.

Can you help me worry less about calcium deficiency?

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.

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.

Applying Paleo Diet Principles to Dentistry: Dr. John Sorrentino

tooth structure, paleo diet, caries, enamel

Cross-section of a tooth

When I think about a Paleolithic approach to dental disease, the first expert that comes to mind is dentist John Sorrentino, D.D.S.  The only other living “authority” that pops up is Stephan Guyenet, Ph.D., and he’s not even a dentist.  Stephan focused his literature review more on malocclusions than teeth per se, as I recall.  Dr. Sorrentino cites dentist Weston A. Price as a ground-breaker, documenting the deterioration of dental health as traditional cultures moved to modern diets loaded with refined and concentrated sugars and starches.

Fortunately for us, Dr. Sorrentino has blogged about the intersection of dentistry, evolution, and the paleo diet.  Malocclusion and caries (cavities) weren’t  problems for our Paleolithic ancestors, although “…they wore thru their enamel by the time they were middle aged.”  Then what happened?

Regarding caries, Dr. Sorrentino wrote:

Caries was just about non-existent because simple sugars and the refined carbohydrates that cause them were just not present in any Paleolithic diet.  Since the Paleolithic covered such a vast period of time and many, many different populations it is important to remember that there is no one “Paleolithic Diet,” but rather a continuum or “envelope” of certain related types of foodstuffs that were consumed. These included but were not limited to fish, shellfish, leafy green plants, root vegetables, and fruit in season.  It was interesting to note that there is decay in some lowland gorillas.  It is present mostly as interproximal decay on the upper anterior teeth.  It was speculated that sucking on fruit or raiding human garbage dumps, common in the area, caused this.  In either case it shows that our closest living relatives are not very well adapted to eat sugar either.

Read the rest.

paleo diet, teeth, smile

Are these healthy teeth a result of proper diet, dental self-care, dentistry, Photoshop, or a combination?

I was perusing his website looking for reliable information on flossing and Water Pik-like devices and their proper roles in periodontal disease and caries prevention.  I didn’t find much other than recommendations to eat a paleo diet, naturally low in concentrated sugars and refined starches, especially grains.

Steve Parker, M.D.

QOTD: Calcium and the Paleo Diet

“Low calcium intake, which is often considered as a potential disadvantage of the Paleolithic diet model, should be weighed against the low content of phytates and the low content of sodium chloride, as well as the high amount of net base yielding vegetables and fruits.”

L.M. Kowalski and J. Bujko

Hamburger-Avocado Salad with tomatoes, cucumbers, lettuce, salt/pepper, and olive oil vinaigrette

Hamburger-Avocado Salad with tomatoes, cucumbers, lettuce, salt/pepper, and olive oil vinaigrette

PS: Low calcium consumption is thought to predispose to osteoporosis, a bone-thinning disease that causes fractures.  It affects women far more than men.  If you don’t live past 50 or 60, it’s not much of a problem.  Kowalski and Bujko imply that low phytate and sodium content, plus alkaline veggies and fruit, counteract any adverse bone effects of low calcium consumption.  I’m not sure because I don’t read Polish.  Loren Cordain’s paleo diet website talks about the diet being healthy for bones, citing the acid-base issue.

h/t Amy Kubal (Twitter: @AmykRd)