MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The Paleo diet is based on the evolutionary discordance hypothesis, according to which departures from the nutrition and activity patterns of our hunter-gatherer ancestors have contributed greatly and in specifically definable ways to the endemic chronic diseases of modern civilization. The assumption is that during the Paleolithic era — a period lasting around 2.5 million years that ended about 10,000 years ago with the advent of agriculture and domestication of animals — humans evolved nutritional needs specific to the foods available at that time, and that the nutritional needs of modern humans remain best adapted to the diet of their Paleolithic ancestors. Today’s humans are said to be not well adapted to eating foods such as grain, legumes, and dairy, and in particular the high-calorie processed foods. Proponents claim that modern humans’ inability to properly metabolize these comparatively new types of food has led to modern-day problems such as obesity, heart disease, and diabetes. They furthermore claim that followers of the Paleolithic diet may enjoy a longer, healthier, more active life.

The Paleo Diet is alleged to work by two fundamental principles:

  •  Put the optimal nutrition into your body.
  •  Reduce or eliminate toxins and “interference”.

And what are the results, as claimed by those who promote (and profit from) the Paleo diet? The alleged benefits include:

  • Leaner, Stronger Muscles
  • Increased Energy
  • Significantly More Stamina
  • Clearer, Smoother Skin
  • Weight Loss Results
  • Better Performance and Recovery
  • Stronger Immune System
  • Enhanced Libido
  • Greater Mental Clarity
  • No More Hunger/Cravings
  • Thicker, Fuller Hair
  • Clear Eyes

Critics of the Paleo diet point towards abundant evidence that paleolithic humans did, in fact, eat grains and legumes. They also stress that humans are much more nutritionally flexible than previously thought, that the hypothesis that Paleolithic humans were genetically adapted to specific local diets is unproven, that the Paleolithic period was extremely long and saw a variety of forms of human settlement and subsistence in a wide variety of changing nutritional landscapes, and that currently very little is known for certain about what Paleolithic humans ate.

So, the theories behind the Paleo diet are flimsy and naïve; the most crucial question, however, is does it work?

Overall there is little solid evidence; unsurprisingly, some studies have shown that cardiovascular risk factors can be positively influenced, for instance, in patients with diabetes. But the more specific claims, like the ones above, are not supported by good clinical evidence.

It seems that, yet again, less than responsible entrepreneurs have jumped on a popular band-wagon to exploit the often hopelessly gullible public.

31 Responses to The ‘Paleo diet’

  • Follow your ancestors diet and you can live as long as they did – 26, 27, maybe even 30 years!

    • Pat Harkin on Thursday 02 April 2015 at 10:12
      Follow your ancestors diet and you can live as long as they did – 26, 27, maybe even 30 years!

      That always mystifies me. Life expectancy at birth has essentially quadrupled. Whatever we have been doing, is clearly going in the right direction. Yet, the quacks and their followers do not seem to be interested in that at all.
       
      At the most, they offer the argument that the numbers are skewed because there are fewer children dying before they are five. To me, that is an insensitive and cruel remark. Are children really so unimportant that their dying before five should simply be brushed aside as irrelevant?

    • Exactly, but then stupid people can breed now and become fat as they want.
      Women no longer walk for miles collecting scarce very brief seasonal vegetables (and run from predators)
      available for perhaps less than a month out of the year, unless they were dried & stored. (cached)
      excessive starvation also kept them lean, and culled the weak.
      The American Indian tribes made pemmican, meat preserved in fat. Fat was necessary for survival, you can starve to death eating rabbit.
      This is told in the stories by the early beaver hunters in American West.

      Modern women still expect men to be their main provider, and prize their most valuable asset accordingly.
      Then they moan enough about having to do a little housework just by turning on a machine.
      The Paleo diet promoters are frauds who are just buying into ego.

      • *Eye-popping remark*

        “Modern women still expect men to be their main provider, and prize their most valuable asset accordingly.
        Then they moan enough about having to do a little housework just by turning on a machine.”

        Um, that’s not really how ‘modern men’ talk about women any more. Oddly enough my husband knows how a hoover works, and he’s not afraid to use one.

        • My point being that the Paleo diet is a fad based on ego.
          Modern women have a easy indolent sedentary lifestyle, they want everything as easy as possible.
          These diets are promoted by guys with alpha status, but are beta competitors.
          its pandering to ego, not science. snake oil salesman is an appropriate term.
          And you will outlive your husband by 5 years +.
          Now just eat meat for six months and enjoy the ricketts.

          • That’s an outrageous and unsubstantiated claim! Modern women in the West mainly work as well as doing the bulk of childcare and household work. In less developed countries, they also tend to work harder than the men so I wonder if you are an embittered divorcee?!

          • never been married, non breeder, i kept my lads on a lease,
            if women do end up doing most of the work,
            its because yous made poor choices
            in plonker alpha males, its not hard to turn on a vacuum, or washing machine
            i couldnt comment on changing a nappy, ekk,
            yous still have it easy than at any other time in history.

  • This diet’s appeal is a complete mystery to me, having no rational basis that I can comprehend.

    However a version called the Stone Age diet is promoted by a qualified medical practitioner. I’d be interested in your ‘take’ on this. http://www.doctormyhill.co.uk/wiki/Stone_Age_Diet_-_this_is_a_diet_which_we_all_should_follow

    Dr Myhill states:

    “ALL OTHER FOODS ARE FORBIDDEN!!! – this means unfiltered tap water, alcohol, all grains including wheat (bread, biscuit, cake, pasta, pastry), rye (Ryvita), other grains (corn, rice, millet), dairy products (milk, butter, cheese, yoghurt, dried milk), and sugar. Avoid high carbohydrate vegetables such as potato, sweet potato, parsnip, swede. Try to avoid drugs and medicines, many of which contain fillers of corn, lactose, colourings etc. Toothpaste must be avoided.”

      • Eye-popping stuff. I was following this case from the beginning, so I can remember every mind-boggling development. She remains popular with her patients.

        https://witness.theguardian.com/assignment/54d47c0ce4b00cb437de4585/1428927

        • I despair when I see things like this, and you see them everywhere.
           
          You see the same thing on marijuana (and other drug) fora. Grandiose claims on how fantastic it is, how The Government is colluding with big industry and big pharma to keep the benefits of this wonderful product for themselves and prevent us, poor misinformed citizens, from benefitting from this wonderful product … and then you go to Toronto’s CAMH where drug users yelling and screaming to be admitted, accusing that same Government of not providing enough care for these poor addicts and of not informing them of the dangers.
           
          In “Sanfte medizin und Satte Gewinne” [Gentle medicine and fat profits] we see two women and a man who are being misled by quacks. One of them ultimately sees the light and is now outraged that this type of life threatening quackery is allowed, while she is hoping genuine medicine will still be able to pull her through, but how many victims do the quacks make? Since there are no records, we simply cannot know.
           
          Then there is the case of “liberation therapy” for multiple sclerosis. The list goes on and on and on, and yet, most quacks are allowed to continue as if nothing is wrong with what they do. Sure, Dr. Oz got a few unpleasant moments when he was accused of lying, by an American senator, and sure, “Dr” Young and his wife of miracle pH fame, are being sued, but on the whole, the quacks just go on undisturbed and fêted by the very people they may end up killing.
           
          I think our system is simply wrong. We provide children with ridiculously inadequate education, we allow their parents and religionists of all types to indoctrinate them with fairy tales and set them up for belief in the unbelievable and unbelief in the believable, and then wonder why they flock to the quacks who tell them all they want to hear in exchange for their hard-earned money.
           
          It is so sad.

          • they say the same about marriage and claim how men are better off,
            tax concession n healthier,
            they ignor that 80% of divorces are instigated women,
            and men have no paternity rights,

            this is why the only carrot men get is tax breaks,
            i living on 20 hours a week, drink in gamble, when I want too,
            and prostitution is legal in New Zealand
            have you seen our bachelor show, this is what we compete for and against + married guys,
            I have a passport, might look at Thailand n Cebu visit next year.

  • It seems to me that all these “health through food” claims have one thing in common: ignorance is the number one requirement.

    • Bart, it’s also basic marketing:
      1. Invent a problem that doesn’t exist (scaremongering).
      2. Offer to purge the invented problem by selling the ‘cure’.

      • Pete Attkins on Thursday 02 April 2015 at 13:27
        Bart, it’s also basic marketing:
        1. Invent a problem that doesn’t exist (scaremongering).
        2. Offer to purge the invented problem by selling the ‘cure’.

        Indeed, and that is why our system is rotten. We are worse than the Ferengi. Allowing snake-oil merchants to encourage and even induce life-threatening behaviour in people for their own personal gain is morally even more despicable than burglary.

  • The main difference between the average human diet during the stone age, and the average (developed world) human diet in the present day, leading to obesity, heart disease, and diabetes, is the *quantity* of food.

    • The main difference between the average human diet during the stone age, and the average (developed world) human diet in the present day, leading to obesity, heart disease, and diabetes, is the *quantity* of food.

      That seems reasonable enough. I would also add that the palatability of that abundant food has become so great that we now eat purely for pleasure. When I was little, I was very skinny, because I ate no more than what I felt to be absolutely necessary, because most of the food was so disgusting that my stomach churns even now when I merely think of it: over-cooked Brussels sprouts, sickeningly sweet red cabbage, spinach that looked like baby diarrhoea, on and on it goes.

      • When Aborigines when into the Australia, they only ate some like 30% of the eatable food, that wasnt moving.
        so its a nonsense the the Paleo diet was varied.
        hunter gathers simply starve if the dont look for food waking hours,
        its a false dichotomy its good for modern women,

  • The idea of eating what we evolved to eat is basically sound surely?

    Extreme paleo advocates tend to go too far, BUT it is clear that we do eat a lot of things that were either not available, or only available in limited quantities, until very recently ( sugar, refined grains…). Agriculture only appeared about 10,000 years ago and took time to spread: we only have only had a few thousand years of a grain dominated diet (certainly grains were eaten before, but the proportion of our diet from grains has rocketed).

    I think the biggest flaw in the extreme paleo position is the avoidance of dairy. We clearly evolved to digest dairy when young, and a high proportion of us come from populations that did evolve to keep that ability as adults.

    On the other hand taking paleo as a starting point – basing a diet on foods we have known have been part of the human diet for a long time (meat, fruit, a variety of veg) and adjusting it in the light of whatever research is available seems reasonable.

  • What always strikes me as the ultimate stupidity of this paleo diet stuff is that there are paleolithic peoples still around in this day and age. New Guinea, the Amazon basin, Australia and Africa still have groups that have nothing but stone and wood tools and live as hunter gatherers. These groups have been studied extensively and any benefits of a paleo existence would be well documented. I suggest paleo diet supporters read anything about the Yanomamo tribe by anthropologist Napoleon A. Chagnon. If that is the kind of life you are looking for, the paleo diet may be just the ticket to perfect health for your first 20 years of life.

  • Hardly different from Benedict Lust’s ‘Naturopathy’.
    He published the Universal Naturopathic Encyclopaedia for Drugless Therapy and the magazine Nature’s Path.
    Apart from healthcare methods originating in Europe, he introduced Indian Ayurvedic and Yoga to America and established health resorts in New Jersey and Florida.
    Lust thought of Naturopathy as a way of life, a belief system, philosophy and system of healing alternative to conventional medicine. He emphasised the importance of prevention of disease and promotion of health: ‘We plead for the renouncing of poisons from the coffee, white flour, glucose, lard, and like venom of the American table, and of patent medicines, tobacco, liquor and the other inevitable recourse of perverted appetite. Naturopathy stands for the reconciling, harmonizing and unifying of nature, humanity, and God.’ (Benedict Lust. Editorial, The Naturopathic and Herald of Health. Issue 1 January 1902).
    It’s all a matter of marketing.

  • As an anthropologist I get apoplexy (apoplectic?) whenever anyone goes into paleodiet mode. Yes, many of us consume too much empty calorie food, but as Danny says, it’s the QUANTITY. People are fat because they eat too much of–whatever. Appropriate serving sizes of a variety of foods is just too simple for simpletons it seems.

    Nice summary of the problems with paleo diet assumptions, Dr Ernst.

    @fiorello – I like the gist of your thoughts, but people who live as hunter gatherers today are NOT Paleolithic people–they live NOW–but I take your point. These people survive in different parts of the world and subsist on a number of diet variations. They eat what’s available! They do well in general, but many nutritional deficiencies have occurred historically and prehistorically–goiter from iodine deficiency for example.

  • Again, I am surprised by the sheer childishness of human thinking about food: these ludicrous diets are purely designed (and poorly designed, to boot) to add a few more years or squeeze a little better packaging, out of human life, whilst we know that the planet cannot sustain the omnivorous diet, it causes poverty, pollution and hunger outside the rich world and obesity heart disease and a host of etcs inside it. And that without opening the numerous and irrefutable arguments against causing suffering and death to millions of other sentient beings, i.e., the nonhumans involved. Must humans expose their utter selfishness every time they consider what to put in their moiuths?

  • Without any evidence to justify it, I think the concept of the paleo diet is sound, except, that as it is described, it is fanciful.
    ~
    I think that human ancestors were physically stronger than we are now, simply because they survived. Despite being stronger, I can’t see humans as “hunter/gatherers”. Tools and weapons are only a very recent development and evolution isn’t that quick to take in a completely different diet, particularly one so high in fat when humans learnt to kill bigger animals.
    ~
    As a thought experiment, I ask other posters; which animals could humans catch, kill and eat now, without weapons? Some birds, some small animals, insects, and what else? Take a modern day sheep, for example, it is far less dangerous than its predecessors, but while a human being could catch and possibly kill one, how could they eat one, without weapons?
    ~
    As with all such questions, I think the answer to what constitutes a “sound” human diet rests with what our nearest relatives eat.
    ~
    Come on, shoot me down?

    • and, of course our nearest relatives have a very low-animal-products percentage in their diets. However, there is one element missing from the discussion, which is: What ethical requirements do humans have when deciding on a diet? We know from the pronouncements of all the professional associations that a well planned vegan diet is adequate for human health – as it would be good for the planet. So why are humans still banging on about paleo-diets, Atkins, low-carb, blood-group types-diets etc, tweaking their overfed wellness (at least in the Northern hemisphere) and entirely neglecting the philosophical aspect?

      • Our nearest relatives, the chimpanzees, love meat and they will viciously hunt down their prey with no consideration we can detect for the feelings and/or well being of this prey.
         
        As for humans, we do not know enough about nutrition to be sure that a vegan diet is good for us. In fact, we know it is not, since vegans must take vitamin supplements. We know very little about nutrition, and it is not likely that our knowledge will increase significantly in the short term, which is precisely why the quacks are having such a good time with it.
         
        I’m no fan of the National Geographic, since they tend to cater to the American hillbilly manlyman Ram-Silverado crowd, but this is the first thing that came up in a YouTube search: https://www.youtube.com/watch?v=mpYViR9MqrU

        • Excuse me, as I said above, all the professional dieticians associations have stated firmly and repeatedly that a vegan diet is adequate for human health (and may, indeed have health benefits) The only supplements vegans need are those of B12: the very same are in animal feed since these unfortunates mostly no longer ingest the necessary elements from the soil. Chimps will indeed hunt viciously for meat, but that is no excuse for humans to continue doing so, not if they wish to preserve the planet and sleep with clean consciences.

          However, Professor Ernst’s page is not the place to rehearse these arguments, I shall leave it there.

          • Excuse me, as I said above, all the professional dieticians associations have stated firmly and repeatedly that a vegan diet is adequate for human health…

            The only supplements vegans need are those of B12

            Why would they need supplements if their diet is adequate for human health?

          • A vegan diet is clearly not adequate for human health which is why there is such a massive problem in India with vitamin B12 deficiency. Studies have shown that in the past Indian vegans were only healthy because they acquired B12 directly from the soil clinging to the vegetables they ate. Since their soil is now becoming denuded of B12 the country is suffering an epidemic of B12 deficiency.

            Vegetarianism, veganism, etc are nothing more than fad diets and are probably responsible for ruining the health of and indeed killing large numbers of gullible people.

          • Jim said:

            Vegetarianism, veganism, etc are nothing more than fad diets and are probably responsible for ruining the health of and indeed killing large numbers of gullible people.

            That may come as a bit of a surprise to the 350 million Indians (~one third of the population) who have been vegetarian for centuries, if not millennia.

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