Paleo: Why it Works

As a Christian, I admittedly don't buy into the evolutionary flim flam that so often seems a default side-note in the theoretical tackle box of many mainstream paleo-eating advocates.  Every couple of years we find another skeleton in the mud somewhere that changes everything science had been preaching as fact for the previous 12 months.  (side note:  this is an interesting blurb by another paleo/Christian on the topic of faith and food.)

I do buy into the paleo-logical fact that mankind is older than grain-harvesting en-mass and processed foods-  people did eat before chemistry and combines came along.  However, I don't think we have to look back a million years to see some logical reasons why the paleo approach can work for weight loss, maintenance, and overall health.

Have you seen the documentary Fathead yet?  If not, you should.  Then, if you're into science and nutrition, read up on The Zone.  You'll notice pretty quickly that, in Fathead, Tom Naughton was essentially making choices at fast food restaurants that kept his carbohydrate/fat/protein ratio and calorie count within Zone parameters.

Anyone who's tried it will probably attest to the fact that staying in the Zone is enormously inconvenient to accomplish due to all of the label-reading and calorie counting involved.  When I tried it, I eventually ended up with a go-to list of recipes and over time got sick of having to choose between eating the same old stuff, or crunching numbers to come up with something fresh.

Think about paleo for a second:  exclude grains, processed foods, and sugar from your diet.  If you're a well balanced paleo-eater then all of your carbs from hearty portions of nutrient-dense fruits and vegetables, naturally loaded with fiber, which makes it almost impossible to get out of the Zone.  Cavemen who go bacon or steak-crazy and exclude fruits and other high GI foods in an effort to lose weight usually achieve ketosis- essentially slipping into the Atkins diet.

 get the shirt here

I'm convinced that anyone who is overweight, if they have the willpower to give up grains and sugar, can easily lose poundage, keeping themselves somewhere within the spectrum between the Zone and ketosis by eating the paleo way.  Throw in a little intermittent fasting (IF) to give the calorie deficit a boost (and your body a chance to det-tox) and excess pounds should melt away.  Intermittent fasting is another idea that a lot of paleo-eaters like to experiment with.  For more on that, check out Lean Gains-  a great blog full of science behind the benefits of giving your digestive system a break now and then.

It's been nice to land squarely in Technorati's top 100 list for health blogs over the last couple of months, but I can only stay on one topic for so long.  I have a bit more up my sleeve, but there are more important things in life than dietary speculation.  Expect to see the subject matter branch out a bit over the next few weeks on One Face.

"Gateway Foods" and Dr. Cordain's Letter

Mark and I must be on the same wavelength, he saved me a lot of work with his post today on "Gateway Foods"- a good follow-up to yesterday's here.

Also, Robb Wolf has featured a good retaliatory piece in light Paleo's low ranking, and encouraged re-posting of the centerpiece- a letter from Dr. Loren Cordain- so here it is:

June 8, 2011

Hi Seth,

Good to hear from you and many thanks for your continued support of the Paleo Diet.  I hadn’t seen this piece, but I appreciate that you have brought it to my attention.  It is obvious that whoever wrote this piece did not do their homework and has not read the peer review scientific papers which have examined contemporary diets based upon the Paleolithic food groups which shaped the genomes of our ancestors.  Accordingly the writer’s conclusions are erroneous and misleading.  I feel strongly that it is necessary to point out these errors and make this information known to a much wider audience than those reached by the readers of the U.S. News and World Report.  You have my permission to syndicate my response and or your write up for the CSU Collegian to any of the major news services including AP and UPI.  Additionally, I will copy a number of colleagues and scientists worldwide with this message to ensure that it will be widely circulated on the web, blogs and chat groups.
The writer of this article suggests that the Paleo Diet has only been scientifically tested in “one tiny study”.  This quote is incorrect as five studies (1-7); four since 2007, have experimentally tested contemporary versions of ancestral human diets and have found them to be superior to Mediterranean diets, diabetic diets and typical western diets in regards to weight loss, cardiovascular disease risk factors and risk factors for type 2 diabetes.
The first study to experimentally test diets devoid of grains, dairy and processed foods was performed by Dr. Kerin O’Dea at the University of Melbourne and published in the Journal, Diabetes in 1984 (6).  In this study Dr. O’Dea gathered together 10 middle aged Australian Aborigines who had been born in the “Outback”.  They had lived their early days primarily as hunter gatherers until they had no choice but to finally settle into a rural community with access to western goods.  Predictably, all ten subjects eventually became overweight and developed type 2 diabetes as they adopted western sedentary lifestyles in the community of Mowwanjum in the northern Kimberley region of Western Australia.  However, inherent in their upbringing was the knowledge to live and survive in this seemingly desolate land without any of the trappings of the modern world.
Dr. O’Dea requested these 10 middle aged subjects to revert to their former lives as hunter gatherers for a seven week period.  All agreed and traveled back into the isolated land from which they originated.  Their daily sustenance came only from native foods that could be foraged, hunted or gathered.  Instead of white bread, corn, sugar, powdered milk and canned foods, they began to eat the traditional fresh foods of their ancestral past: kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey.   At the experiment’s conclusion, the results were spectacular, but not altogether unexpected given what known about Paleo diets, even then.  The average weight loss in the group was 16.5 lbs; blood cholesterol dropped by 12 % and triglycerides were reduced by a whopping 72 %.  Insulin and glucose metabolism became normal, and their diabetes effectively disappeared.
The first recent study to experimentally test contemporary Paleo diets was published in 2007 (5). Dr. Lindeberg and associates placed 29 patients with type 2 diabetes and heart disease on either a Paleo diet or a Mediterranean diet based upon whole grains, low-fat dairy products, vegetables, fruits, fish, oils, and margarines.  Note that the Paleo diet excludes grains, dairy products and margarines while encouraging greater consumption of meat and fish.  After 12 weeks on either diet blood glucose tolerance (a risk factor for heart disease) improved in both groups, but was better in the Paleo dieters.  In a  2010 follow-up publication, of this same experiment the Paleo diet was shown to be more satiating on a calorie by calorie basis than the Mediterranean diet because it caused greater changes in leptin, a hormone which regulates appetite and body weight.
In the second modern study (2008) of Paleo Diets, Dr. Osterdahl and co-workers (7) put 14 healthy subjects on a Paleo diet.  After only three weeks the subjects lost weight, reduced their waist size and experienced significant reductions in blood pressure, and plasminogen activator inhibitor (a substance in blood which promotes clotting and accelerates artery clogging).  Because no control group was employed in this study, some scientists would argue that the beneficial changes might not necessarily be due to the Paleo diet.  However, a better controlled more recent experiments showed similar results.
In 2009, Dr. Frasetto and co-workers (1) put nine inactive subjects on a Paleo diet for just 10 days.  In this experiment, the Paleo diet was exactly matched in calories with the subjects’ usual diet.  Anytime people eat diets that are calorically reduced, no matter what foods are involved, they exhibit beneficial health effects.  So the beauty of this experiment was that any therapeutic changes in the subjects’ health could not be credited to reductions in calories, but rather to changes in the types of food eaten.  While on the Paleo diet either eight or all nine participants  experienced improvements in blood pressure, arterial function, insulin, total cholesterol, LDL cholesterol and triglycerides.  What is striking about this experiment is how rapidly so many markers of health improved, and that they occurred in every single patient.
In an even more convincing recent (2009) experiment, Dr. Lindeberg and colleagues (2) compared the effects of a Paleo diet to a diabetes diet generally recommended for patients with type 2 diabetes.  The diabetes diet was intended to reduce total fat by increasing whole grain bread and cereals, low fat dairy products, fruits and vegetables while restricting animal foods.   In contrast, the Paleo diet was lower in cereals, dairy products, potatoes, beans, and bakery foods but higher in fruits, vegetables, meat, and eggs compared to the diabetes diet.  The strength of this experiment was its cross over design in which all 13 diabetes patients first ate one diet for three months and then crossed over and ate the other diet for three months.  Compared to the diabetes diet, the Paleo diet resulted in improved weight loss, waist size, blood pressure, HDL cholesterol, triglycerides, blood glucose and hemoglobin A1c (a marker for long term blood glucose control).    This experiment represents the most powerful example to date of the Paleo diet’s effectiveness in treating people with serious health problems.
So, now that I have summarized the experimental evidence supporting the health and weight loss benefits of Paleo Diets, I would like to directly respond to the errors in the U.S. News and World Report article.

1.            “Will you lose weight? No way to tell.”
Obviously, the author of this article did not read either the study by O’Dea (6) or the more powerful three month crossover experiment by Jonsson and colleagues (9) which demonstrated the superior weight loss potential of high protein, low glycemic load Paleo diets.  Similar results of high protein, low glycemic load diets have recently been reported in the largest randomized controlled trials ever undertaken in both adults and children.
A 2010 randomized trial involving 773 subjects and published in the New England Journal of Medicine (8) confirmed that high protein, low glycemic index diets were the most effective strategy to keep weight off.   The same beneficial effects of high protein, low glycemic index diets were dramatically demonstrated in largest nutritional trial, The DiOGenes Study (9), ever conducted in a sample of 827 children. Children assigned to low protein, high glycemic diets became significantly fatter over the 6 month experiment, whereas those overweight and obese children assigned to the high protein, low glycemic nutritional plan lost significant weight.
2.            “Does it have cardiovascular benefits? Unknown.”
This comment shows just how uninformed this writer really is.  Clearly, this person hasn’t read the following papers (1 – 6) which unequivocally show the therapeutic effects of Paleo Diets upon cardiovascular risk factors.
“And all that fat would worry most experts.”
This statement represents a “scare tactic” unsubstantiated by the data.  As I, and almost the entire nutritional community,  have previously pointed out, it is not the quantity of fat which increases the risk for cardiovascular disease or cancer, or any other health problem, but rather the quality.  Contemporary Paleo Diets contain high concentrations of healthful omega 3 fatty acids, monounsaturated fatty acids and long chain polyunsaturated fatty acids that actually reduce the risk for chronic disease (10-18).
3.            “Can it prevent or control diabetes? Unknown.”
Here is another example of irresponsible and biased journalism which doesn’t let the facts speak for themselves.  Obviously, the author did not read the study by O’dea (6) or Jonsson et al. (2) which showed dramatic improvements in type 2 diabetics consuming Paleo diets.

“but most diabetes experts recommend a diet that includes whole grains and dairy products.”
If the truth be known, in a randomized controlled trial, 24 8-y-old boys were asked to take 53 g of protein as milk or meat daily (19).  After only 7 days on the high milk diet, the boys became insulin resistant.  This is a condition that precedes the development of type 2 diabetes.  In contrast, In the meat-group, there was no increase in insulin and insulin resistance.  Further, in the Jonsson et al. study (2) milk and grain free diets were shown to have superior results in improving disease symptoms in type 2 diabetics.
4.            “Are there health risks? Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients.”
Once again, this statement shows the writer’s ignorance and blatant disregard for the facts.  Because contemporary ancestral diets exclude processed foods, dairy and grains, they are actually more nutrient (vitamins, minerals and phytochemicals) dense than government recommended diets such as the food pyramid.    I have pointed out these facts in a paper I published in the American Journal of Nutrition in 2005 (13) along with another paper in which I analyzed the nutrient content of modern day Paleo diets (12 ).  Most nutritionists are aware that processed foods made with refined grains, sugars and vegetable oils have low concentrations of vitamins and minerals, but few realized that dairy products and whole grains contain significantly lower concentrations of the 13 vitamins and minerals most lacking in the U.S. diet compared to lean meats, fish and fresh fruit and vegetables (12, 13).
“Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems” .
Actually, the most recent comprehensive meta analyses do not show fresh meat consumption whether fat or lean to be a significant risk factor for cardiovascular disease (20-25), only processed meats such as salami, bologna, bacon and sausages (20).
References

1.            Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.

2.            Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35

3.            Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85

4.            Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson Lindeberg S: A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond) 2006, 3:39.

5.            Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.

6.            O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.

7.            Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.

8.            Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, Astrup A; Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010 Nov 25;363(22):2102-13

9.            Papadaki A, Linardakis M, Larsen TM, van Baak MA, Lindroos AK, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesová M, Holst C, Astrup A, Saris WH, Kafatos A; DiOGenes Study Group. The effect of protein and glycemic index on children’s body composition: the DiOGenes randomized study. Pediatrics. 2010 Nov;126(5):e1143-52

10.            Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes.  In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126.

11.            Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets.Am J Clin Nutr. 2000 Mar;71(3):682-92.

12.            Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24.

13.            Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.

14.            Kuipers RS, Luxwolda MF, Dijck-Brouwer DA, Eaton SB, Crawford MA, Cordain L, Muskiet FA. Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet. Br J Nutr. 2010 Dec;104(11):1666-87.

15.            Ramsden CE, Faurot KR, Carrera-Bastos P, Cordain L, De Lorgeril M, Sperling LS.Dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global, and modern perspectives. Curr Treat Options Cardiovasc Med. 2009 Aug;11(4):289-301.

16.            Cordain L, Eaton SB, Miller JB, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr. 2002 Mar;56 Suppl 1:S42-52

17.            Cordain L, Watkins BA, Florant GL, Kelher M, Rogers L, Li Y. Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease. Eur J Clin Nutr. 2002 Mar;56(3):181-91

18.            Carrera-Bastos P, Fontes Villalba M, O’Keefe JH, Lindeberg S, Cordain L. The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol 2011; 2: 215-235.

19.            Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8.

20.            Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010 Jun 1;121(21):2271-83

21.            Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010 Oct;45(10):893-905. Epub 2010 Mar 31.

22.            Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010 Mar 23;7(3):e1000252.

23.            Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. Curr Atheroscler Rep. 2010 Nov;12(6):384-90.

24.            Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):502-9

25.            Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46

In Defense of Paleo (and bending the rules)

I happened to run across a blurb on US News and World Report's list of the top 20 eating plans today.  Their ranking system is suspicious to say the least, putting Paleo in 20th place, even behind Atkins.  The numbers in the survey are worth noting, though, in that the Paleo Diet only worked for 19% of people who tried it, while the Vegetarian diet (ranked 9th) worked for over 93%.

Paleo understandably got a bad rap for it's difficulty to adhere to, but there was also this, and I quote from this article:

. . . .most versions [of the Paleo diet] didn’t hold true to the Paleo diet plans or rules.

If that's true, then wouldn't it seem that they were never on it in the first place?  Most of the reasoning shown here for the bad rankings seems due to the lack of data from controlled [tax-funded] studies.  There seems to be a guilty-until-proven-effective-by-the-establishment rule in effect.  On top of all that, the entire segment has somewhat of a cynical tone to it.  Apparently they didn't talk to these folks, or these fine specimens, or those who penned most of the reviews here.

That said, adhering to the paleo way of eating can be a real challenge- especially if your significant other isn't on board, and your pantry is well-stocked with high-GI temptation.  My wife is a happy (and fit) carb-o-holic, who asked me 10 minutes ago whether I would partake if she prepped a large bowl of popcorn.  I stood strong this time around, but it wasn't easy.

A lot of us, myself included, try to practically align ourselves with Paleo principals, but tend to fudge on things like grass-fed ($$$) meat and an abundance of organic veggies.  We may even buckle once in a blue moon to the beckoning of spaghetti, lasagna, or free donuts.  We refuse to be socially awkward when our hosts bring out a gi-normous carrot cake with inch-deep frosting.  I think that's healthy. . . . to a point.

The season of eating is upon us- it begins with surplus Halloween candy abandoned in the breakroom at work.  Soon there will be Thanksgiving potlucks, Christmas parties, New Year's Celebrations, egg nog, and hot chocolate.  Personally, when I give an inch and pick up a tiny box of Milk Duds it becomes really tough not to take a mile.  Maybe our next topic to explore will be tactics for fighting the urge and avoiding the bulge this season.

Paleo on Reddit and Pizza Crust

Overwhelmed by what people I hardly knew in high school ate for breakfast, and pelted by pictures of their kids, I took a hiatus from Facebook a few years back.  Then a friend showed me how to "hide" each poster-child I wasn't interested in.  That led to another enjoyable season of electro-social networking. . . but then came Facebook's latest updates.  There now seems to be some kind of big brother software running in the background that thinks it knows what I want to see more than I do- it's a little too 1984 for my taste.

Lately I've taken a liking to Reddit.  There I can share, read, and discuss interesting and entertaining things while avoiding invitations to Farmville and Mafia Wars.  Inside Reddit you can subscribe to "sub-reddits" that have their own moderators and sub-sets of guidelines for posting and commenting.  There seems to be a sub-reddit for every topic under the sun, including Paleo.

On the hunt for a paleo-friendly pizza crust, I posted the question to Reddit. . . and yes, I got gently flamed for asking. . . . apparently I should have searched first (I'm new to this, people!)  Anyway,  here are a couple of the responses that look promising:

Cauliflower-based

Almond meal based

This one is beautiful (scroll down). . . but I've never seen a potato shredding gadget like that.

Sausage Based

Beautiful Greens

Feast your eyes on this.