It now seems that barely a day goes by without some individual or group attacking the Paleo Diet. The reason for this is certainly up for debate but because the diet eliminates grains, legumes and dairy, it should not be surprising that it is going to come under fire from companies and corporations that stand to lose financially the more popular and successful the Paleo Diet becomes. One might not expect, however, for organizations that, in their own words, “use the most up to date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices,” to do the same.
I’m British, and my father routinely sends me articles from the British media. Last week, he sent me a short piece from the Daily Mail newspaper that reported on the British Dietetic Association (BDA) of the Top 5 “Celebrity Diets” to avoid in 2015. A tagline contained in the graphic states, “Being famous does not make someone an expert on diet.” It appears the same can be said for being part of a large nutritional organization. Based upon “telephone calls and other contributing factors,” they ranked the Paleo Diet second in this list, being surpassed only by the Urine Therapy Diet! While there are indeed many celebrities (and, by the way, top professional athletes) that have adopted the Paleo Diet, calling it a “celebrity diet” clearly attempts to mislead the reader that the diet has no research and is simply a “dodgy fad diet.” After outlining the major tenants of the diet fairly accurately, they, then, provide the BDA Verdict:
“Jurassic fad! A diet with fewer processed foods, less sugar and salt is actually a good idea, but unless for medical reason, there is absolutely no need to cut any food group out of your diet. In fact, by cutting out dairy completely from the diet, without very careful substitution, you could be in danger of compromising your bone health because of a lack of calcium. An unbalanced, time consuming, socially isolating diet, which this could easily be, is a sure-fire way to develop nutrient deficiencies, which can compromise health and your relationship with food.”
So, in the very first statement, the BDA does actually recognize that the Paleo Diet is beneficial by eliminating the processed foods typically found in most Western diets. However, they quickly move into the misconception that by removing certain foods from the diet (i.e., grains, legumes and dairy), “without very careful substitution,” one will likely suffer nutrient deficiencies.
Let us dwell on this statement for a moment.
This is a classic position from those that are against the Paleo Diet, and yet, it is so easy to demonstrate how wrong this thinking is. Certainly, for the general public that perhaps has little nutritional knowledge, the thought of completely removing a number of elements of what has been thrown at them as a must staple for so many years, may seem less than prudent. However, it is not difficult to run a nutritional analysis on any true Paleo meal that have these elements removed and realize that not only are there no deficiencies, but the nutrient density for the 13 nutrients most lacking in the US diet, compared to the USDA Food Plate (formerly the Pyramid) actually improves, including calcium! And, there is absolutely no need for careful substitution, simply following the Paleo template that nature has served will provide this nutritional benefit. In spite of this, one should be aware of the hypocrisy of the BDA on this issue. Both the BDA and The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) endorse vegan diets, which eliminate dairy, meat and fish. Accordingly, the BDA is simply hypocritical in their criticism of the Paleo Diet for eliminating dairy.
As I have previously stated in other writings, there are now hundreds of thousands of physicians, naturopaths, nutritionists, chiropractors, conditioning coaches, and other healthcare professionals who advocate for the Paleo Diet and rely on results for their businesses to be successful. As a consequence, millions of people have benefited from adopting this way of eating and it astounds me that the BDA would ignore this reality and instead portray the diet as a “fad celebrity” diet that will be short lived.
However, of even greater concern, is that an organization that claims to use the most up-to-date scientific research to form their positions, appears completely unaware that there are now 15 human experimental studies on the Paleolithic Diet that demonstrate a benefit to adopting this dietary template.1,2,3,4,5,6,7,8,9,10,11,12,13,14,15 In all clinical trials to date, the Paleo Diet outperforms the Food Plate, the Mediterranean Diet, and diabetic diets for a variety of clinical endpoints including weight loss and cardiovascular disease symptoms. There are also many more peer reviewed scientific papers that lend support to the Paleolithic Diet template with which the BDA might benefit from becoming a little more familiar when advising and educating their base.
Here are a few important points that can be found within the published research referenced above that I’m guessing would be unknown to the BDA. Simply put, humans have no dietary requirement. In fact, whole grains are one of the worst food groups in terms of their nutrient density for the 13 nutrients most lacking in the US diet and are poor sources of fiber compared to fresh fruits and vegetables. Around 5% of the UK (~3.25 million people) and US (~16 million people) populations have either celiac disease or gluten intolerance. Gluten containing grains increase intestinal permeability via the upregulation of zonulin (a protein that modulates the permeability of tight junctions between cells of the digestive tract), and this increased permeability promotes chronic low level inflammation, a universal characteristic underlying CVD, cancer and autoimmunity. Whole grains also contain phytate and other antinutrients, which impair divalent ion absorption. Further, wheat contains wheat germ agglutinin (WGA), which likely enters the systemic circulation (not in plasma but bound to formed elements) and can interact with the immune system. And 65% of the world’s people are lactose intolerant and have no ill effects from eliminating dairy from their diet.
Critics of the Paleo Diet need to understand a very important issue. Unlike the vast majority of diets out there, no one person has formulated this diet. It is based on the concept of evolutionary dietary selective pressure and all of the published research on the diet has attempted to examine the concept that following a diet that humans evolved with over a long period of time, may provide an optimal dietary template. The vast majority of the published data and the clinical findings, to date, support this idea. Any researcher I know in this field of evolutionary nutrition is more than open to being shown research to the contrary; but, respectfully, would request that the data shows that, not someone’s opinion.
I recently wrote a response to an article critical of the Paleo Diet written by Professor (). I attempted to engage Professor Finkelstein to support the points in his article and counter my critique that used the published data. However, his simply stated that “to suggest that the science behind the diet is incontrovertible, or that questioning the Paleo prescription is an affront to logic, is ludicrous.” So here’s a really good example of my point. An initial critique of the Paleo Diet with no scientific support is rebutted with the published data and the comeback is to state that the “Paleo Police” are unhappy about “their” diet being questioned. For those of us involved in the research and clinical trenches, that could not be further from the truth; we would just like the counter arguments to have some published data supporting them or at least some substance with sound logic so that further research can be conducted based upon those arguments to help determine what may be an optimal diet for human health and performance.
Dr. Loren Cordain, the very founder of the modern Paleo Diet movement, demonstrated an example of being open minded when he changed his position on dietary saturated fats. Upon re-examining his initial work through the lens of the evolutionary template, he realized a different conclusion. And there is no evidence that that wouldn’t happen again if an argument or data showed a flaw in an original position or research finding. In his response to my critique of his article, Dr. Finkelstein, a professor of management, goes on to further state, “The truth is, it’s hard to know what the best solution is in most areas of life and in companies. But having one best way – one only way – is dangerous whether practiced by governments, academics, or corporate leaders. And yes, the Paleo Police are no different.” The question begs, however, is this logic, which may work well regarding strategic leadership and management, appropriate for nutritional science? As researchers in the Paleolithic nutrition field, we are examining a potential optimal dietary template and if the research continues to support this template, when it comes to nutrition, there actually may be one best way or perhaps some slight variations based upon one best template. Time will obviously tell, however; in the meantime, it only makes sense to make formulations based upon the current data of published research.
So, in closing, I would like to throw out a challenge to the BDA. In addition to obviously becoming familiar with the published research on Paleolithic nutrition, I challenge them to choose and analyze 21 meals (7 breakfasts, 7 lunches and 7 dinners) from Dr. Cordain’s The Paleo Diet Cookbook. Then, having done so, defend their position that the Paleo Diet is “an unbalanced… sure-fire way to develop nutrient deficiencies, which can compromise health.” I am very confident that it will be an impossible task.
Dr. Mark J. Smith
Dr. Mark J. Smith graduated from Loughborough University of Technology, England, with a Bachelor of Science in PE & Sports Science and then obtained his teaching certificate in PE & Mathematics. As a top-level rugby player, he then moved to the United States and played for the Boston Rugby Club while searching the American college system for an opportunity to commence his Master’s degree. That search led him to Colorado State University where Dr. Smith completed his Masters degree in Exercise and Sport Science, with a specialization in Exercise Physiology. He continued his studies in the Department of Physiology, where he obtained his Doctorate. His research focused on the prevention of atherosclerosis (the build up of plaque in arteries that leads to cardiovascular disease); in particular, using low-dose aspirin and antioxidant supplementation. Read more…
Bisht B1, Darling WG, Grossmann RE, Shivapour ET, Lutgendorf SK, Snetselaar LG, Hall MJ, Zimmerman MB, Wahls TL. A multimodal intervention for patients with secondary progressive multiple sclerosis: Feasibility and effect on fatigue. J Altern Complement Med. 2014 Jan 29. [Epub ahead of print].
Boers I, Muskiet FA, Berkelaar E, Schur E, Penders R, Hoenderdos K, Wichers HJ, Jong MC. Favourable effects of consuming a Palaeolithic-type die ton characteristics of the metabolic syndrom. A randomized controlled pilot-study. Eur J Clin Nutr. 2014, in press.
Fontes-Villalba M, Jönsson T, Granfeldt Y, Frassetto LA, Sundquist J, Sundquist K, Carrera-Bastos P, Fika-Hernándo M, Picazo Ó, Lindeberg S. A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study–Alimentation and Diabetes in Lanzarote–ADILAN. Trials. 2014 Jan 2;15:2. doi: 10.1186/1745-6215-15-2.
 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.
Frassetto LA, Shi L, Schloetter M, Sebastian A, Remer T. Established dietary estimates of net acid production do not predict measured net acid excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets. Eur J Clin Nutr. 2013 Sep;67(9):899-903.
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.
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.
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.
Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC.Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013 Jul 29;12:105. doi: 10.1186/1475-2891-12-105.
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.
Mellberg C, Sandberg S, Ryberg M, Eriksson M, Brage S, Larsson C, Olsson T, Lindahl B. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr. 2014 Mar;68(3):350-7.
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.
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.
Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, Hauksson J, Olsson T. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013 Jul;274(1):67-76.
Talreja D, Buchanan H, Talreja R, Heiby L, Thomas B, Wetmore J, Pourfarzib R, Winegar D. Impact of a Paleolithic diet on modifiable CV risk factors. Journal of Clinical Lipidology, Volume 8, Issue3, Page 341, May 2014.