The temptation to return to the dietary roots of humankind by jumping on the Paleo Diet bandwagon is tempting for many, but is this enthusiasm for eating whole foods, grass-fed meats and fish, while eliminating dairy and grains really healthy or practical? The Paleo Diet is controversial and has been getting significant media coverage recently. When the 2014 U.S. News & World Report ranked the top diets in the United States, the Paleo Diet tied for last place with the restrictive, high-protein Dukan Diet due to its difficulty, cost, and lack of long-term research supporting its proposed health benefits. A panel of twenty-two medical and nutritional experts assessed common diets for nutritional value, ease, affordability, weight loss potential, and possible benefit for diabetes and cardiovascular disease. The experts concluded that there was a lack of evidence to support many of the common Paleo Diets claims. The only long-term study cited in the U.S. News and World Report was done with a relatively small sample size, and solely investigated the weight loss potential of the diet.
The theory behind the Paleo Diet is simple. Our genetic makeup has changed relatively little since the Stone Age and because archeological evidence suggests that our ancestors had less chronic disease, the assumption is that if we eat and exercise like them we too will be healthier. As a naturopathic physician who focuses on nutrition and preventive medicine I am obligated to investigate reliable evidence to explain the motivation for dietary changes, their potential health benefits, and the social and emotional impacts of restrictive diets and exercise programs. Nutritional knowledge, affordability, and access to food are all factors that influence our dietary choices. It is because of these potential barriers that “going Paleo” may not be feasible for everyone.
The motivation to change eating and exercise patterns can have a positive impact on health depending on how health goals are individually defined. The concepts of health and health consciousness can be as controversial as any treatment or diet aimed to support them. Mainstream and social media suggest that many women initiate the Paleo Diet to lose body fat. Endless online testimonials claiming that the diet can give you six pack abs or lead to significant weight loss while improving your health are encouraging women to make the drastic dietary switch. Some researchers are investigating the effects of the diet on chronic diseases, but an overwhelming number of studies are examining the weight loss potential of the diet alone. While many positive short-term effects have been shown, few studies have examined the long-term feasibility, nutritional implications, psychological impact, health benefits, and quality of life outcomes associated with the Paleo Diet.
The premise that the contemporary Paleo Diet is actually similar to the diets of our ancient ancestors is controversial and not significantly supported by current archaeological research. Dr. Christina Warinner Ph.D., Assistant Professor of Anthropology and researcher at the University of Oklahoma, explains the myths and benefits of ancient Paleolithic diets and the importance of anthropological and evolutionary medicine in her 2013 TED Talk: Debunking The Paleo Diet. Dr. Warinner and her colleagues use bone biochemistry techniques to harvest ancient DNA from fossilized bone and teeth, and in doing so they have extracted evidence of legumes, grains, starches, and pollen, suggesting that ancient peoples ate a much wider variety of foods than allowed in today’s Paleo Diet.
The predecessor to the current Paleo Diet was the Caveman Diet of the 1970s, which was originally marketed toward men with pictures of virile, muscular, half-dressed men exercising and eating plates of steak. The modern marketing scheme has had a facelift and now the Paleo Diet is aggressively marketed toward women, especially for weight loss. Esther Blum’s book Cave Women Don’t Get Fat: The Paleo Chic Diet for Rapid Results, Nell Stephenson’s book Paleoista: Gain Energy, Get Lean, and Feel Fabulous with the Diet You Were Born to Eat, or Emile Jarreau’s book The Ultimate Paleo Weight Loss Diet for Women are just three examples of books marketed to women promising to quickly make them skinny and further reinforcing the reductionist concept that skinny equals healthy.
A two year randomized control trial published in the European Journal of Clinical Nutrition in March of 2014 investigated the health benefits of the Paleo Diet compared to a diet following the Nordic Nutrition Recommendations – a whole food diet including grains and dairy – in obese, postmenopausal women. The study found that both diets had similarly significant decreases in triglyceride levels, body fat, and waist circumference. The Paleo Diet had a quicker effect on these measurements at six months, but by the end of two years the diets were comparable. The study, however, did not assess nutritional status or quality of life outcomes. While studies such as these suggest the diet produces health benefits, it is crucial to remember that this study looked at a relatively small sample of a specific group over a short period of time. A one-size-fits-all approach to dietary recommendations may pose unforeseen risks when applied generally.
Given the restrictive nature of this diet, it may not be an appropriate choice for everyone. Without proper nutritional education and access to food, the Paleo dieter may unknowingly be eating an imbalanced nutrient deficient diet. It can also be difficult to navigate the strict guidelines for a variety of socioeconomic reasons. Eating whole foods while avoiding processed foods and sugar are the cornerstones of any healthy diet. These dietary recommendations are where the Paleo Diet shines if executed properly.
However, following the diet correctly can be expensive and finding the fresh, non-packaged, whole foods required to sustain nutrition can be difficult for some working class people living in urban areas, where grocery stores are often inaccessible. A 2011 study in the journal Nutritional Research using data from the United States Department of Agriculture investigated the feasibility of the Paleo Diet for people with lower incomes. The study found that to follow the Paleo Diet an increase in income of 9.3% would be required to meet all of the daily nutrient requirements, which were set for a woman age 20-50 with low-level activity. The study found that the specific nutrient most depleted on an income-restricted Paleo Diet would be calcium, a mineral crucial for bone health. The study did not assess the effects of nutrient requirements for pregnancy or for a more active woman. Both conditions would require increased nutrient intake, which would be difficult on the income-restricted Paleo Diet. This study suggests that for some people, attempting this diet would not lead to health benefits, but could potentially cause health problems related to nutritional deficiency.
People with restricted income have significant rates of obesity and chronic disease. People with these conditions would potentially benefit greatly from a Paleolithic type diet, which recommends higher consumption of whole foods and decreased consumption of nutrient-poor, refined, and processed foods. The health experts examining the Paleo Diet for the U.S. News & World Report concluded that the Paleo Diet is difficult to follow and maintain long term. This is partly because avoiding all dairy and grains, which are easily accessible and rich sources of vitamins and minerals, is challenging. The restrictive nature of this diet is compounded by socioeconomic barriers which may prevent equal access to Paleo-friendly foods, making this diet a more feasible option for the more privileged eater.
The archaeological evidence suggests that our modern concept of ancient Paleolithic diets is limited and possibly inaccurate. However, the Paleo Diet is inspiring the incorporation of whole foods into the otherwise overly-processed American diet. This inclusion of healthier whole foods juxtaposed with the restrictive nature of this potentially nutritionally, emotionally, and monetarily costly diet makes recommending the Paleo Diet difficult without further research examining the long term safety, efficacy, and health benefits of the diet for a wide variety of people.
Dr. Chelsie Falk lives in Portland, Oregon. She teaches cooking and nutrition courses for the Master of Science in Nutrition program at the National College of Natural Medicine's School of Research and Graduate Studies. Her areas of expertise include nutrition, preventive medicine and evidence based holistic management of acute and chronic health concerns. Follow her blog Wishing You Health Wealth Happiness and Time to Enjoy Them All!
Aparicio, Michel, Philippe Chauveau, Christian Combe, and Denis Fouque." Changing Diet Paleolithic to Present Day: Progression or Regression?" Nephrology & Therapeutics 9 (4): 202-208.
Brage, S., M. Eriksson, C. Larsson, B. Lindahl, C. Mellberg, T. Olsson, M. Ryberg, and S. Sandberg. "Long-Term Effects of a Palaeolithic-Type Diet in Obese Postmenopausal Women." European Journal of Clinical Nutrition 68 (3): 350-357.
Centers for Disease Control and Prevention. “Obesity and Socioeconomic Status in Adults: United States, 2005-2008.” NCHS Data Brief. http://www.cdc.gov/nchs/data/databriefs/db50.htm (accessed May 8, 2014).
Drewnowski, Adam, Colin D Rehm, David Solet. “Disparities in Obesity Rates: Analysis by ZIP Code Area.” Social Science & Medicine 65 (12): 2458-2463. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709073/ (accessed May 8, 2014).
Fontes-Villalba, Maelan, Remko S. Kuipers, Matthew Metzgar, and Todd C. Rideout. "The Feasibility of a Paleolithic Diet for Low-Income Consumers." Nutrition Research 31 (6): 444-451.
Nordic Council of Ministers. "Nordic Nutrition Recommendations - Focus on Quality and the Whole Diet." Nordic Nutritional Recommendations. https://www.norden.org/en/publications/publikationer/nord-2013-009/fact-sheet-nordic-nutrition-recommendations-2012 (accessed April 17, 2014).
U.S. News & World Report. "Best Diets 2014." US News Health & Wellness. http://health.usnews.com/best-diet (accessed April 17, 2014).
Warinner, Christina. "Debunking the Paleo Diet: Christina Warinner at TEDxOU." YouTube. https://www.youtube.com/watch?v=BMOjVYgYaG8 (accessed April 17, 2014).
World Health Organization. “Part Two. The Urgent Need for Action; Chapter Two. Chronic Diseases and Poverty.” Chronic Disease and Health Promotion. http://www.who.int/chp/chronic_disease_report/part2_ch2/en/ (accessed May 8, 2014).
*Editor's Note: This article first appeared in the FLESH issue of Render: Feminist Food and Culture Quarterly. It was originally printed without the author's list of research sources. They have been added here. Our sincerest apologies to Dr. Falk for this oversight on our part.