What is paleo?

[Jerry Adams]

or, no refined foods like sugar, white flour, white rice, potatoes

[George F]

Thats what I'm saying. People lived in different places and ate different things depending on what the local landscape provided. Some groups would have had healthy diets, others less so. The big health difference would be the manipulation and additives we do today.

[Jeremy and Angela]

How about lots of processed carbs, lots of fatty meats, cigars and wine????
http://en.wikipedia.org/wiki/Roseto_effect

From Wiki:
They smoked unfiltered stogies, drank wine "with seeming abandon" in lieu of milk and soft drinks, skipped the Mediterranean diet in favor of meatballs and sausages fried in lard with hard and soft cheeses.

Hmm… sounds looks almost like Atkins.

-J

edit: ok, I'm partially kidding there. Here's what one of the residents recalled as the dinner menu: "Mondays," recalled 66-year-old Angie Martocci, "almost everyone in town ate spezzati (a spinach and egg soup). Tuesdays, it was spaghetti and gravy (tomato sauce). Wednesdays was roast chicken and potatoes. Thursdays, spaghetti again. Fish on Fridays, of course. Veal and peppers on Saturdays; and antipasto, meatballs and spaghetti on Sundays."

[Ralph Burgess]

…is that reliable data are extremely hard to obtain. In general, you are considering long term health effects. How can you practically carry out a controlled scientific study of the long term effects of a specific bulk dietary change in humans (excluding highly specific things like vitamin deficiency, which can be studied like a drug)? The only well controlled studies that you have are mouse models for a few months or maybe a few years. Then you have natural human populations, separated either by culture or time, with major differences in diet — but inevitably, many other uncontrolled differences too. That's why there's so much uncertainty in scientific diet recommendations. There's very little reliable data, and in general just no way to get it. That creates a void for fads and quackery. And things like paleo – which is a nice plausible story, and perhaps deserves a little more credit than the "fad" label – but ultimately has no better evidence base than any other aspect of nutritional science, and no conceivable way to obtain that evidence.

Really, the "everything in moderation" advice is not just a cop-out. It's a rational response when nobody knows.

[Paul Magnanti]

"Hmm… sounds looks almost like Atkins."

Would be except….

The veal and peppers probably had some delicious, cheap and crusty bread to go with it along with a pasta course (or macaroni as it was called by that generation)

The soup? Immigrants and their children had bread with it. Add some bulk to a simple (and delicious) meal.

The fish on Friday? Probably had linguine on the side.

Of course regular veal was a luxury unheard of where these people came from… The abundance of America added more meat to the diet.

And so on.

Now, pass the sausage and peppers, crusty bread and wine! It is good for the heart apparently. ;)

[jimmer ultralight]

Pmags,

One common thresd of the Italian diet you dedcribe and the French, who eat similar high fat plenty of carbs diet is the regular consumption of wine…Flavinoids are good for you…

[Aubrey W. Bogard]

I find it interesting that people tend to embrace or dismiss nutrition much like they do religion.

One thing I believe is that the medical community and the general public are misinformed on nutrition for optimal health. One can label a nutrition philosophy as fad or pseudoscience, but I would argue that the "conventional wisdom" of low-fat and thus high-carb diets as advocated for years now for health are now proving to be not beneficial.

I do also believe that "Paleo" and other nutrition trends are being over-commercialized and that some are pushing them for financial gain. That does not, however, mean that they do not offer benefits.

[David Ure]

"high-carb diets as advocated for years now for health are now proving to be not beneficial."

To whom? The Marathoner? The Long distance Thru-Hiker? The Bodybuilder? The Fashion Model? Or the general population that can't help themselves from consuming huge quantities of fast food and sugar laden soft drinks. Those who haven't exercised in years. When 'those' people try Paleo it is a Godsend. I wonder why?

[Jerry Adams]

"conventional wisdom" of low-fat and thus high-carb diets as advocated for years now for health are now proving to be not beneficial"

yeah, that's funny how the conventional wisdom has led us all astray

and the subsidization of corn and soy has led to cheap sugar that has been put in everything that is also part of the problem

Even if paleo is "a fad", if people are eating better, it's a good thing

Maybe it would be better to say half your diet should be fruits and vegetables, etc. but that's not as catchy as "paleo" so won't be as effective?

[Ralph Burgess]

"Even if paleo is a fad, if people are eating better, it's a good thing. Maybe it would be better to say half your diet should be fruits and vegetables, etc. but that's not as catchy as "paleo" so won't be as effective?"

Hmm. It doesn't strike me that "eat fruit and vegetables" is hard to understand. If people choose not to, that's up to them. I'm struggling to understand the merits of somehow tricking them into doing so by selling the idea through a pseudoscientific fad dietary philosophy.

I think a sensible approach to diet is quite simple, even if the ultimate answers are not: any nutritional claim made without citing compelling evidence – by which I don't mean anecdotes or just-so stories, I mean large, carefully constructed, controlled scientific studies – is worthless.

To the extent that certain aspects of the paleo diet are well supported by evidence (the main one seems to be – not eating large amounts of sugar and other high-GI processed carbs), then this is just part of the body of mainstream scientific knowledge about diet. To the extent that other aspects of paleo are based on a fabricated just-so story "philosophy", unsupported by evidence, then it's a pseudoscientific fad.

As for the problems with subsidies and evil corporations…. well, I don't know how much that's responsible for poor nutritional habits, but in a parallel reference to the problems with "Big Pharma" and "alternative medicine", Ben Goldacre has pointed out "just because pharma is shit doesn't mean magic beans cure cancer".

[Robert Blean]

One thing I believe is that the medical community and the general public are misinformed on nutrition for optimal health. One can label a nutrition philosophy as fad or pseudoscience, but I would argue that the "conventional wisdom" of low-fat and thus high-carb diets as advocated for years now for health are now proving to be not beneficial.

I do not agree that the medical community is misinformed and advocating a low-fat diet. As one example the Harvard School of Public health book Eat, Drink, and Be Healthy: the Harvard Medical School Guide to Healthy Eating (copyright 2001) has "Plant Oils" in the base food layer of its "New Healthy Eating Pyramid". Chapter 4 is Entitled "Surprising News About Fat", with the first sub-section "Some Fats Are Good for You". It says, in bold print, some fats are good for you, and it is important to include these good fats in your diet. It goes on about how a low fat diet is a bad idea — that good fats are important and have genuine health benefits.

By the way, the term "high carb" is far too inclusive. Modern dietary advice is to eat a sensible amount of whole grains and legumes, but to avoid most other carbohydrates. I would not call that a "high carb" diet, except when compared to diets that proscribe even nutritious carbohydrates. (I have to wonder where such diets get the vitamins, minerals, and other nutrition that are normally provided by whole grains and legumes.)

–MV

[Aubrey W. Bogard]

Is this "Pseudoscience"? If so, please elaborate. If you are opposed to the nutritional recommendations of Dr. Cordain, Robb Wolf, et al, please explain why (e.g., do you believe that grains, legumes and other "non-Paleo" foods are optimal for health and why)? What are your qualifications?

From Dr. Cordain's site:
http://thepaleodiet.com/research/

Science and Low Carb / Paleo
http://www.dietdoctor.com/science

What if It's All Been a Big Fat Lie?
http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

World Renown Heart Surgeon Speaks Out On What Really Causes Heart Disease
http://preventdisease.com/news/12/030112_World-Renown-Heart-Surgeon-Speaks-Out-On-What-Really-Causes-Heart-Disease.shtml

The #1 Cause of Obesity: Insulin
http://www.dietdoctor.com/the-1-cause-of-obesity-insulin

[Robert Blean]

This discussion finally got me to take a quick look at the paleo diet. As far as I can see, it is nothing special. It contains a mixture of sound advice (that agrees with pretty much all modern dietary advice) together with some amount of pseudo-scientific mumbo-jumbo. It seems to me that some of the paleo diet rationale is setting up a straw man to hit. For example, I found this on on a paleo site just now: "… indicate it is our modern diet, full of refined foods, trans fats and sugar, that is at the root of degenerative diseases such as …" Duh! I know of no responsible modern dietary approach that does not agree with avoiding those things.

The list of things the paleo diet says to include (fruits, vegetables, lean meats, seafood, nuts & seeds, healthy fats) is a list that all modern dietary advice agrees with including — nothing special about paleo here.

Some of the things the paleo diet excludes (processed food & sugars, starches) are things that all modern dietary advice also says to exclude — nothing special about paleo here either. (As far as I can tell "starches" means high GI, often refined, starches as well as such things as white potatoes.)

It appears to me that the controversy comes from the rest of the paleo exclusion list (dairy, grains, legumes, alcohol). The fact is that paleolithic man was an omnivore whose diet depended on whatever was locally available. One location or another of paleolithic man had a diet that included most of the things from that exclusion list.

• dairy — paleolithic man probably did not have much dairy in the diet. Current best advice seems to be for adults to be careful of dairy (largely because of saturated fat and calorie considerations), so semi-agreement here.
• grains — the evidence is that paleolithic man did in fact opportunistically eat grains, contrary to what the paleo diet folks say. Whole grains provide important nutritional elements; I do not see where the paleo diet gets those if it omits all grains.
• legumes — the evidence is that paleolithic man did in fact opportunistically eat legumes, contrary to what the paleo diet folks say. Legumes provide important nutritional elements; I do not see where the paleo diet gets those if it omits all legumes.
• alcohol — give me a break! Man has been drinking alcohol since he first discovered fermented fruit! I cannot believe that some form of alcohol was not part of at least religious ceremonies for paleolithic man.

–MV

[Ralph Burgess]

"Is this "Pseudoscience"? If so, please elaborate….."

Aubrey, I looked at your first link,
http://thepaleodiet.com/research/

I'm always happy to have a look at some research. I'm not a nutritionist, but I have a background in molecular biology – I know how to read a scientific paper. But pretty much anyone with basic scientific literacy can absorb those, there's nothing especially difficult or technical. Here's a synposis of the first 9 papers cited here as evidence in support of the paleo diet:

1. Effect of paleo diet on unhealthy people with metabolic syndrome (overweight, high blood pressure, high blood sugar, etc.) Experimental design seems ok, but small sample size (n=18), VERY short duration (2 weeks). Paleo diet had some positive effects in reducing high blood pressure and improving cholesterol.

2. Hidden behind paywall.

3. This is a poorly designed uncontrolled study… which concludes that the paleo diet has BAD effects on cholesterol and other lipids in healthy people.

4. Specific to obese postmenopausal women. It has reasonable controls, decent size and duration of study (2 years).
Paleo diet led to improved triglyceride levels. Weight loss seen after 6 months was not sustained at 2 years.

5. This is a joke. It does not bear even a passing resemblance to science.

6. This is the protocol for a PLANNED study. There are no results.

7. I don't know the significance of Net Acid Excretion.

8. Obese postmenopausal women again. AWFUL design: n=10, only 5 weeks long, NO CONTROLS. Meaningless.

9. Surely this is a joke? The object of the study was to ASK the participants how they felt about the diet. They didn't seem to like it, by the way.

Summary:

5 and 9 are pseudoscience. Many of the others are pretty bad science. Really, the burden of proof is on those advocating paleo to demonstrate the benefits. If this is the best that they can come up with, I feel far more confident in saying that it's utterly unsupported by evidence.

[Robert Blean]

Really, the burden of proof is on those advocating paleo to demonstrate the benefits.

I agree. To be more specific, as I noted in my previous posts, much of the paleo diet is nothing special or contentious — it is indistinguishable from modern, scientifically sound, dietary advice. The thing I need to see paleo advocates prove is the wisdom of totally excluding dairy, grains, and legumes.

• If the item is harmful, show me the evidence
• Show me how the paleo diet provides for the vitamins, minerals, and other dietary benefits that are lost by excluding those items.

Simply showing benefits from switching from an agreed bad diet to the paleo diet is not at all convincing — there is so much overlap with generally-agreed good dietary advice that you need to show the benefit is specifically due to excluding dairy, grains and legumes.

–MV

[Roger Caffin]

One should perhaps consider that a paleo diet might be more healthy than the heap of highly processed, fat-rich, salt-rich and sugar-rich (but value-free) food so many people eat. The crap you see piled into supermarket trolleys sometimes …

Cheers

[Stuart R]

"high-carb diets as advocated for years now for health are now proving to be not beneficial."

Quite the reverse, in fact. It is refined carbs that are proving to be harmful.

During and after WWII food was rationed in UK and
"People were encouraged to eat protein, carbohydrates, pulses and fruit and vegetables. Babies, pregnant women and the sick were allocated additional nutrients such as milk, orange juice and cod liver oil. Luxuries, including alcohol and cigarettes, weren't officially rationed but were limited and expensive as factories focused on the war effort."

and "Despite the stresses of wartime, the health of the poor improved."

(ref http://www.bbc.co.uk/history/topics/rationing_in_ww2)

Also
"Rationing meant people ate a balanced diet, with extra vegetables to fill up.
Some of the more unhealthy foods, such as white bread and sugar, were removed or much reduced in the diet, making everyone healthier.
It is generally accepted that food rationing improved the nation’s health, resulting in a better diet with more essential vitamins. The Ministry of Food reported that people had lost weight but were generally healthier for it. They were eating a more balanced diet and drinking less."

(ref http://cookit.e2bn.org/historycookbook/20-98-world-war-2-Health-facts.html)

[Robert Blean]

One should perhaps consider that a paleo diet might be more healthy than the heap of highly processed, fat-rich, salt-rich and sugar-rich (but value-free) food so many people eat. The crap you see piled into supermarket trolleys sometimes …

Faint praise.

Since you are talking about changing from unhealthy to a more healthy diet, how about comparing the Paleo diet to something without the controversial exclusions, such as a Mediterranean or DASH diet?

[Aubrey W. Bogard]

Thanks for taking things more seriously folks. I don't pretend to have all of this figured out. I'm much less interested in what early bipeds did or didn't eat than in what I should or shouldn't eat. Unfortunately, by the time the truth is proven to convince the entire scientific/medical/government community, I'll have decades of bad or not-so-bad nutrition through my aging earthly body.

[David Ure]

"One should perhaps consider that a paleo diet might be more healthy than the heap of highly processed, fat-rich, salt-rich and sugar-rich (but value-free) food so many people eat."

Well said.

[Robert Blean]

Unfortunately, by the time the truth is proven to convince the entire scientific/medical/government community, I'll have decades of bad or not-so-bad nutrition through my aging earthly body.

I think that is too pessimistic. My take is that there is pretty widespread medical agreement these days on what makes a good diet. There is some variation in a few details, partly due to different dietary goals (e.g. overall health, heart health, weight loss, etc), but the core is pretty consistent. For some examples check out the information from the Mayo Clinic, the Harvard Public Health folks, and the Mediterranean (and similar) type diets. Unfortunately that consensus is not what the "typical American" eats.

–MV

[Alexander S]

Food before domesticated carbs and refined sugars.

[Roger Caffin]

Hi David U

For that one you get brownie points and forgiveness for many sins.

Do you have a hi-res source? Just wondering.

Cheers

[David Ure]

Lol. I will see what I can do. Needing those brownie points. Speaking of brownies, I understand these are NOT permitted under Paleo.

[Aubrey W. Bogard]

That's SAD but true Dave U (Standard American Diet = "SAD").

There are lots of "Paleo" recipes for baked things like brownies, but they all taste the same to me, since they are all made from coconut flour or such (i.e., not so good).

[Author]

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