Pondering Paleo: channeling your inner caveperson.

The Paleo Solution. Everyday Practical Paleo. Paleo Comfort Foods.

Paleo Slow Cooking. The Paleo Diet for Athletes. Paleo Desserts.

Dozens of books tout the wonders of the “original human

diet.” But how certain are we that there was an original diet? And

if there was, exactly what did it include? More importantly: Did

cavewomen and cavemen really eat dessert?

Q: Is the Paleo diet our natural diet?

A: Some people claim that the cause of our so-called “diseases

of civilization” that are diet related, such as diabetes or high

blood pressure, is that our diets have changed radically since the time

that human beings evolved hundreds of thousands of years ago. If we

could go back to the way we were eating before, then we would be much

healthier, they say.

It sounds pretty reasonable that if human beings evolved living a

certain way and eating certain foods, and if we suddenly and rapidly

change from those circumstances, there’s a risk of eating foods

that are not necessarily the healthiest for us.

This idea is supported by looking at modern foraging peoples, who

don’t eat Western diets and who certainly don’t seem to suffer

as much from conditions like diabetes or hypertension. So,

superficially, a Paleo diet makes a lot of sense.

Q: But not when you look deeper?

A: Right. The problem is that it’s really a fantasy to try to

construct what early humans were eating.

First of all, what do you mean by early humans? The word

“Paleo” doesn’t mean much from a scientific perspective.

Are you talking about the ancestors of the genus Homo, such as

Australopithecus? Are you talking about other members of the genus Homo,

like Homo erectus? Or do you mean humans in Africa before they migrated

out of that continent? Or is it after they left Africa? Or are we

talking about people who were living the way that contemporary

hunter-gatherers do–people who forage and hunt but don’t use


Q: What difference would that make?

A: Because so far as we can understand, the diets of all these

different early humans were really different. What people were eating

10,000 years ago at the dawn of agriculture, for instance, was doubtless

not what people were eating 100,000 years before that.

Q: Didn’t their diets also depend on where they were living?

A: Yes. Picking a specific place or time to say, “Oh yes, we

should be eating like those people,” doesn’t make sense. Is

seafood okay on a Paleo diet? I suppose it depends on whether you think

Paleo people were living on the northwest coast of North America, or

whether you think they were in central Africa, in which case I

don’t think there were a lot of shrimp available there.


Take the ancestors of the Inuit First Americans living in the

Arctic. They get a lot of attention from Paleo enthusiasts because they

relied on meat and seafood for food since so few edible plants grow up

there. But the fact that nothing grows there just means that people can

adapt to living without a lot of plant food. It doesn’t mean that

they should live that way if they have a choice.

Q: The Paleo diet seems to assume that we’ve stopped evolving.

Have we?

A: No. It’s clear that we are not the same as our Paleo

ancestors. We’ve changed radically in some ways, like our

resistance to diseases such as malaria, and not so radically in others,

like the structure of our spines.

We didn’t evolve, evolve, evolve to a certain point and then

go, “Phew! Done with that! We’re now perfectly adapted to our

environment, and we can eat the same diet from now on. Then dang!

Somebody developed agriculture, which was a mistake, and now we’re

in trouble.”

There just wasn’t an ideal time and ideal diet from which we

are now deviating.

Q: What’s an example of how humans continue to change?

A: People say that humans are the only mammals that continue to

drink milk past weaning, which is absolutely true. Some of them then

conclude that it’s unnatural for mammals to do this, and that

it’s therefore much healthier for us to not consume dairy foods.

Well, the fact is that a great number of human beings have evolved

an ability to keep digesting the lactose in milk throughout their

lifetimes. That change happened just over the last 5,000 to 7,000 years,

which is really quick from the standpoint of evolutionary change.

So saying that we should eat only what our ancestors ate before

this genetic change happened makes as much sense as saying that we

should eat only what our mammalian ancestors ate before they came down

from the trees and started living on the ground.

That’s not to say that there aren’t some people who have

trouble digesting milk, but that’s different from saying that all

people, all the time, would be better off without it.

Q: The Paleo diet shuns grains. Did early humans ever eat them?

A: The absence of starchy foods on a Paleo diet is really

interesting because it’s based on a fantasy of what our ancestors

ate. Over the last 10 years, after Paleo diets started to become

popular, scientists have discovered traces of seeds and grains on the

teeth of fossilized early humans. They’ve also found remnants of

grains on stone cooking tools.


It’s looking like some early humans not only ate grain, but

they also were grinding it into a crude flour and cooking that into a

primitive form of pita bread.

There’s also good evidence now for a continued evolution in

amylase genes. Amylase is an enzyme in our saliva and our small

intestine that breaks down starches so we can absorb them. If you look

at populations today that eat a lot of starch, they’ve evolved more

copies of amylase genes than populations that don’t eat much

starch. Extra copies make the digestion of starchy foods even easier.

The moral is that you’re really on shaky ground every time you

try to set up a “this is how it was and that’s how we should

be” standard. We’re always revising our ideas of what early

humans were like, and that is a worthwhile endeavor. But we

shouldn’t do it to find what we’re supposed to emulate.

Q: We’re now learning that our microbiome can affect our

health. Has our microbiome changed?

A: We are quite different from our ancestors in our microbiome, the

billions of microorganisms that reside on and in us that we didn’t

know existed 25 years ago when the Paleo movement began.

Think of yourself as a coat hanger of humanity on which are draped

this huge number of microbial cells. The microbiome is a part of who we

are and it’s essential for our normal functioning. But it differs

from person to person, from place to place, and probably over time.

We don’t know how much or in what ways our microbiome has

changed from that of our ancestors, although we do have a hint that

there have been enormous changes. Some of this probably has to do with

changes in the atmosphere or diet, not evolution. It’s more

evidence that we are not who our ancestors were.

Q: Does Paleo food exist today?

A: Not really. Even if you wanted to try to eat what people were

eating a long time ago, the majority of those foods are simply not

available. Early humans were not eating plants or animals that resembled

very closely the plants or animals that we eat today.

Human beings have been influencing the foods they eat ever since

there were people. For example, the ancestors of apples were nasty,

horrible, little tiny bitter things that, really, why would one eat


The ancestor of corn that was used by peoples in the Americas for

quite a long time was called teosinte. It looked like the head of a

grass seed, which it basically was, and nothing like what people eat


The meat in the supermarket, even grass-fed beef, has also been

modified from its ancestors by breeding. People underestimate the degree

to which human beings have affected everything in their environment.

Q: Don’t some people say that they feel healthier eating a

Paleo diet?

A: I’m not arguing with people who say, “I started eating

this way and I feel great.” More power to you. But it’s also

perfectly possible that people who eat in a variety of other ways, as

long as they’re not subsisting on Coke and Cheetos, would be

healthy as well.

The way to find that out is not to look more closely at what early

people were supposedly eating. It’s to gather evidence about who we

are now.

Q: S. Boyd Eaton, the Emory University professor who co-wrote The

Paleolithic Prescription in 1988, which helped start the Paleo movement,

says that he eats a “soft version” of the Paleolithic diet,

which includes whole grains, low-fat dairy foods, and wine. Those are

foods that are usually forbidden on a strict Paleo diet.

A: That’s exactly the point. You can call the diet Paleo, but

let’s take as an inspiration what we think was a healthy way to

live and then figure out which aspects of the diet make the most sense,

relying on science, not on an idealized version of our earlier selves,

for the answers.

Marlene Zuk is professor of ecology, evolution, and behavior at the

University of Minnesota and author of the new book Paleofantasy: What

Evolution Really Tells Us about Sex, Diet, and How We Live (W. W. Norton

& Company). Zuk spoke to Nutrition Action’s David Schardt by

phone from St. Paul.

Paleo in Comparison

“If it wasn’t on a caveman’s menu, it shouldn’t

be on yours.” That’s the basic premise of a Paleo diet.

Translation: plenty of meat, poultry, eggs, seafood, vegetables,

fruit, honey, and nuts, but no grains (breads, cereals, pasta, rice,

oatmeal, cookies, pastries, cakes, muffins, etc.), beans, dairy foods,

refined sugars, caffeine, or alcohol.

What does a Paleo diet look like? Most books give no specifics

(like “eat 20 ounces of meat, poultry, or seafood and 12 cups of

vegetables and fruit a day”). But we did find this sample

day’s worth of food (2,200 calories)for a young woman in The Paleo

Solution, by Robb Wolf (Victory Bell Publishing, 2010), one of the

best-selling Paleo books on amazon.com:


Broiled salmon (12 oz.)

Cantaloupe (1 3/4 cups)


Broiled lean pork loin (3 oz.)

Salad–lettuce (1/2 cups), carrots (1/2 cup), cucumbers (3/4 cup),

tomatoes (1 1/3 cups), walnuts (5 halves), lemon juice (2 Tbs.)


Lean sirloin tip roast (8 oz.)

Steamed broccoli (3 cups)

Salad–mixed greens (3 cups), tomato (3/4 cup), avocado (1/2 cup),

almonds (35), onions (1/4 cup), lemon juice (2 Tbs.)

Strawberries (1 cup) for dessert


Orange (1/2)

Carrots (1/4 cup)

Celery (1 cup)

How healthy is the Paleo diet (assuming this sample is typical)? On

the plus side, it’s rich in fruits, vegetables, fiber, vitamins,

potassium, and magnesium. It also has no refined sugar or white flour

and it’s low in sodium (unless you pour on the sea salt).

But the diet has some drawbacks. Red meat–and especially processed

meats (like sausage, ham, and bacon)–may raise the risk of colorectal

cancer. The red meat (and the coconut oil and butter in some books)

could be high in saturated fat. (Paleo books recommend lean meats, but

the meats in their recipes often aren’t.) The diet is also high in

cholesterol and low in calcium and vitamin D.

A safer bet: the diets used in the OmniHeart study, which lower

blood pressure, LDL (“bad”) cholesterol, and triglycerides.

They’re similar to the Paleo diet in that they have far more fruits

and vegetables and far fewer grains and sweets than the average American

diet. But the OmniHeart diets limit red meats, saturated fat, and

cholesterol. (See Nutrition Action, Oct. 2009, cover story.)


Food (serving size) Paleo Diet OmniHeart

Meat, poultry, fish (1/4 lb.) 8 4

Vegetables, fruit (1/2 cup) 27 9

Nuts (1/4 cup) 1 1/2 1

Grains (1/2 cup or 1 slice bread) 0 4

Low-fat dairy (1 cup milk) 0 2

Oil, mayo (1 Tbs.) 0 4

Sweets (1 small cookie) 0 2

* We converted Paleo servings into OmniHeart servings for


Source: JAMA 294; 2455, 2005.

Shed Pounds on Paleo? No Evidence

Earlier this year, US News & World Report asked a panel of 22

diet experts to rank 28 popular diets. The criteria: Were they effective

for short-term or long-term weight reduction? Were they easy to follow?

Were they safe and nutritionally balanced?

Topping the list was the DASH diet. (A variation of DASH called

OmniHeart is the diet recommended by most health experts. See Nutrition

Action, Oct. 2009, cover story.)

Dead last? The Paleo diet, which the panel noted was supported by

studies that were “few, small, and short.”

Loren Cordain, an exercise physiologist at Colorado State

University and author of The Paleo Answer: 7 Days to Lose Weight, Feel

Great, Stay Young, disputed the panel’s conclusions.

“Five studies, including four since 2007, have tested

ancestral–or Paleo–diets and have found them 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,” he wrote to the magazine.

But all five studies cited by Cordain were just as US News said:

small and short term. Three of the five didn’t compare people who

were randomly assigned to either the Paleo diet or another diet (1-3)

Without that “control group” following another diet,

researchers couldn’t tell if people lost weight because they were

on a particular diet or simply because they were participating in a


In one of the two studies that did compare Paleo with other diets,

Swedish researchers randomly assigned 29 middle-aged or older men with

heart disease and pre-diabetes or type 2 diabetes to an “Old Stone

Age” diet (lean meat, fish, fruits, vegetables, root vegetables,

eggs, nuts) or to a “Mediterranean” diet (whole grains,

low-fat dairy foods, vegetables, fruits, fish, oils, margarine). (4)

After 12 weeks, the Paleo eaters had lost no more weight than those

on the Mediterranean diet. However, the Paleo group did have lower blood

sugar levels after a glucose tolerance test, which measures how well

insulin controls blood sugar.

Two years later, the same researchers looked at 13 men and women in

their 60s with type 2 diabetes. The volunteers were told to eat a Paleo

diet for three months and then a standard diet for people with diabetes

for three months, or vice versa. The Paleo diet had more fruits,

vegetables, lean meat, fish, nuts, and eggs, and no grains, dairy,

beans, refined fats, sugar, candy, soft drinks, or beer. (5) They ended

up eating 300 fewer calories a day on the Paleo diet, which may explain

why they lost seven more pounds during those three months. And their

triglycerides were lower. But there were no differences in blood sugar

levels after a glucose tolerance test.

The bigger question: What happens over the long run? At least three

trials have compared diets that were either high or low in protein,

carbohydrates, or fat–such as Atkins, Ornish, Weight Watchers, and The

Zone–on a total of more than 1,200 people. (6-8)

After one or two years, none of the diets outshined the others.

What mattered most was whether people stuck to them. (The more extreme

diets–like the high-protein Atkins and the low-fat Ornish–were the

hardest to stay on.)

The bottom line: There’s no good evidence that the Paleo diet

will make those extra pounds vanish.

(1) Diabetes 33: 596, 1984.

(2) Eur. J. Clin. Nutr. 62: 682, 2008.

(3) Eur J. Clin. Nutr. 63: 947, 2009.

(4) Diabetologia 50:1795, 2007.

(5) Cardiovasc. Diabetol. 8: 35, 2009.

(6) JAMA 293: 43, 2005.

(7) N. Engl. J. Med. 360: 859, 2009.

(8) Ann. Intern. Med. 153: 147, 2010.

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