Is the Paleo Diet Healthy or Unhealthy?

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Whatever you choose to call it – the ‘Stone Age diet’ , ‘Hunter-gatherer diet’, ‘Paleolithic diet’ or just the ‘Paleo diet’ – one thing is for sure. It’s growing in popularity by the day and going mainstream. The supermarkets have caught on (and cashed in), stocking stuff your local supermarket might not have had a few years ago.

But is the diet of Wilma and Fred nothing but a craze that will soon fade away? And more importantly, is the Paleo diet healthy?

Why the Paleo Diet is Healthy

The core principle of the Paleo diet is that one should eat fresh, unprocessed foods and eschew processed foods. You’ll be hard-pressed to find an expert who’ll argue with that.

The core foods of the Paleo diet are:

  • Meat
  • Fish and seafood
  • Eggs
  • Vegetables
  • Fruits
  • Nuts and seeds
  • Healthy fats and oils
  • Herbs and spices

So while the diet as a whole hasn’t been thoroughly studied, the payoff for cutting processed foods from your diet could be huge. If there is a balanced consumption of all of the different paleo food groups the diet can be healthy.

And get this. One study found that people who cook at home tend to have a healthier diet, eat fewer calories, and find it easier to lose weight.19

The Paleo diet gets easier to follow once you get the hang of it and involves no calorie counting.

Why the Paleo Diet may be Unhealthy

What some health professionals are likely to worry about is eating too much meat, especially red meat on this diet – a common mistake. This results in over-consuming saturated fats, which has negative health effects. Saturated fat is linked to a higher risk of heart disease and negative metabolic effects. The bulk of the diet of people living in the Paleolithic period was plant-based. So the Paleo diet should consist mostly of fibrous vegetables, fruits, nuts and seeds.

Read on: 7 Common Paleo Diet Mistakes & How to Fix Them

The Paleo diet excludes dairy, legumes and grains. Eliminating these food groups entirely may have a negative impact on health. Furthermore, the evidence does not back the claims that our ancestors’ diet excluded these foods.

For example, milk is part of the diet of the the !Kung San of the Kalahari desert. If milk is not replaced with alternative food sources of calcium, it may be necessary to supplement with calcium and vitamin D, which are important for bone health. Lack of these nutrients increases the risk of osteoporosis and bone fractures.

Furthermore, research suggests that legumes were consumed by Paleolithic humans and that our ancient ancestors may have been consuming cereals and grasses even before the Paleolithic era. New research also shows that these foods may play an important role in maintaining a healthy gut and that eliminating them may affect heart health (see below).

Read on: Foods to Eat on the Paleo Diet – The Complete Food List

How the Paleo Diet Affects Health

We’ve looked at the science of it and here’s what we found.

As the Paleo diet is a relatively recent phenomenon, a lot of the studies and research have involved small numbers of people and often did not include long-term follow-up or a control group.

These studies are too small and short to form conclusive judgments about the Paleo diet, but here’s what some of that research suggests.

Weight loss

In one small study 1, participants were asked to adhere to a Paleo diet for 3 weeks. During the study period, their weight dropped by about 2.3kg (about 5lb), their waist circumference shrunk by 1.5cm (about 1/2in) and their blood pressure also improved.

Wondering how the volunteers were able to experience results so fast? Well, the researchers report that the Paleo diet helped the subjects reduce their overall daily calorie intake by about 900kcal and their daily fat intake by 20g. The participants’ daily carbohydrate intake also dropped by 177g on average.

Furthermore, a 2019 systematic review and meta-analysis of over a thousand articles, supported the use of the Paleo diet in aiding weight loss, and the reduction of waist circumference and BMI.20

Heart Health & Diabetes

Research suggests that adhering to the Paleo diet can lead to a 72% reduction in plasminogen activator inhibitor-1 (PAI-1).1 High levels of PAI-1 have been linked to the development of type 2 diabetes 2 as well as an increased risk of heart disease 3.

Moreover, other studies have shown that even a short-term adherence to the Paleo diet results in improved blood pressure, blood lipid and blood glucose control, in addition to improved insulin sensitivity while reducing insulin secretion 4.

Another study showed that the Paleo diet lowered blood pressure, fasting blood glucose, HbA1c and triglyceride levels in patients with type 2 diabetes.5 The study participants also lost weight and had higher HDL levels than individuals on a standard diabetic diet.

However, an Australian study suggests that the Paleo diet may increase the risk of heart disease. The study looked at how the Paleo diet can affect gut bacteria. It found that the diet is associated with elevated levels of a substance produced by the gut called trimethylamine-N-oxide (TMAO).21 TMAO is associated with an increased risk of heart disease.22 

The researchers believe these elevated levels of TMAO may be due to the lack of whole grains in the diet, which changes the gut bacteria and causes more TMAO to be produced.

Furthermore, twice the recommended level of saturated fat, due to higher servings of red meat, was consumed by the study participants following the Paleo diet.21 Red meat also provides precursor substances used by the body to produce TMAO. This suggests that high consumption of red meat may be linked to the elevated levels of TMAO. In other words, eating too much red meat may increase the risk of heart disease by increasing the levels of saturated fat in the blood and TMAO in the gut.

Gut Health

The Paleo diet is generally thought to promote good gut health. The Paleo framework promotes the consumption of gut-healing antioxidants and fermentable fibers from fruits, veggies and spices and restricts the intake gut unfriendly foods.

Therefore, the Paleo diet is thought to thwart inflammation and restore the beneficial bacteria in your gut that help process hard-to-digest foods, produce nutrients, and even guard against disease.

However, according to the Australian study looking how the Paleo diet impacts gut health, the Paleo diet may be associated with different gut microbiota and lower populations of beneficial bacterial species.21 The study’s scientists think this may be a result of eliminating whole grains from the diet. Whole grains are a rich source of resistant starch and other fermentable fibers. These fibers play an important role in maintaining a healthy microbiome.

Read on: How to improve your gut health & microbiome

How to Make the Paleo Diet Healthier

The Paleo diet is a potentially healthy diet. The central premise of the Paleo diet is to consume natural, whole foods that are unprocessed or minimally processed.

Unfortunately, overconsumption of meat, especially red meat, can turn a potentially healthy diet into a health nightmare. Research also suggests that cutting out entire food groups, such as whole grains, can have adverse health consequences.

However, the goal of the Paleo diet isn’t to re-enact the lifestyle and diet of our forefathers food for food, but to get the general gist – the principle of the diet. Furthermore, as explained above, there is no such thing as a single Paleo diet. Some primal diets included dairy, legumes, and grains.

Most of us can improve our health and the way we look and feel without eliminating these food groups. Recently, proponents of the Paleo diet have have supported this leniency, as well as encouraging the inclusion of some red wine, non-grain spirits, and dark chocolate.

Therefore, customize the Paleo diet to suit your needs. A customized Paleo plan may include whole grains, legumes or modest amounts of dairy. Of course, those with sensitivities or intolerances to these foods should avoid them.

The point is to make the diet work for you. Listening to how you feel and how your body reacts is more important than following any specific food list, anti-food list, or dietary theory.

Health Benefits of Whole Foods

The Paleo diet has a valid premise. Most modern foods are highly processed, which has adverse health effects. More than 70% of our calories come from refined sugars, refined vegetable oils, and highly processed dairy products and cereals.

Avoiding highly processed foods and eating a diet rich in natural, whole foods has many health benefits.

Inflammation

The standard American diet is often said to be inflammation promoting because it is packed with pro-inflammatory foods, such as refined grains, high fructose corn syrup, sugar and industrial oils (like those of canola, safflower and sunflower). To make matters worse, it’s also low in inflammation fighting foods such as veggies, omega-3s and fruits.

This modern way of eating is thought to contribute to low-grade chronic inflammation and promote the development of many chronic diseases.23,24

More Energy

Green leafy veggies, lean meats and seafood and healthy fats from avocado, nuts and seeds are rich in magnesium, a deficiency of which has been linked to:

  • Low energy levels 6
  • Insomnia 7
  • An inability to stay asleep for long 7
  • Depression 8

Better Skin, Hair and Nail Health

Modern diets rely heavily on industrial vegetable oils, highly processed foods and sugar-laden ones – foods thought to be an optimal environment for ‘bad bacteria’ to thrive, upsetting the healthy balance of bacteria in your gut. Bad bacteria produce endotoxins that can damage the gut’s lining,12 and are increasingly linked to a wide range of health problems from obesity and skin problems to depression and allergies.

An unhealthy balance of gut flora is associated with inflammation, increasing the likelihood of skin disorders such as acne.14

Read on: Why you need to heal your gut if you want healthy clear skin

Research has also shown that bacterial overgrowth in the small intestine may compromise the absorption of nutrients essential for skin and hair health.13 Therefore, if you’re nutrient deficient it will show on your skin, hair and nails.

Improved Fitness

During exercise, your body uses extra oxygen which can increase the levels of reactive oxygen species (ROS).15 These ROS can make the mitochondria less efficient at fueling muscles. This leads to lowered ‎energy and endurance levels and increase muscle fatigue and soreness.16 ‎

Research has shown that a diet packed with antioxidants such as selenium can:15

  • Delay muscle fatigue.
  • Speed up muscle recovery after a workout.
  • Allow for longer training sessions.

Fertility

If you’re trying to get pregnant, make sure to check your diet. Research suggests that diet (in addition to physical activity and healthy overall lifestyle habits) can improve your odds of conceiving.17

Avoiding unhealthy trans fats has been shown to increase infertility due to ovulation issues  and low sperm count.17,18

To boost your chances of conceiving, try eating minimally processed and unprocessed natural whole foods least 3 months before.  A healthy diet rich in whole grains, vegetables, fruits, poultry and seafood are associated with better fertility in women and better semen quality in men.25

Bottom Line

Overconsumption of meat, especially red meat, and cutting out food groups entirely, can result in adverse health effects. However, the Paleo diet has the potential to be healthy, if followed in a balanced way.

Think of the Paleo diet as the starting point – as a template or framework for a healthy diet that needs to be customized to your own needs. Consider adding beans, lentils, whole grains, and sources of calcium such as dark leafy greens, almond milk, tofu, soy or dairy.

Remember, for optimal results make sure to get enough sleep, exercise and tank up with some daily sunshine.

25 sources

  1. Österdahl, M., Kocturk, T., Koochek, A., & Wändell, P. E. (2008). Effects of a short-term intervention with a paleolithic diet in healthy volunteers. European journal of clinical nutrition, 62(5), 682-685.
  2. Festa, A., D’Agostino, R., Tracy, R. P., & Haffner, S. M. (2002). Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes the insulin resistance atherosclerosis study. Diabetes, 51(4), 1131-1137.
  3. Thögersen, A. M., Jansson, J. H., Boman, K., Nilsson, T. K., Weinehall, L., Huhtasaari, F., & Hallmans, G. (1998). High plasminogen activator inhibitor and tissue plasminogen activator levels in plasma precede a first acute myocardial infarction in both men and women Evidence for the fibrinolytic system as an independent primary risk factor. Circulation, 98(21), 2241-2247.
  4. Frassetto, L. A., Schloetter, M., Mietus-Synder, M., Morris, R. C., & Sebastian, A. (2009). Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. European journal of clinical nutrition, 63(8), 947-955.
  5. Jönsson, T., Granfeldt, Y., Ahrén, B., Branell, U. C., Pålsson, G., Hansson, A., … & Lindeberg, S. (2009). Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol, 8(35), 1-14.
  6. Lukaski, HC & Nielsen, FH (2002) Dietary Magnesium Depletion Affects Metabolic Responses during Submaximal Exercise in Postmenopausal Women. J. Nutr 132(5):930-935
  7. Eby GA & Eby KL (2006) Rapid recovery from major depression using magnesium treatment. Medical Hypotheses 67(2): 362-370
  8. Huang, J. H., Lu, Y. F., Cheng, F. C., Lee, J. N., & Tsai, L. C. (2012). Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study. Nutr J, 11(1), 41.
  9. Fukudome, S. I., & Yoshikawa, M. (1992). Opioid peptides derived from wheat gluten: their isolation and characterization. FEBS letters, 296(1), 107-111.
  10. Herbert MR, Buckley JA. (2013) Autism and dietary therapy: case report and review of the literature. J Child Neurol.;28(8):975-82.
  11. Nadon G, Feldman DE, Dunn W, Gisel E. (2011) Association of sensory processing and eating problems in children with autism spectrum disorders. Autism Res Treat:541926.
  12. Bjarnason I, MacPherson A, Hollander D (1995) Intestinal permeability: an overview. Gastroenterology, 108:1566–1581.
  13. Toskes PP (1993) Bacterial overgrowth of the gastrointestinal tract. Adv Intern Med 1993, 38:387-407.
  14. Juhlin L & Michaëlsson G. (1983) Fibrin microclot formation in patients with acne. Acta Derm Venereol. 3(6):538-40.
  15. Clarkson P. & Thompson HS (2000) Antioxidants: what role do they play in physical activity and health? Am J Clin Nutr 72(suppl):637S–46S.
  16. Powers SK, Deruisseau KC, Quindry J & Hamilton KL (2004) Dietary antioxidants and exercise. Journal of Sports Sciences 22(1):81-94
  17. Chavarro, J. E., Rich-Edwards, J. W., Rosner, B. A., & Willett, W. C. (2007). Dietary fatty acid intakes and the risk of ovulatory infertility. The American journal of clinical nutrition, 85(1), 231-237.
  18. Chavarro, J. E., Furtado, J., Toth, T. L., Ford, J., Keller, M., Campos, H., & Hauser, R. (2011). Trans–fatty acid levels in sperm are associated with sperm concentration among men from an infertility clinic. Fertility and sterility, 95(5), 1794-1797.
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