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ThePaleoDiet:ClaimsVersusEvidence

ByAlanAragon
Site:www.alanaragon.com
Blog:www.alanaragonblog.com
Contact:alaneats@gmail.com

Firstoff,awordof

Agenda
Background&DefinitionalClaims
Grains&LegumesClaims
DairyClaims
SugarClaims
FattyAcidClaims
ComparativeResearchClaims
Conclusions&Applications

Background:ThePaleolithicEra
ItsgenerallyacceptedthatthePaleolithicperiodspannedfromthe
earliestestimateduseofstonetools(about2.5millionyearsago)
untilroughly10,000yearsago[1].
TheAgriculturalRevolution(alsocalledtheNeolithicRevolution)
beganroughly10,000yearsago,withwidespreadgrainproduction
andanimalhusbandryrepresentinglessthan1%ofhuman
existence[2].
Paleodietproponentsblamethespreadofagriculturefortheso
calleddiseasesofcivilization.
Itsbeenproposedthatthehumangenomehasnotundergone
sufficientmutation&evolutionarychangetohandleNeolithicfood
consumptionwithoutadversehealthconsequences.Thebig
questionis,howstrongistheevidencebehindthisclaim?

Background:CherryPickingtheCulprit
TheIndustrialRevolutionoccurredapproximately200yearsago.
Itscharacterizedbythewidespreadtransitionofhand
productionmethodstomachinebasedmethods.
TheDigitalRevolution (whichincludestheadventofthe
internet),characterizedbythechangefromanalog,mechanical,
andelectronictechnologytodigitaltechnology,beganroughly
30yearsago,andcontinuesuntilthepresent.
TheIndustrial&DigitalRevolutionaremarkedbyprogressive
downshiftsinphysicalactivity.Itsoddthattheseimportant
periodsofhistoryareignoredbyPaleodietproponents,who
selectivelyblamethe10,000yearoldagriculturalrevolutionfor
diseasesofthemodernday.

ModernAdaptationofthePaleoDiet
Allowed:
Poultry,fish,meat(puristspreferorganic/grassfed)
Eggs
Fruit(puristssticktoberries)
Vegetables(exceptnightshadesliketomatoes,potatoes,&eggplants)
Nuts(exceptpeanuts),seeds(sparingly)
Prohibited:
Grains&legumes
Milk&milkproducts
Refined/addedsugars
Highomega6,refinedorhydrogenatedvegetableoils
Nightshadevegetablessuchastomatoes,potatoes,&eggplant
Addedsalt
Coffee&alcohol

DefinitionalClaims
Claim: ThePaleoDietconsistsofa
strict,specificsetoffoodsthatwe
ashumansweremeanttoeatsince
thisishowourprehistoricancestors
ate,andallelseshouldbeavoided.

Evidence:
Ancestraldietsvariedwidelyin
termsofbothfoodselectionand
macronutrientcomposition,
dependinguponthefoodsavailable
geographically.

DefinitionalClaims
Evidence(continued):3
Immediateancestorsofmodernhumansarebelievedtohave
evolvedinthetropics(i.e.,Africa)roughly200,000yearsago,
wherethelargemajority(perhaps70%)oftheirdietwasplant
based.
Incontrast,modernhumansenteringEurope40,000yearsago
arelikely throughnecessity tohavehadameatbaseddiet,
whichwasmaintainedoverhundredsofgenerations.
Thedietaryhabitsofmodernhunters&gathererspotentially
reflectthewidelyvaryingdietsofourprehistoricancestors
becausetheycovertherangefrombeinglargelyplantbased(in
thetropics)toanimalbased(inthearctic).

DefinitionalClaims
Claim: Thedietofourprehistoricancestorsisaccurately
definedbytheeatinghabitsofmoderndayhunter
gatherersocieties.
Evidence:
ActualintakeofourStoneAgeforefathersisdevoidofany
accuratehistoricalrecords.Thus,Paleodietingislargely
basedoneducatedguessing,atbest.ToquoteLauren
Cordain[4],Unfortunately,notasinglecomprehensive
studyevaluatingthemacronutrientandtracenutrient
contentsofthewildplantandanimalfoodsactually
consumedinunWesternizedhuntergathererdietswas
everconducted.

Grains&LegumesClaims
Claim: Grainswerenotapartofour
prehistoricancestorsdiets.They
haveonlybeenconsumedsincethe
adventofagriculture10,000years
ago,andthereforeshouldnotbe
eatenbymodernhumans.
Evidence:
Recent=dangerous=false.
Recentpeerrevieweddatahave
challengedtheideathatgrain
production&consumptionisas
recentaphenomenonassuggested
byPaleodietproponents.

Grains&LegumesClaims
Evidence(continued):
2009:Mercaderetalfoundalargeassemblageofstarch
granulesonthesurfacesofMiddleStoneAgestonetoolsfrom
Mozambique,showingthatearlyHomosapiensreliedongrass
seeds includingthoseofsorghumgrasses startingatleast
105,000yearsago[5].
2010:Revedinetalfoundevidenceofstarchgrainsonthe
surfacesofgrindingtoolsfromavarietyofgeographicaland
environmentalcontexts,rangingfromnortheasternEuropeto
thecentralMediterranean,anddatedtotheMidUpper
Paleolithic.Thethreesitessuggestthatplantfoodprocessing,
andpossiblytheproductionofflour(predictable/reliablehigh
energy),wasawidespreadpracticeacrossEuropefromat
least30,000yearsago[6].

Grains&LegumesClaims
Evidence(continued):
2011:HenryetalfounddirectevidenceforNeanderthal
consumptionofavarietyofplantfoods,includingstarchgrains
recoveredfromdentalcalculusofNeanderthalskeletonsfrom
ShanidarCave,Iraq,andSpyCave,Belgium.Someoftheplantsare
typicalofrecentmodernhumandiets,includingdatepalms,
legumes,andgrassseeds[7].
HenryetalconcludedthatinbothwarmEasternMediterranean
andcoldNorthwesternEuropeanclimates,andacrosstheir
latitudinalrange,Neanderthalsmadeuseofthediverseavailable
plantfoodsbytransformingthemintomoreeasilydigestible
foodstuffs(inpart,throughcooking),suggestinganoverall
sophisticationinNeanderthaldietaryregimes datingback44,000
years.

Grains&LegumesClaims
Claim: Grains&legumesareunhealthy
andshouldbeavoided.
Evidence:
Aconvergenceofevidence from
observationalresearch[814]and
experimentalresearch[1524]have
shownmultipletherapeuticand
protectivehealthbenefitsofwhole
grain(&legume)consumption,
includingimprovedbloodlipidprofile,
glucosecontrol,reductionof
inflammation,andreducedriskof
stroke&coronaryheartdisease.

Grains&LegumesClaims
Claim: Grainscontainphytatesandoxalates,
whichareantinutrients(designedto
protecttheplant)thatreducethe
bioavailabilityofessentialminerals.
Evidence:
Phytatesandoxalatesarenotexclusively
containedingrains.Theyexistinawide
rangeofplantfoods,includinggreen/leafy
vegetables[25].
Selectivelyclaimingthatcertainplants
shouldnotbeeatenbecausetheywere
designedtoresistconsumptionisas
illogicalasclaimingnooneshouldeat
animalswithdefensesagainstpredation.

Grains&LegumesClaims
Evidence(continued):
Invegetarians,theeliminationofmeatalongsideincreased
consumptionofphytatefromgrains&legumeshasbeenseento
reduceironandzincabsorption.
Despiteironandzincbeingthetracemineralsofgreatest
concerninvegetariandiets,thesedeficienciesseenin
impoverishednationsarenotassociatedwiththevegetarian
dietsinindustrializednationswithdiverseandabundantfood
supplies[26].
Keepinmindthatthesereductionsofnutrientbioavailabilityare
ofquestionablesignificanceinvegetariandiets.Inthecaseof
varied,omnivorousdiets,theseconcernswouldbeminimal,at
best.

Grains&LegumesClaims
Claim: Grainscauseinflammation,theroot
ofalldisease.
Evidence:
Firstofall,inflammationisnottherootof
alldisease.Chronic,systemic
inflammationisoftenasymptomof
diseaseratherthanacausalagentof
disease.
Inadditiontothefactthatcorrelation
doesnotautomaticallyequalcausation,
thereareseveraloriginsofdisease
stemmingfromfactorsotherthan
inflammation.

Grains&LegumesClaims
Evidence(continued):
Anexampleofmultiplepossibilitiesfortheoriginofdiseaseisthe
universaldifferentialdiagnosismnemonic(awellknownmemory
joggerinmedicine),containedintheacronymVINDICATE[27]:
V Vascular
I Infectious
N Neoplastic
D Drugrelated(or)degenerative
I Inflammatory(or)idiopathic
C Congenital(or)developmental
A Autoimmune(or)allergic
T Traumatic(or)toxic
E Endocrine(or)metabolic

Grains&LegumesClaims
Evidence(continued):
Observationalresearchhasshowndivergenteffects apositive
correlationbetweenrefinedgrainconsumptionandinflammation,
butaninversecorrelationbetweenwholegrainconsumptionand
inflammation[28].
However,controlledcomparisonsbetweenrefinedandwholegrain
consumptionhaveconsistentlyshownnoinflammatoryeffectsfrom
eithertypeofgrainconsumption,withservingsrangingfrom3to4
perday[2932].
Theclaimthatgrainscausesystemicinflammationthereforehasno
basisincontrolledhumanresearch,whichlargelyhasshowna
neutraleffectonhealthmarkers.

Grains&LegumesClaims
Claim: Glutenintoleranceiswidespread,
andmainstreamscienceisindenialofit.
Evidence:
Celiacdisease(CD),aglutendependent
autoimmunedisorderofthesmallintestine,
isestimatedtoaffect0.31.2%ofthe
population[33].
Glutenintolerance alsocallednonceliac
glutensensitivity(NCGS)orsimplygluten
sensitivity currentlyhasnoclear
diagnosticcriteria.Thecombined
prevalenceofCD,NCGS,andwheatallergy
ishypothesizedtobeashighas10%ofthe
generalpopulation[33].

GlutenIntolerant?

Grains&LegumesClaims
Claim: Grains,legumes,andnightshade
vegetablesliketomato,potato,and
eggplantcontainlectinswhichcauseleaky
gutandadverseautoimmuneresponses.
Evidence:
Thisclaimislargelyspeculativesinceits
primarilybasedoninvitroandanimal
data.ToquoteCarreraBastosetal[34]:
Unfortunately,theeffectsoflectinsand
saponinsonintestinalpermeability,
endotoxemia,andinflammationhave
beenpoorlystudiedinhumanstoallow
ustodrawsignificantconclusions.

Grains&LegumesClaims
Evidence(continued):
Despiteclaimsofgrain,legume,&nightshadevegetable
consumptiondamagingtheintestines,thereisnoresearchon
healthyhumanssupportingthis.Eveninthediseasedpopulation,
grainconsumptionhasnotbeenconsistentlydemonstratedto
exacerbatepreexistingGIdisorders.
Infact,supplementingwithwheatbranhasbeeninvestigatedasa
therapeutictreatmentoptionforirritablebowelsyndrome(IBS),
themostcommonintestinalproblemthatcausespatientstobe
referredtoagastroenterologist.Althoughithaslargelybeen
ineffectivefortreatingIBS,noadverseeffectsonGIfunctionhave
beenobservedwithbransupplementation[3537].

Grains&LegumesClaims
2012:Ajalaetalassessedtheeffectofvariousdietsonglycemiccontrol,
lipids,andweightlossinasystematicreview&metaanalysis.The
mainfindingswere:
Thelowcarbohydrate,lowGI,Mediterranean,andhighprotein
dietsallledtoagreaterimprovementinglycemic controlcompared
withtheirrespectivecontroldiets(whichincludedlowfat,highGI,
AmericanDiabetesAssociation,EuropeanAssociationfortheStudy
ofDiabetes,andlowproteindiets).
ThelowcarbohydratedietwasthemosteffectiveforraisingHDL.
TheMediterraneandietshowedthegreatestimprovementsin
glycemic controlandweightlosscomparedtothecontroldiets.
Ajala O,EnglishP,Pinkney J.Systematicreviewandmetaanalysisofdifferentdietaryapproaches
tothemanagementoftype2diabetes.AmJClin Nutr.2013Mar;97(3):50516.

PaleoViolationRoyale:Grains,Legumes,Nightshades,&Dairy
MediterraneanPerilonaPlate!

ChickenSouvlaki,olive&fetarelish,andpintobeanjalapeohummus:extremelyunPaleo
Source:http://www.motherfitness.com/mykitchenchickensouvlakioliveandfetarelishandpintobeanjalapenohummus/

DairyClaims
Claim: Dairyhasanacidicinsteadofalkaline
effectonthebodyanddoesnotprotectbone
health.
Evidence:
Theacid/baseclaimdoesnotreflectthecurrent
scientificevidence[38,39].Milkanddairy
productsneitherproduceaciduponmetabolism,
nordotheycausemetabolicacidosis.
Furthermore,systemicpHisnotinfluencedby
diet;acidicpHurinedoesnotautomaticallyreflect
metabolicacidosisoranadversestateofhealth
[38].
Dairysboneprotectiveeffectissupportedbythe
majorityofobservationalresearchandnearlyALL
controlledinterventionalresearch[40,41].

DairyClaims
Claim: Cowsmilkisgoodforbabycows,butnot
humans.Wearetheonlyanimalthatdrinksthe
milkofanotheranimal.
Evidence:
Itsfalsetothinkthatonlyhumansconsumethe
milkofotheranimalspecies.Forexample,feral
catsandwesterngullswererecentlyreportedto
stealmilkfromnorthernelephantseals[42].

Whogetstodecidewhichpartsofthecowwe
shouldconsume?ItsperfectlyPaleotoeatthe
cowsmuscles,butnotthemilkthatlaidthe
foundationforthegrowthofthosesamemuscles?
Illogicaboundsinthisclaim.

Nightshades&Dairy Deadly!

Potato&eggplantbake,withtomato&mozzarellacheese:veryunPaleo
Source: http://www.grandmaskitchen.com/recipes/comfortingpotatoes/potatoeggplantbake

WheyIronic

NOTPALEO

Roti MediterraneanGrill,WashingtonDC

PALEO

http://paleologix.com/

SugarClaims
Claim: Sugaristoxic,andisresponsible
fortheriseofobesityinrecent
decades.

Evidence:
Sayingthatsugaristoxicisjustassilly
assayingthatsaltistoxic.Itdependson
thedose&thecontext.
Themedianlethaldose(LD50)ofsugar
isabout30g/kgofbodymass(6
poundsfora180lbman).
Incontrast,theLD50oftablesaltis
about3g/kg(0.6poundsfora180lb
man).Isitfairtosaythatsaltis10
timesmoretoxicthansugar?

SugarClaims
Evidence(continued):
AccordingtothemostrecentdatafromtheERS/USDA[43]:
In1970,Americansconsumedanestimated2,169calories
perpersonperday.In2010,theyconsumedanestimated
2,614calories(anincreaseof445kcal).
Ofthis445kcalincrease,grains(mainlyrefinedgrains)
accountedfor188calories;addedfatsandoils,188calories;
caloricsweeteners,42calories;dairyfats,16calories;fruits
andvegetables,15calories;andmeats,8calories.Only
dairyproductsdeclined(12calories).
Thisindicatesthatcaloricsweetenerscontributedlessthan
10%ofthetotalcaloricincreasethatoccurredinthelast4
decades.

SugarClaims
Evidence(continued):
NHANESdatashowsadropof142kcalsinoccupationrelated
energyexpenditurecomparedtotheearly1960s[44].
Thisexpendituredecreasecombinedwiththeestimated445
kcalintakeincreaseamountsto587kcalinthepositive
comparedtoahalfcenturyago.
Thisalonewouldaccountfortheriseinratesofoverweight&
obesity(whoseprofiletrackscloselywiththeadventofthe
internet).
Thisstilldoesnotaccountforthedecreaseinnonoccupational
energyexpenditure,whichifweconservativelyestimate
dropped100kcal,wouldbringthesurplustoroughly700kcal.
Blamingeverythingonsugarignoresahostoflargerfactors.

FattyAcidClaims
Claim: ThemodernWesternizeddiethasamuch
higherratioofomega6toomega3fattyacids
thanthePaleodiet,sowemustmimicour
prehistoricancestorsandincreasethe
proportionofomega3s.

Evidence:
Thecurrentscientificevidencedoesnotsupport
theimportanceofaspecificratioofomega6to
omega3fattyacids[45].Toquoteareviewby
Harrisetal[46]:
theratiois,onboththeoreticaland
evidentialgrounds,oflittlevalue.Metricsthat
includeomega3fattyacidsalone,especially
eicosapentaenoicacidanddocosahexaenoic
acids,appeartoholdthegreatestpromise.

FattyAcidClaims
Evidence(continued):
Increasingomega3intake(especiallyfrommarinesources)isagood
generalrecommendation,especiallywhenaddressingthetypicalWestern
diet.
However,Paleoproponentstendtoencourageindiscriminate
minimizationoravoidanceofomega6sourcesinanefforttodecrease
theirproportioninthediet.Thiscanbecounterproductiveforthegoalof
achievingahealthydiet.Heresasampleofsomehealthyfoodswithhigh
omega6:3ratios:
o Coconutoil 3923:1
o Almonds 2010:1
o Sunflowerseeds 457:1
o Oliveoil 20:1
o Avocado 15:1
o Chicken 8:1
o Beef 5:1
o Walnuts 4:1

PaleoComparisonResearch:NotSurprising 4750

DietaryHabitsoftheWorldsHealthiestPopulations
TheBlueZonesarepopulationswiththelongestlifeexpectancies,
highestcentenarianrates,andlowestratesofchronic&degenerative
disease[51].Fivelongevityhotspotshavebeenidentifiedand
studiedbyresearchteamsledbyexplorer DanBuettner.
TheBlueZones
Ikaria,Greece:AvariationoftheMediterraneandiet,richin
oliveoil,fruits,vegetables(wildgreens),wholegrains,fruitand
alittlefish.Goatmilkandwine(about2glassesperday)arealso
traditional.Coffeeandteaareconsumedregularly.
SeventhDayAdventistsinLomaLinda,California:Vegetariandiet
richinbeans&nuts,lowEPA/DHAintake,highintakeofthe
plantderivedomega6fattyacid,noalcoholicbeverage
consumption.

DietaryHabitsoftheWorldsHealthiestPopulations
TheBlueZones(continued)
Nicoya,CostaRica:Blackbeans,whiterice,corntortillas,squash,eggs
(mostlyfried),andfruitarestaples.Moremeat(mainlychicken&pork)
andfruitisconsumedcomparedtootherbluezones.Thewaterisvery
highinminerals,especiallycalciumduetotheregionslimestone
bedrock.Coffeeisdrankdaily,sweetenedwithrawsugarcane.
Sardinia,Italy:Plantdominantdiet,largequantitiesofdarkredwine,
favabeans,andbarleyareconsumed.Goatmilk&goatcheeseare
staples.Meatintake(lamb,leanpork,oilyfish,andshellfish)ismodest
&infrequent.Coffeeisdrankdaily.
Okinawa,Japan:Plantdominantdiet,largeamountsofvarioustypes
ofseaweedareconsumed.Staplesincludesweetpotatoes,soybeans
&soyproductssuchastofu&miso,whiterice,andtea.Rawsugaris
eatenwithsnacks.Minorconsumptionoffish&pork.Thedietisvery
highcarb,verylowfat.Virtuallynoeggsordairy.

DietaryHabitsoftheWorldsHealthiestPopulations
DietaryCommonalitiesAmongtheBlueZones
Largelyplantbased.
Noovereating.
Foodsarelocallyorhomegrown&homeprepared.
Carbohydrate(largelyfromstarch)isthepredominant
macronutrient.
Beans,includingfava,black,soyandlentils,arethe
cornerstoneofmostcentenariandiets.
3ofthe5zonesareregularcoffeeconsumers.
4ofthe5zonesareregularalcoholconsumers.
All5zonesareregularconsumersofgrains&legumes.
NoneofthezonesfollowaPaleotypediet.

Conclusions

Itsimpossibletouniversallydefinethedietofourprehistoricancestors
duetowidelyvaryingintakesaccordingtofoodavailabilityand
geographicallocation.

Multiplelinesofrecentarchaeologicaldatahavechallengedtheidea
thatgrainconsumptionwasnotapartofthePaleolithic/ancestraldiet.

ComparativeresearchfavoringPaleodietshavefailedtomatch
macronutrientintake,makingitimpossibletoisolatetheinherent
benefitofPaleoapprovedfoods.

ModernadaptationsofthePaleodiethavedistinctbenefits.The
strongestbenefitisthefocusonwhole/unrefinedfoods.ThePaleo
friendlyfoodshaveplentyofsupportingresearch.

Onthedownside,thereislittletonosupportingresearchforavoiding
themainPaleoprohibitedfoods(apracticewhichtendstofoster
orthorexia).Paleoproponentstendtothinkinextreme,black&white
termsinsteadofthehealthieralternative moderation&sanity.

Applications
Avoidanceofglutenanddairy(oranyfood,forthatmatter),should
bedonethebasisofanobjectivelydiagnosedintoleranceorallergy.
AvoidanceofanyfoodshouldNOTbedoneonthebasisof
pseudoscientifichearsayordietlore.Myonlypersonalruleis,
wheneverpossible,avoidfoodavoidance.
Achievingahealthydietcanbeaccomplishedby:
Stayingintheballparkofyourmacronutrienttargets.
Predominatingyourintakewithavarietyofwholeand
minimallyrefinedfoods.
Leavingaminorityofthedietopenforindulgencesof
whateveryouwant(1020%guideline).
Ignoringtherulesoffaddiets&stickingwithfoodsthat
fityourpersonalpreference&tolerance.

Thanksforlistening,enjoyyourfreedom!

Peanutbutter&chocolateoatmealbars:mortalsinaccordingtoPaleodoctrine
Source: http://pastrychefbaking.blogspot.com/2012/11/peanutbutterchocolateoatmealbars.html

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