Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
14 Jan

Why Does the Paleo Diet Continue to Receive Low Points from “Established Authorities”?

Thumbs DownYou may have heard the big news: the paleo diet ranked dead last in the US News and World Report diet rankings. When my inbox floods with links to the latest paleo bashing in the media, I don’t even get surprised or annoyed anymore. It amuses me. The one downside of this stuff is that work grinds to a halt for a few hours because a popular pastime around the Primal headquarters whenever one of these reports comes out is to see who can pick the ripest, most ridiculous misconceptions or blatant falsehoods. The big upside is even more publicity, more notoriety, and more laughter. Laughter is always a good thing.

Initially, you may weep at the ignorance on display. That’s how I was when I first started out, along with a bit of teeth gnashing. But it gives way to deep belly laughter that resonates through every bone in your body and plucks at the ligaments holding them together to create a sweet sonorous melody filling the room and reaching up to the skies above. At least it did for me.

So let’s laugh together. I’ll draw on three of the best statements and quotes we’ve been passing around and provide a bit of translation and/or commentary. Bonus: you can use these as quick replies whenever someone smugly thrusts the US News diet ranking in your face.

Does it have cardiovascular benefits?

While some studies have linked Paleo diets with reducing blood pressure, bad “LDL” cholesterol, and triglycerides (a fatty substance that can raise heart disease risk), they have been few, small, and short. And all that fat would worry most experts.

Translation: Although actual studies on the Paleo diet in live human subjects result in improved risk factors for heart disease, including lower blood pressure, LDL cholesterol, and triglycerides, “all that fat” worries our expert panel. We’ve got a hunch that those results are invalid and do not reflect reality. Because reasons. Just trust us. Hey, who’s up for a SlimFast shake whose third ingredient is heart-healthy sugar?

In reality: They say it right there, don’t they, and somehow choose to ignore it? And “some studies” haven’t just “linked” Paleo diets to lower blood pressure, LDL cholesterol, and triglycerides. Randomized controlled trials have legitimately shown that Paleo diets can directly cause the improvements in traditional cardiovascular disease markers. You can argue that they were too small to draw overarching conclusions about the population at large, and that would be fair, absolutely, but the studies show causation, not just association.

Will you lose weight?

No way to tell.

Translation: There’s absolutely no way to tell if you’ll lose weight on this diet. None. We’ve racked our considerable brains, combed through the scientific literature, and consulted with several dozen different experts on human metabolism and nutrition. We’re all absolutely stumped. There is literally nothing present in the extant body of human knowledge that would indicate the Paleo diet can help you lose weight. The likely, if unfortunate, answer is that we will never – absent divine intervention – truly know if this diet can work for weight loss. We strongly suggest that you abandon your futile pursuit of weight loss on the Paleo diet and turn to one of the weight loss diets with extensive support in the scientific literature, like the Cookie Diet. Oh, and if you think “trying it out for yourself” can help you learn whether or not you’ll lose weight on Paleo, think again! Your inherent bias toward wanting to lose weight on the Paleo diet may induce hallucinatory delusions whenever you step on a scale to track your progress. Your weight will only appear to be lowering, and you’ve always worn that same size pant. What, you had to buy a new belt because the old one wouldn’t fit? How do you know you didn’t just imagine buying a new belt – ever think of that? Exactly. Don’t be fooled by the placebo effect, people.

In reality: Randomized controlled trials of the Paleo diet have shown it works for weight loss. And when compared to the Mediterranean diet, the Paleo diet has been shown to be more satiating per calorie. More recently, the same thing happened when they compared a Paleo diet to a standard diabetes diet in type 2 diabetics. Being able to eat fewer calories – spontaneously – without getting any hungrier is pretty much the defining characteristic of a successful weight loss diet. Paleo is also pretty good at helping you lose fat where it matters most. A recent study showed that postmenopausal women eating Paleo lost liver and waist fat, improving their waist-to-hip ratio and lowering their ApoB (a good approximation for LDL particle number) among other improvements.

Even if those studies didn’t exist, you always have the ability to determine if a diet works by trying it out yourself.

Are there health risks?

Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients. Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems.

Translation: By embracing eggs, beef, wild salmon, chicken, lamb, pork, kale, chard, romaine lettuce, spinach, blackberries, blueberries, raspberries, apples, broccoli, sweet potatoes, beets, carrots, oranges, sardines, organ meatsshellfish, fennel, onions, garlic, asparagus, seaweed, butternut squash, yellow squash, zucchini, tomatoes, strawberries, cantaloupe, almonds, macadamia nuts, sunflower seeds, pumpkin seeds, pecans, walnuts, and tuna, you’re at risk of missing out on a lot of nutrients. All those foods might taste nice and look pretty on a plate, but they are incredibly nutrient-sparse.

You won’t just increase your risk of heart disease. You will “quickly ratchet up” your risk. Let’s take this apart, because it’s a sneaky choice of words. “To ratchet” is “to cause something to rise (or fall) as a step in what is perceived to be an irreversible progress.” So not only are you increasing your risk of heart disease, you are setting out on an irreversible path toward heart problems. Each bite of 85/15 ground beef you take, each morsel of lamb chop you swallow, each time you fail to make a lean meat choice – these are death contracts upon which you can never renege.

In reality: I actually won’t quibble on the notion of dairy being a good, dependable source of nutrients like calcium, potassium, protein, and healthy fats. It is, which is why I support the consumption of dairy as long as you’re not intolerant of any of the components and suffer no ill symptoms. That said, you don’t need to eat dairy to get calcium, potassium, protein, or fat (besides, I highly doubt US News and World Reports count “dairy fat” as one of the benefits). In fact, leafy greens like kale, collards, mustard greens, and spinach and other vegetables like bok choy are excellent sources of calcium. Edible bony fish like canned sardines are also a great Paleo source of calcium, while protein and potassium are easy to come by on Paleo (in fact, the US News and World ranking committee admitted that Paleo provided nearly 10 grams of potassium, or double the recommended amount). As for general nutrient density, basic Paleo meets or (more commonly) exceeds the USDA recommendations for most nutrients (PDF).

Meat, whether lean or fatty, has never been consistently linked to heart disease. The most recent epidemiology actually vindicates fresh red meat, while condemning only processed meats like hot dogs and bologna. And even those associations are likely confounded by variables like the healthy user bias.

I was disappointed to see that they’d removed the reader response section, where readers could vote on whether a particular diet had worked for them or not. In 2011, when Paleo was similarly trashed by US News and World Report, the reader response overwhelmingly indicated that the diet worked for people (who were possibly experiencing a collective hallucination). This directly contradicts the opinion of the experts that Paleo is just too hard to follow (even if it were effective). Same goes for the way “paleo diet” is trending on Google. As Robb Wolf illustrates in his recent rebuttal to the diet rankings, if Paleo was “too hard,” we wouldn’t see the consistent upward trend of Google searches. We’d see a big drop off in interest – and we just aren’t seeing that.

Anyway, those are my thoughts. What about you? How many relatives and friends have you heard from regarding this? Does it change your mind at all?

Thanks for reading, all!

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You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. From the second point of interest “Will you lose weight?”, we can see that one of main markers in the scientific literature for the prevalent health problems in the U.S. is grounded in excess body fat (or rather BMI, which is a poor measure if ever there was one).
    But what about those of us (and please don’t stone me and cast me out of the primal village for writing this) who actually needed to GAIN WEIGHT?

    When I came upon the Primal Blueprint (Yes, everyone, it’s an anecdote) I was getting over being sick from trying everything conventional wisdom shouted was the proper way to a healthy, long, fit lifestyle. 3+hours of cardio a day, 8-9 servings of whole grains, shunning anything with fat, and even avoiding the weights in the gym entirely (Ha! Those bodybuilders are just going to get fat and suffer heart disease because of their massive BMI numbers!).

    What happened? I lost weight, but not the good kind. I was already lean at 6’4” 180 lbs. But in 4 months I dropped to a skeletal 155 on the triathlon diet, which actually consists of your eating muscle and connective tissue, not whole grains. I got sick, head in the toilet bowl sick, and lost an additional 5 lbs heaving. But hey! I had rocking abs, right? Yeah, they went past my ribs.

    While lying abed I scanned the internet with WTF? on my mind. Found the Primal Blueprint. Needless to say (well, almost) I got much better, regained my lost pounds, but maintained leanness with far more energy and focus than ever before. 3 years later I’m 190# and could lift my younger self over my shoulder and carry him up a mountain if so inclined.
    My point is, for some people, weight loss isn’t an issue, it’s returning our bodies to a healthy, stable weight that includes strong, functional muscle and lets us perform well in daily life, whatever that entails. I’ll shut up now.

    Kevin wrote on January 16th, 2014
  2. “but the studies show causation, not just association.”

    Whoa there horsie (Mark)! I’m all for primal eating- just ate a bunch of full fat stuff with added fat and stuff- but I’d just like to point out that it’s dangerous to say that a study “shows” (or even worse “proves”) something. “Suggests” is known to be a much safer word here in the science community :)

    SophieE wrote on January 16th, 2014
    • sophie,

      Did you click on the link to the study? The authors claimed causation in the abstract – this is NOT Mark going crazy.

      grisly atoms wrote on November 11th, 2015
  3. In my neck of the woods Paleo is on the rise! People who have joined in since I first found out about Primal eating:

    2009 – My husband and me! –> Combined weight loss of 115 (Him 50, Me 65)
    2011 – Husband’s Brother and his wife –> At least 15-20 pounds lost each
    2013 – My Sister –>Helping to clear up disordered eating
    2013 – My 70-yr-old Dad –> At least 25 pounds lost so far
    2014 – Husband’s Mom & Step-Dad –> Just getting started!
    2014 – Two of my business partners –> Just getting started!

    My husband and my health improvements and weight loss have contributed to almost all of these folks’ decisions to go primal. Some have had other positive influences in their decisions, as well.

    Then, of course, there was my Husband’s other Brother, who pretty much went primal in 2005 and quietly lost probably 70 pounds in about a year. If only I had been paying attention…

    Ellen wrote on January 16th, 2014
  4. I have learnt over the years to mistrust so called experts they are often anything but! My ex wife said once that one the traits she found least endearing was that I tended to dismiss such people as “a***holes” – its true but then I don’t get disappointed that often and am pleasantly surprised now and then!

    Are these experts by any chance funded by the pharmaceutical companies? The food companies? The agricultural lobby? The diet industry? Or even doctors, for whom the admission that they have been down the wrong road for a while and that perhaps they needn’t have prescribed statins for so long when a simple change of eating habits would do might be a step too far. God forbid – the class actions that might follow! might they have got anti depressants wrong too?

    Simon wrote on January 17th, 2014
  5. Great post, there will always be naysayers, and companies looking to fund another research project to ‘subliminally’ promote their products. The proof is in the pudding (so to speak) for me, I eat a primal diet, I feel better and look better. I get moody when I am eating too many packaged or carb heavy foods, that’s all I need to know! Besides, it’s a lifestyle, not just a diet, so yes, sticking to it isn’t always easy, we are now a convenience lead society. In which, from the looks of things we need a 2014 list of ‘best diets’.. I assume that’s so that we can start working our way down the list as each one fails and we end up gaining weight, only to go on the next one!
    As a side note… there’s a cookie diet?! That’s actually a real thing?! Hilarious, most of it is justified by being within ‘government guidelines’, I’m sure plenty of things are, but that doesn’t mean it’s good!

    Liv wrote on January 18th, 2014
  6. Paleo/Primal isn’t a diet. It’s a lifestyle. And I feel so good, I’m never going back. “Experts” be damned. These are the same people that think “I Can’t Believe It’s Not Butter” is healthier than actual butter. Primal makes intuitive sense. That’s why it’s so easy to follow.

    Samantha wrote on January 18th, 2014
  7. I actually took a geography class in college recently and my teacher brought up an interesting point. He said that native-born populations in western industrialized countries is actually going down. What happens when the rest of our world gets on our level industrially? Will their population go down? Or is it more cultural? Even if the population does continue to rise, we could still do more to conserve land. Not to mention, there is farming that can be done in multi-level greenhouses. Just think about how much soil there is on this earth. Multi-level greenhouses can be used for animals to, although they are not currently. I don’t think there is any reason to feel guilty about eating high-quality foods.

    D Fritters wrote on January 18th, 2014
    • Hans Rosling (who can blow your mind using statistics) did an interesting Ted talk about his prediction for the max world population. According to him -and the data- main predictors are health and income, not religion or culture, we’ve already reached peak child and the wold population will level off at about 9-10 billion. That’s still 3 billion more than we have now, and some number crunching to do on how to sustain all of us without ruining this world, but it beats exponential growth.

      Feather wrote on January 19th, 2014
  8. “Will you lose weight?

    No way to tell.”

    Hahaha. Even if I was 439, I would choose a lifestyle that had the potential of healing my depleted endocrine and digestive system (like paleo or gaps) over one that had the promise of steadily losing weight while ingesting toxic, highly processed “diet foods.”

    I use to be upset about America’s obession with “diets,” now I just laugh. We have the highest instance of obesity.I have never seen a single build board or advertisement for a diet or weight loss program in France: the country with the second lowest overall BMI which is consumes more fat than most countries. Hmmm wonder what’s going on there..

    libby wrote on February 17th, 2014
  9. I have been following the Paleo AIP program for about a month now. I have set my macros for protein to be at my ideal body weight in grams (about 30% of my diet – a pretty commonly agreed upon amount amongst trainers & athletic nutritional folks). I recently saw an article suggesting to set your carbs at the same amount (so again 30%) and the rest from fat (about 40%, consisting of animal fats, moderate coconut consumption, and plant fats – no nuts or seeds yet). I have been weighing and tracking everything. To my surprise, the only days I exceeded the AHA recommended 10% saturated fat consumption were the days I had coconut curries or coconut yogurt smoothies – and even then it was generally by only a few grams. Plus, I actually had to increase my fat intake to get my calories up – generally by adding in avocado. I am not sure where the idea of excess saturated fat comes in. Its not like paleo advocates snacking on mounds of lard and pork rinds.

    Kistin wrote on February 19th, 2014
  10. When I read that article, I couldn’t help thinking “OOOF”, in a Batman sort of way.

    Chrispy wrote on February 21st, 2014
  11. Actually, the reason “paleo” gets a bad review probably stems from the fact that the Crossfit community does such a terrible job of following it.

    They go to the store and buy normal grain fed factory beef, brined bacon from feedlot pigs and pig out on it and call it “paleo.”

    They have no idea what the hell they’re doing. Anybody who thinks ordering a “prime rib and mixed vegetables, hold the bread, hold the potatoes” at Chili’s counts as “paleo” is the reason “paleo” receives a bad rap.

    Jean wrote on March 2nd, 2014
    • If you’re out to dinner, prime rib and veggies sounds like a good choice to me (if the veggies don’t include corn and beans of course). We do the best we can with what we have. My budget doesn’t always support everything grass fed, pastured, organic, but I still think my LCHF diet is way healthier than the alternatives.

      Maxine wrote on March 3rd, 2014
  12. Conventional health propaganda in one hand, paleo propaganda in the other hand. Every health fad has its proponents and “proof” that it works.

    – eat real food
    – move your body
    – do some things you love
    – prevent and treat illness and injury

    prufock wrote on March 6th, 2014
  13. Has anyone else experienced increase in LDL after starting the diet?

    Angie wrote on March 14th, 2014
  14. All I ever hear is “All that fat…”. When I point out that my blood tests are perfect, I lost 100lbs and don’t have to take 12 pills a day anymore, they just go back to “But all that fat…you’re going to have a heart attack!”. Hmm, so are all the blood tests we use to determine health bogus or does this diet actually work? “But all that fat is going to clog your arteries!”. Did you hear the question?

    People have fully indoctrinated to stuff themselves with grain. They’re cheap and easy to grow especially with all the genetic work, they keep well for a long time, and they’re highly profitable. A cracker made from corn, rice and wheat boiled in soybean oil and sprayed with sugar tastes good and costs nothing. An acre of wheat generated 4-6x the profit of a head of cattle. Meat is messy, annoying to raise, expensive, and requires a lot of work to get to market. Building bogus studies full of links, ties and connections that aren’t there and a government driven advertising program are pretty effective.

    So its pretty easy to see what drives all of this ($), but good luck changing 95% of the populations minds. Fat and meat are bad, whole grain corn, wheat and soy are good. Even my ex-wife who watched me lose 100lbs and significantly improve my blood work still chants about the benefits of whole grains, and she’s a nurse. You’d think she’d be able to see the contradictions especially in the blood testing.

    Tom wrote on March 14th, 2014
  15. I’ve thought about this a lot. The real reason is that the liberal elites (no offense to left leaning paleos) are tied to the anti meat eaters (vegans), enviros and China study nonsense. And everyone knows they mostly control the mainstream media. I don’t want to see paleo get political though IT IS NOT!

    Tony wrote on March 14th, 2014
  16. It is exhausting when we have to constantly defend things that we know work well. I am a breast imager, and every year or two, someone publishes a very flawed article that makes people think that they don’t need mammograms, even though we know that mammography saves lives. I wish I had a solution!

    Ginger Layne wrote on March 14th, 2014
  17. I just don’t care what ‘they’ say. For me it just made sense, and reading the unsolicited experiences and results people were having eating this way just could not be ignored. I went for it, focused on all the delicious things I could have, made it look pretty so it felt like I was spoiling myself and voila! Energy through the roof within days, immediate and substantial weight loss, glowing skin (maybe because I was so happy to be losing weight without weighing, measuring, counting, ugh), no more heartburn and Prilosec, and enjoying food instead of obsessing over it. Sweet tooth…no longer hanging over my head. So ‘they’ can say what they want. If this way of living is ultimately going to kill me, well, at least I will feel my best, look my best, and accomplish a lot more before I go! Well, it is Sunday…going to go prep some fresh clean food for the week.

    Tia Stanley wrote on April 13th, 2014
  18. Seems to me that all organised ‘diet’ groups are there to make money. Not just out of your membership fee, weekly attendance fee but also out of all the accompanying merchandise. The great thing I found about them was that it helped me to have someone else who wanted me to loose weight and who had to listen to me when I wanted to talk. I just made sure I didn’t actually talk about what I was eating – just about the way to avoid eating the things I knew I shouldn’t eat.
    Over the years I have tried all kinds of different diets or ‘healthy lifestyles’ with varying degrees of success. I’m not completely sold on Paleo, but I certainly believe that eating natural, unprocessed foods, prepared and cooked at home is by far the best way to live.
    As soon as you give a diet/lifestyle a name it seems to me that business jumps on the band wagon and tries to create merchandise that will fit. How about Paleo snackbars – sweetened with honey to avoid the need for refined sugar, but just as bad for your blood sugar levels in the long run.
    Scientists have sold out to the big food companies and so have governments – they are all running scared and that’s why any thing that promotes natural food (read no added value) will always be rubbished.

    Ruth wrote on July 30th, 2014
  19. what irks me is that most of the “commercial” diets rated at the top, and the simple do-it-yourself diets were at the bottom. Also, if you pull apart some of the better rated diets, they have principles which basically follow the primal diet. Even the “volumetrics” diet – eat lower volumes of more nutrient dense foods – sounds a lot like the premise of the primal diet.

    We can’t have people with do-it-yourself diets, they need to be controlled and forced to join a membership club.

    Storm wrote on March 25th, 2015
  20. One other big point – all these “diets” don’t mention anything about the type of EXERCISE you need to do in conjunction with the diet – that’s what makes the Palio less attractive, because it will actually require you to get up and move to successful. Even more so for the Primal blueprint, for example, I find if I don’t get in a weekly “sprint” session, my bodyfat increases. What would be interesting is to rate these “diets” in terms of effects when doing exercise.

    The primal blueprint “diet” cannot even be rated with these others as its not a “diet”, its a total lifestyle eating, exercising, living guide.

    Storm wrote on March 25th, 2015
  21. I had really a laugh….

    Certainly the people writing this information have no idea about medicine whatsoever.

    From an endocrinological point of view it has been proved that the Gluconeogenesis happens even during fasting in the liver, that is a fact. So even if you don’t consume Carbs, glucose will be generated by this metabolic path.

    Historically agriculture and this carbs are quite new, if we can compare it to the human existence on this planet, just investigate how long have we been here and the story of certain foods, like “potatoes, rice, and few others”.

    If a paleo diet works or not depends exclusively on your metabolism, you could have a neolithic metabolism, which means that through the exposure to Carbs your body has already learnt how to process them correctly, while a Paleolithic metabolism will process the Carbs into Sugar and simultaneously do the Gluconeogenesis.

    It really depends of the metabolism of the person, my metabolism is Paleo, and I live Paleo… you gotta know what metabolism you got.

    We the human, are the only animals who changed the way we eat…. I haven’t seen a cow eating meat…. or a Lion eating grass….

    I.D. wrote on November 11th, 2015
  22. “Your inherent bias toward wanting to lose weight on the Paleo diet may induce hallucinatory delusions whenever you step on a scale to track your progress. Your weight will only appear to be lowering”

    It all makes so much sense now. I didn’t lose 12 pounds after going primal – turns out the bathroom scale must have malfunctioned.

    At first I put in a new battery, thinking that might solve the problem, but it still showed that I lost 12 pounds.

    I took the scale back to the store and exchanged it for a brand new one, but the new one also showed 12 pounds of weight loss.

    So now I have no idea why the scale showed me losing 12 pounds – I think I will write a strongly worded letter to the manufacturer! What are they trying to pull?

    grisly atoms wrote on November 11th, 2015

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