Is a Paleo Diet Healthy?
Kellyann Petrucci says eliminating
foods such as grains and dairy leads to better health; Marion Nestle says good
nutrition involves balance and variety
The statistics tell a scary story.
More than one-third of U.S. adults—close to 80 million people, according to the
Centers for Disease Control and Prevention—are obese, and as Americans’
waistlines continue to grow so do rates for chronic health conditions such as
Type 2 diabetes and cardiovascular disease.
But does the path to weight loss and
better health lie in eating like our hunter-gatherer ancestors, eschewing
grains, dairy products and the other foods of the modern agricultural era in
favor of protein, nonstarchy vegetables and healthy fats such as coconut oil?
That’s what advocates of a paleo
diet say. Government health experts in Washington, though, seem to disagree.
The latest dietary guidelines from the U.S. Agriculture Department encourage
Americans to consume whole grains and dairy products on a daily basis, and to
avoid foods high in fat.
Arguing in favor of a paleo diet is
Kellyann Petrucci, a naturopathic physician, certified nutritional consultant
and clinical director of Birmingham Wellness Center in Birmingham, Mich. Making
the case against it is Marion Nestle, a professor of nutrition, food studies
and public health at New York University and author of “What to Eat.”
YES:
It Helps Control Weight and Lowers Risk of Cancers
By Kellyann Petrucci
I prescribe a paleo diet for my
patients because I’ve found that it is the best diet to foster weight loss and
good health.
In contrast to high-carbohydrate
diets that have led to skyrocketing rates of diabetes, obesity and inflammatory
diseases, a paleo diet can reduce inflammation, reverse diabetes symptoms,
lower blood pressure and cut cancer risk by providing a template of foods that
are as close to nature as we can get today. Science backs me up.
A study
published last October in Lipids in Health and Disease found a paleo diet to be
more effective in reversing metabolic syndrome (the first step toward diabetes)
and cardiovascular risks in patients with extra belly fat or other risk factors
for diabetes than a diet based on standard guidelines. What’s more, the paleo
group lost more weight even when the researchers tried to keep their weight
stable by adding extra calories.
A study
published in Cardiovascular Diabetology in 2009, meanwhile, compared a paleo
diet and a standard low-fat diabetic diet on people with Type 2 diabetes. The
paleo group ended up with lower HbA1c levels (a long-term measure of blood
sugar), lower triglyceride and blood-pressure levels, and higher levels of
“good” cholesterol. They also lost more weight and belly fat.
Good fats
Many doctors believe a Mediterranean
diet—emphasizing whole grains, low-fat dairy foods, vegetables, fruits, fish
and olive oil—is the best. However, a 2007 study
in Diabetologia comparing it to paleo found that in patients with ischemic
heart disease, the paleo diet led to better glucose tolerance and a larger drop
in abdominal fat.
Because it is low in carbohydrates,
a paleo diet may cut your risk of cancer. A 2014 study in Cell suggests a low-carb diet can reduce the risk of
colon cancer, and a 2011 study in Cancer Research indicates it may lower the
risk of breast cancer. A diet high in carbohydrates, in contrast, increases the
risk of colon cancer.
Critics of the paleo diet like to
point out that it isn’t low in saturated fats. However, a recent meta-analysis of more than 70 studies found no evidence that saturated
fat is bad for your heart or that other kinds of fats are more beneficial.
Moreover, the fats in a paleo diet come from natural sources such as coconut
oil—not from heavily processed seed oils.
Some nutritionists charge that by
eliminating certain food groups such as dairy, a paleo diet can lead to
nutrient deficiencies. That criticism is flawed, too. Paleo foods such as
salmon, sardines, kale, broccoli and figs are rich in calcium, and you can get
the same fiber and nutrients from vegetables, healthy oils, seafood, eggs, meat
and fruits as you get from beans, grains and soy. And you’ll get them without
overloading your body with gluten (to which many people react badly),
insulin-spiking carbs and phytic acid, which impairs your uptake of crucial minerals
like calcium and iron.
Food swap
The great thing about the paleo diet
is that it doesn’t require you to give up cultural traditions or foods you
love; it simply asks you to adapt them in ways that make you healthier. My
family adores my Italian grandmother’s marinara sauce tossed with spaghetti
squash strands or zucchini ribbons.
In short, I prescribe a paleo diet
for my patients because science shows it is healthier, and that’s why I believe
you should follow it, too.
Dr. Petrucci is a naturopathic
physician, certified nutritional consultant, and clinical director of
Birmingham Wellness Center in Birmingham, Mich. Email her at reports@wsj.com.
NO:
You Lose Too Much Pleasure for Dubious Benefits
By Marion Nestle
Nutritionist that I am, the first
questions I have about any diet are: What is it? Is the rationale behind it
logical? And does it promote health?
A paleo diet is based on the premise
that our genes govern what’s best for us to eat. We evolved to eat whatever
could be hunted or gathered. This makes it OK to eat leaves, shoots, roots,
seeds, eggs, animals, birds and fish, but not OK to eat grains, legumes, dairy
or processed foods.
Why do paleo proponents think the
ills of modern society stem from a mismatch between our genetics and today’s
typical diets? The cave men, some argue, didn’t suffer from diseases such as
obesity, heart disease and diabetes.
The problem with that theory is that
we really don’t know what our Paleolithic ancestors ate. As I often argue,
determining what people eat is the single most intellectually challenging
question in nutrition science. It is extraordinarily difficult to get an
accurate idea of what people ate yesterday, let alone 10,000 to a million or more
years ago.
In reality, scientists are nowhere
near being able to match genes to specific kinds of diets. The reason cave men
didn’t have chronic diseases like diabetes is more likely because they didn’t
live long enough and lacked antibiotics, rather than because they didn’t eat
carbohydrates.
Variety is key
What we know for sure is that the
fundamental tenets of nutrition are variety, balance and moderation. The fewer
kinds of foods consumed, the greater the chance of nutrient deficiencies. So
while it is certainly possible to eat healthfully on a paleo diet, restricting
whole groups of relatively unprocessed foods can make this more challenging. It
also can take some of the joy out of eating by forcing people to give up foods
that they love or that are part of their cultural heritage.
While there is no doubt that highly
processed “junk” foods are unhealthy and should be kept to a minimum, grains
and legumes are hardly the enemy. Diets that vary enormously—from the
traditional high carbohydrate, rice-based cuisines of Asia to those of the
Mediterranean rich in grains and olive oil—have been shown to promote health
and longevity.
Yes, grains contain glutens, and
bread and pasta are caloric, but such foods are also delicious and part of
traditional diets in nearly every culture. Yes, legumes contain unpleasant
phytochemicals, but these are mostly destroyed by cooking, and beans and peas
are excellent sources of vegetable protein. If you eat foods from animal
sources, why restrict dairy? Cheese and yogurt are lovely foods, and I, for
one, cannot imagine life without an occasional serving of ice cream.
Eating less works
Any restrictive diet helps to reduce
calorie intake, so it isn’t surprising that there are studies linking paleo to
weight loss, lower blood sugar and a reduced risk of cancers for which obesity
is a risk factor. Eating less works every time.
So does eating a largely plant-based
diet. Research suggests that we can reduce risks for today’s diseases of
affluence by eating more foods from plant sources and balancing calorie intake
with expenditure. To the extent the paleo diet achieves these goals, it is a
reasonable choice.
But food is so much more than
bundles of nutrients. What we eat also nourishes us psychologically and
culturally. So while a paleo diet isn’t necessarily bad, why bother? I’d be sad
to miss all those delicious forbidden foods.
Dr. Nestle is a professor of
nutrition, food studies and public health at New York University.
Maybe paleo works for some people.
What I don't understand is why they feel the need to talk about it so much. I
know a couple of people following it and every meal with them is turned into a
monologue of what they can and cannot eat under paleo and how it is working
great for them.
Personally, I eat everything in
moderation and exercise regulary. 19% bodyfat.
Btw, did the caveman drink alcohol?
None of the paleo dieters I know have given up alcohol.
Yeah, there just isn't enough
balance and variety in eating almost every meat, vegetable and fruit product on
earth.
Eating a lot of grains and sugar
just gets you on the blood sugar rollercoaster. And there are no decent
studies that say a plant based diet does anything for you either.
Once again, we assume a paleo/primal
type diet involves gorging yourself on meat and fat. Or that we have to
debate whether primal man ate this diet or not.
Three years ago I was eating the
'fabulous balanced diet' of 'healthy whole grains' and so forth. I
couldn't stop gaining weight even though I ate < 2000 calories a day and
exercised regularly. When I stopped doing what doesn't work and ate 1/3
protein, 1/3 fat and 1/3 carbs, I lost 90lbs and feel great. My bloodwork
is pristine.
I've seen Paleo work for a lot of
people. It's a healthy satisfying diet once you learn how to use
it. I'm all for changing our "cultural traditions" if it means
a healthier life which eliminates disease and suffering. The American
consumer is being sold a lot of poison that will only make the doctors
rich. They need to educate themselves and eat less. Slowly that is
happening. The obese have to realize that there is something they can do
to help themselves. We have to learn to become aware of and control what
we eat. It's is amazing how much food is available here.
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