1) The Paleo Diet is based on a simple premise: stripping our diet down to the basics and mimicking the consumption habits of our caveman ancestors. Can you explain what this means from a food standpoint?
I wouldn’t necessarily agree that contemporary Paleo diets “strip our diets down”, but rather the opposite – they enrich our diets by reducing nutrient depleted foods that are ubiquitous in the typical western diet. This lifelong plan of eating to maximize health actually increases total micronutrient (vitamins, minerals, phytochemicals, fiber) density compared to the USDA My Plate recommendations, formerly the Food Pyramid as well as other so called healthful nutritional plans such as the Mediterranean Diet, The Dash Diet, Type 2 Diabetic Diets, vegetarian diets and others (1, 2).
Further, we shouldn’t be sexist and characterize this lifelong eating plan as being based upon “cavemen” diets only, rather it also includes the diet of hunter gatherer women. And really it is not scientifically accurate to call it a “caveman” diet, but rather a “pre-agricultural” diet based upon the nutritional practices of our hunter gatherer ancestors (both men and women) who lived during the Paleolithic (old stone age) era and afterwards.
From a food standpoint, it means that we should try to mimic the food groups our hunter gatherer ancestors consumed with contemporary foods available in most supermarkets, farmers markets, co-ops and grocery stores. These foods include fresh vegetables, fruits, fish, seafood, grass produced meat and poultry, nuts and certain healthful oils. People consuming contemporary Paleo diets should try to avoid refined sugars, refined grains, trans fats, salt and almost all processed foods. Our hunter gatherer ancestors rarely or never ate dairy products and cereal grains.
1. Cordain L, The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Neutraceut Assoc 2002; 5:15-24.
2. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54.
2) From Atkins to the South Beach Diet, there is currently a variety of low-carb, high-protein diet plans on the market. In your opinion, what makes the Paleo Diet more effective than other diet plans out there?
As I mentioned earlier, the Paleo Diet is not a “diet” per se, but rather a lifetime plan of healthful eating which reduces the risk of the chronic “diseases of civilization” (obesity, type 2 diabetes, hypertension, high cholesterol, abnormal blood lipids, cancer, heart disease, etc.) which run rampant in the U.S. adult population.
Virtually all popular “diets” such as Atkins, South Beach and others were designed, engineered and created by fallible humans, and as such are rife with our human biases, misinformation and errors concerning the elements of optimal human nutrition. Although, Boyd Eaton, myself and others have been credited with creating “The Paleo Diet”, this perception is incorrect. The Paleo Diet is and always has been a biological force that shaped the human genome including our present day nutritional requirements. It was created not by fallible human judgment but rather by the forces of evolution acting through natural selection over millions of years. Together with anthropologists, physicians and scientists worldwide, Dr. Eaton and I simply uncovered that which was pre-existing. The Paleo diet has always been the native diet of our species until the beginnings of the agricultural revolution 10,000 years ago (a mere 333 human generations). Our hunter gatherer ancestors consumed a wide variety of fresh plant and animal food depending upon their geographic locale, time of season and food availability – hence there was no single “Paleo Diet” but rather numerous versions of these same two food elements: wild animal and plant foods. Hunter gatherers ate no dairy foods, and rarely ate grains and except for seasonal honey ate no refined sugars. Clearly they ate no modern processed foods.
Under these nutritional stipulations our ancestral diet was almost always high in protein and low in carbohydrate (3). Hence, modern diets designed by diet doctors and fallible humans that are high in protein and low in carbs have at least got these two basic elements of our ancestral diet correct. Nevertheless, it is almost axiomatic that the remainder of these fallible human dietary recommendations will be inconsistent with our ancestral diet and ultimately will result in nutritional shortcomings and health problems.
Case in point: The Atkins Diet. This diet has been with us in various forms for at least 40 years and advocates reducing dietary carbohydrates to less than 100 grams per day or lower. Few or no restrictions are placed upon the carbohydrate type, just the absolute amount. So in effect, whole grains, refined grains and refined sugars would be equivalent to fruits and vegetables as long as the total amount is restricted. Additionally, fat types and sources are also undifferentiated, just as long as they don’t contain carbs that would exceed Atkins’ recommended values. Cheese, butter, and cream are advised in lieu of excessive carbs from fresh vegetables and fruit.
The problem with these fallible human dietary recommendations was that Dr. Atkins was unaware of acid/base physiology. Had he considered the evolutionary dietary template, he would have realized that a high protein/high fat diet that restricts carbohydrates from fresh vegetables and fruit was inconsistent with our ancestral nutritional patterns and likely to cause health problems. Further, he placed no limits upon cheese or even salted foods (net acid yielding foods) as long as they were low in carbohydrate. It is now known that diets with excessive acidity without accompanying base (alkalinity) from fruits and veggies adversely affects bone mineral health, blood pressure, kidney function and a variety of other factors (2, 4, 5).
In summary, unless high protein, low carbohydrate diets concocted by mortal humans don’t consider the evolutionary template they will invariably contain recommendations that are inconsistent with our ancestral diet and ultimately will result in sub-optimal health.
3. Cordain L, Brand Miller J, Eaton SB, Mann N, Holt SHA, Speth JD. Plant to animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. American Journal of Clinical Nutrition, 2000, 71:682-92
4. Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr. 2002 Dec;76(6):1308-16
5. Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A.
Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13
3) What initially piqued your interest in studying the human diet of our Stone Age ancestors?
In 1987, I read Dr. Boyd Eaton’s seminal paper on the topic of “Paleolithic Nutrition” which appeared in the prestigious New England Journal of Medicine (6). At the time, I thought this was about the best idea I had ever read on human nutrition, and have spent the past 25 years or so studying this concept.
6. Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med. 1985 Jan 31;312(5):283-9
4) Dairy is one of the foods on the Paleo “do not eat” list. But by shunning dairy, don’t you run the risk of missing out on the many health benefits of dairy, including strong bones and digestive support?
The notion that calcium is the only and most important determinant of bone mineral health is incorrect, and in fact, numerous nutritional elements are involved in producing strong bones including acid base balance (adequate fruit and vegetable consumption) as mentioned above, sufficient high quality dietary protein, and a low dietary salt intake among others (7). Do these nutritional factors sound familiar? Which popular diet simultaneously maintains these characteristics?
Milk and dairy consumptions elicits insulin resistance in children (8) and represents a prominent risk factor for prostate, ovarian cancer, acne, multiple sclerosis and type 1 diabetes (7).
7. Cordain L. Just say no to the milk mustache. In: The Paleo Answer, John Wiley & Sons, New York, NY 2012.
8. Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8
5) Do you think the Paleo Diet is too “strict” and inflexible? How can an individual maintain the Paleo Diet when dining out or in a situation where they are faced with limited food options, for example?
Built into The Paleo Diet is the 85:15 rule meaning that most people can obtain substantial health and weight loss benefits if they are at least 85 % compliant with the diet. Three open meals per week correspond to 15 % non-compliance. So if you want to go out and have pizza and beer with friends on a Saturday evening, it is permissible. However, many people feel so bad after days and weeks of high compliance that it makes them think twice about doing it again. People with serious health and obesity issues should try to maintain high compliance (95 % or greater).
6) In your book The Dietary Cure For Acne, you discuss the ways in which modern environmental factors (including diet) can trigger acne. What are some of the top foods for clearer, blemish-free skin?
The big issue here is the foods that shouldn’t be consumed, These are the high glycemic load carbohydrates (9-11) and dairy products (12-14) which produce hormonal and cellular changes known to cause acne. Again the evolutionary template with a diet consisting of a fresh foods (fresh, grass produced meats, poultry, sea food, fish, fresh vegetables and healthful oils) is the best medicine to produce clearer, blemish-free skin.
9. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002 Dec;138(12):1584-90. http://thepaleodiet.com/research-about-the-paleo-diet/#2002
10. Cordain L, Eades MR, Eades MD. (2003). Hyperinsulinemic diseases of civilization: more than just syndrome X. Comp Biochem Physiol Part A:136:95-112. http://thepaleodiet.com/research-about-the-paleo-diet/#2003
11. Cordain, L. Implications for the role of diet in acne. Semin Cutan Med Surg 2005;24:84-91. http://thepaleodiet.com/research-about-the-paleo-diet/#2005
12. Cordain L. Dietary implications for the development of acne: a shifting paradigm. In: U.S. Dermatology Review II 2006, (Ed.,Bedlow, J). Touch Briefings Publications, London, 2006 http://thepaleodiet.com/research-about-the-paleo-diet/#2006
13. Melnik BC. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestle Nutr Workshop Ser Pediatr Program. 2011;67:131-45.
14. Silverberg NB. Whey protein precipitating moderate to severe acne flares in 5 teenaged athletes. Cutis. 2012 Aug;90(2):70-2
Part II. (These can be very brief, 1-2 sentences).
If you had to sum it up in a word or phrase, what is your health philosophy?
Emulate the activity and nutritional patterns or our hunter gatherer ancestors with all of the advantages of our modern world.
What is your favorite healthy weeknight dish to make?
I don’t distinguish between weekend or week nights. Steamed king crab is a favorite
Do you have a favorite workout or fitness activity?
Exercise, play or any physical activity in the outdoors under the sun in a peaceful, natural setting.
What would you say is your “secret weapon” to staying healthy?
Adopting the beneficial aspects of our ancestral diet/lifestyle while leaving behind their hardships and taking advantages of the technological advances of our modern world.
If you’re ever faced with temptation, how do you keep yourself on track? Any tips?
Think about how well I will feel in the morning if I don’t fall to temptation.
Loren Cordain, Ph.D., Professor Emeritus