Tag Archives: weight loss

Media’s Botched Coverage of Long Term Weight Loss | The Paleo DietIt sounds like a gimmick, doesn’t it?

Well, it would be if the top five tips focused on pills, powders, and packaged shake mixes that often have some side effects and frequently don’t even offer lasting results.

But what if we take a more natural, soundproof approach to turning our bodies into better fat burners instead?

How do we do this?

By changing what we eat.

Some may be surprised to learn that one of the most effective strategies for getting more efficient at using fat rather than carbohydrate as our fuel is to eat more of the very thing we have been told for years to avoid:  fat.

To clarify, this is not to suggest that we should simply add fat to the diet; rather, to shift the focus away from a high carb method of eating to one garnering more of its calories from an array of natural fat sources.

A study published by the Harvard T.H. Chan’s School of Public Heath showed that “a low-carbohydrate diet may help people lose weight more quickly than a low-fat diet and may help them maintain that weight loss.”  In addition, a low-carb diet was most beneficial for lowering triglycerides – the main fat-carrying particle in the bloodstream – and also delivered the biggest boost in protective HDL cholesterol.” (1)

Trust me, not only will you begin to see the pounds come off slowly and surely, you’ll quite likely begin to enjoy your meals much more, due to how satiating fat is.

Below are my top five tips to help make the shift to eating more fat and begin the transition into being a better fat burner.

1. Up the Water

No, I’m not suggesting you take a mind-over-matter approach to your hunger by drinking water instead.  Rather, simply check in to see it the next time you’re feeling hungry, you’re actually just thirsty.  Thirst can sometimes masquerade as hunger since the same part of your brain is responsible for interpreting hunger and thirst signals (resulting in mixed signals) (2), Before reaching for a snack, it’s worth a quick check by simply having a glass or two of alkaline water to make sure that doesn’t do the trick. How much water should you be taking in? There’s no one-size fits all approach, as there are many factors that would skew one’s need for water, such as age, activity level, gender, supplements, and medications. A safer bet is to simply make sure that your urine is light straw-color.   If you actually are thirsty, that’s a clear sign you’re dehydrated. Thirst indicates you’re already about 2-3% under where you should be.   Bottoms up!

2. Reduce the Carbs- That Includes Fruit

Eating white sugar has no part in a sound approach to weight loss, or a sound approach to health, for that matter, but it’s not just white sugar we need to be concerned about.   Many people eat far more fruit than veggies, no thanks to the categorization of the two together when we get the recommendation to ‘eat fruits and veggies.’ The results is more more sugar and less fiber compared to eating abundant veggies.   Begin to reduce the number of fruits you’re consuming each day.   You may be surprised to see the need to eat as often decreases, due to how much more satisfied you are after eating!

3. Audit your Veggie intake

Let’s be honest; are you really eating enough leafy greens?    Did you know only 1 in 10 Americans eat enough? (3)   With spring in the air, this is the perfect time to head to your local farmer’s market and start to develop a relationship with the vendors of some of the most amazing bounty you’ve likley ever seen.   Tip:  Ask them for ‘how to’s’ in terms of ways to prepare veggies that you’re learning about, perhaps for the first time!

4. Up the Fat

While it does require some thinking outside, the box, adding a variety of healthy fats to the diet is really not all that radical.   Simply use a bit more coconut oil to sauté your veggies and prepare your over-easy whole eggs, or top off the meal with some sliced avocado. Little things like this can do the trick to take what might have been a low calorie and low fat meal from ‘lite’ to ‘luscious’.    Plus, it will be all the more enjoyable and you’re not going to need a snack in two hours.

5. Check your sleep

Not getting enough sleep can spoil even the most prefect eating and exercise regimes.  The Mayo Clinic reported in a study that women who slept less than six hours a night or more than nine hours were more likely to gain 11 pounds (5 kilograms) compared with women who slept seven hours per night. (4)


If you’re feeling skeptical about upping the fat and going against what we’ve been told for years, ask yourself one question:  how has the low fat approach been working for you so far?

If you find yourself trying to achieve a different result while following the same approach, why not try something new, rather than banging your head against the wall, trying to figure out why it’s just not working (again)?



1. “Low-Carbohydrate Diets.” The Nutrition Source. Harvard’s HT Chan School of Public Health, 12 Apr. 2016. Web. 07 May 2017.
2. Bruso, Jessica. “Difference Between Being Hungry and Thirsty.” LIVESTRONG.COM. Leaf Group, 13 May 2011. Web. 07 May 2017.
3. Thompson, Dennis. “Only 1 in 10 Americans Eats Enough Fruits and Veggies: CDC.” Consumer HealthDay. N.p., 09 July 2015. Web. 07 May 2017.
4. Hensrud, M.D. Donald. “Sleep and Weight Gain: What’s the Connection?” Mayo Clinic. Mayo Foundation for Medical Education and Research, 16 Apr. 2015. Web. 07 May 2017.



Female sprinter | The Paleo Diet

So with the New Year upon us, diet and exercise resolutions typically feature prominently in many people’s lives.  However, in most cases, these resolutions fail fairly quickly and; in many cases, they have already been broken.  Despite the well-recognized beneficial impact of regular exercise on numerous health parameters, exercise participation and adherence in the general population remains poor1 – ‘lack of time’ being one of the most commonly cited reasons why individuals fail at committing to a regular exercise program2.  Consequently, it would be prudent to examine effective exercise programs that do not require a significant time commitment.

Last year, I wrote an article here that covered some of the science behind supra-maximal interval training (SIT), a mode of exercise that creates physiological benefits with a minimal time investment. And; so, if you think the title of this piece sounds too good to be true, I advise you to go and read or re-read that article so that the protocol I’m about to describe to you is more believable; as well as, understand that it does indeed have scientific backing and makes physiological sense. So the purpose of this article is to simply provide the reader with an easy to implement effective exercise protocol that requires an incredibly small investment of time.

When I lecture about SIT, I describe an activity that helps my audience understand why intensity, not duration, is the key ingredient to improving one’s fitness.  I ask the audience to close their eyes and imagine they are standing at the base of the stairs inside a football stadium. I, then, ask them to imagine ascending the stairs as fast as they can while I describe to them the many varied speeds that would be witnessed despite everyone putting forth the same relative effort.  I also describe what everyone would be typically feeling at 15, 30, 45 and finally 60 seconds when I shout stop. I, then, ask them to compare the heaving breathing and the feeling of lactic acid in their lungs and muscles that they would be experiencing to what they would experience following an hour-long walk or slow jog.  Then a simple question:  which of these two training modalities do they think is going to stress them more to cause a physiological change to their cardiorespiratory and metabolic fitness?  Common sense leads everyone to consistently choose the all-out sprint as the method that they think would lead to a greater physiological change.  After then quantifying the number of steps attained, I state that everyone is done training for the day and; since they will inevitably feel some effects from that all-out effort, they will have a day’s rest before returning to the stadium for their second all-out stair-climb on day three.  I tell them we are going to continue doing this for 30 sprints, which will equate to two months of training requiring just 3½ minutes per week! To clarify this time commitment, it would take two weeks to complete seven “every other day” 60-second sprints, hence 3½ minutes per week.  And, finally, the ultimate question, “does anyone doubt, that on the 30th sprint, you will be able to attain significantly more steps than you did back on day one?”  Intuitively, people understand that they would be able to do more steps on their last sprint compared to their first.  And if this happens, by definition one is now fitter since a greater amount of work has been accomplished in a given amount of time.  So you can indeed improve your fitness in just 3½ minutes per week when the training effort is maximal or close to maximal.

You can test this out for yourself, and so here’s your challenge for the New Year:  While continuing with your current level of activity, add just 3½ minutes per week of all-out sprinting and see for yourself what this can accomplish.  I will offer different options for you on how to accomplish adding in these “sprints”; but, first let me describe what I recently did to prove my point.  Since improvement is always harder when one is already very fit, I reduced my own training to the lowest possible quantity, given that conditioning people is part of what I do for a living and am; therefore, constantly on my feet; as well as, demonstrating exercises throughout the day.  However, eliminating my own training for a few months led to a significant decrease in my maximal 60-second sprint speed, on a treadmill set to a 15% incline, from about 9.0 mph to around 7.0 mph.  I, then, embarked on an exercise protocol that involved sprinting on a treadmill, set at a 15% incline, for just 60-seconds, every other day, beginning at 7.0 mph, a speed previously established as a maximal or at least close to maximal effort.  If the 60-second sprint was successfully completed, the subsequent sprint was done at a speed 0.1 mph greater than the preceding sprint, equivalent to running an additional 2.68 meters in 60-seconds.  If the 60-second sprint was not successfully completed, the speed was not increased for the next sprint until it was successfully completed.  The protocol was conducted for five weeks such that a total of 18 sprints were completed.  Table 1. shows the speed (mph), time completed (s), meters attained, increase in meters from the first sprint, and percent improvement from the first sprint for each of the 18 sprints, and Figure 1. graphically displays the additional meters attained from the first sprint.


Sprint Table with Caption (2)


Sprint Graph with Caption (2)


As both Table 1. and Figure 1. demonstrate, over the course of just five weeks, sprinting all-out for 60 seconds every other day, resulted in an improvement of 32.18 meters (105.58 feet) from the first sprint, a 17.14 percent improvement.  Note that not every sprint was successfully completed on the first attempt at the increased speed.  When you are working at a maximal effort, there are many factors that influence performance, mental fortitude probably playing the largest role.  But even when the sprint isn’t successfully completed, your system is still being significantly challenged and a training effect is still occurring.  Consequently, over time, you will see an increase in performance albeit with a few peaks and valleys along the way.

Now, while this protocol will help you improve your fitness, I’m not suggesting that adding a few more sprints to your work-out is not going to help you more.  In fact, you might be thinking, if I’m going to make the effort to get to the gym, I might as well do a couple more sprints while I’m there!  So, of course, you can do more; but, be careful how much SIT you do, as it is easy to over-train.  Research has already shown that SIT for 8 minutes per week for just 2 weeks can both double endurance capacity3; as well as, substantially improve insulin action4 , so doing significantly more than that likely isn’t necessary for most people.  Additional exercise time could be better spent in other modes of exercise to improve strength and mobility for example.  Since I began my interest in SIT back in the mid 1990s, the research has always suggested a similar quantity to that used in the above referenced research.  As a consequence, I have used with my clients and recommended in lectures, a 12-minute per week protocol that has proven very successful.  This 12-minute per week protocol involves completing four, 60-second sprints, separated by a 4-minute recovery, three days per week.  The three days also need to be separated by at least one days rest in order for the body to adapt and recover.  Consequently, a Monday, Wednesday, Friday timetable works well for many people.  It is important not to shorten the 4-minute recovery because if you do, you will not be able to maintain the power output attained in the first “all-out” effort interval.  In fact, 4 minutes is a minimal recovery timeframe and you can certainly take more recovery with no detriment to the training.  In fact, I have often stated that having a very long recovery (e.g., an hour or more) is better because you will ultimately be able to increase your power output by having more recovery. It is not about “keeping your heart-rate up” during the work-out, the 60-second sprint itself is challenging enough.  Now obviously having an hour recovery is not the most time-efficient if you’re doing this work-out at the gym; however, if you have access to a modality at home or work, this approach can work very well.  For example, many people have a tall enough staircase at their workplace which works well for SIT as the impact is low while the intensity can easily become maximal.

I have conveyed this message to thousands of fellow health-care professionals in my capacity as a lecturer for the Titleist Performance Institute, who, in-turn, have passed this on to their clients, and I have yet to hear that the protocol hasn’t significantly improved anyone’s health and performance.  A year after one such lecture, a physical therapist approached me at another seminar to thank me for the recommendation.  He worked at a hospital and used the staircase in his building to run four, 60-second sprints throughout the day on a Monday, Wednesday, and Friday. A great benefit to spacing the sprints throughout the day is that you do not really perspire in just 60-seconds and; so, with a long recovery, you do not need to be changing into work-out clothes – avoid high-heals; but, other than that, your pretty much good to go in your usual work attire.  The physical therapist went on to tell me that he corralled a group of his co-workers to commit to the program along with him and; in doing, so was able to lose over 50 lbs. over the course of the year!  Pretty good for just 12 minutes per week!

There are many different modalities that can be used for SIT; but, for those where balance, mobility or joint issues come into play, the upright stationary bike is probably the best alternative.  It also works well for everyone else, too.  However, unlike for most treadmills, where the speed is pre-determined, upright stationary bikes set a resistance and the speed is dictated by the user.  As a consequence, the speed is quicker at the beginning and slows quickly as fatigue develops with time; hence, 60 seconds feels like an eternity. So if you choose to use an upright stationary bike, set the resistance to as high as you can handle and complete the time prescription in 30-second increments rather than 60.

So, in closing, don’t give up on a new year’s exercise resolution because you can’t commit to a plan that requires an amount of significant time.  Hopefully, you’ve seen that a little exercise can go a long way when implemented with an all-out effort.  And if you do fail with your New Year’s resolution, don’t give up for the long term; realize that you can get right back on track any time with a minimal amount of time required.


[1]Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet 2012; 380(9838): 247-57.

[2]Korkiakangas EE, Alahuhta MA, Laitinen JH. Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: a systematic review. Health Promot Int 2009; 24(4): 416-27.

[3]Burgomaster KA, Hughes SC, Heigenhauser GJF, Bradwell SN, Gibala MJ. Six sessions of sprint interval training increases muscle oxidative potential and cycle endurance capacity in humans. Journal of Applied Physiology 98: 1985-1990, 2005.

[4]Babraj JA, Vollaard NB, Keast C, Guppy FM, Cottrell, Timmons JA. Extremely short duration high intensity interval training substantially improves insulin action in young healthy males. BMC Endocr. Disord. 2009 Jan 28; 9:3.


Sleep | The Paleo Diet
As we move into the colder, darker and shorter days of fall and winter it becomes more difficult to maintain your energy levels, productivity and fight off nasty colds and flu. These common complaints become the norm as the seasons change and people are constantly looking for that “magic bullet” supplement or medication to keep them running on all cylinders. Interestingly, a new study on the daily patterns of modern hunter-gatherer tribes across the globe might hold a few clues in how we can keep ourselves healthy, fit and productive through the winter season.

How Much Sleep Did Our Paleo Ancestors Really Get?

There is a romantic notion that our “hunter-gatherer” ancestors rested their heads with the setting sun in the evening, slept blissfully through the night for 8-10 hours and woke up with the rising sun. They certainly didn’t have cellphones, laptops or external light sources to keep them up. Was it partly down to this that they were so fit, strong, and free of chronic degenerative diseases? Not quite.

An interesting new study on modern day hunter-gatherer tribes – the San of southern Africa, the Tsimane in Bolivia, and the Hadza in Tanzania – found they only sleep an average of 5.7-7.1 hours per night.1 This is very surprising because sleep research today suggests most westerners are sleep deprived, averaging about 6.5 hours of sleep per night, which is approximately 1.0-1.5 hours less sleep than our grandparents got two generations ago. Experts believe we should be aiming for 7.5-8.0 hours per night for better health.

This new research suggests there is much more at play than simply the amount of hours of sleep you get (although, I believe this is also important). Let’s take a closer look at some key factors that could help you improve your sleep and upgrade your energy levels this winter and help fight off colds and flu.

The Tribes Go To Bed Earlier in the Winter

As the year comes to an end, most people are busier than ever at work and home as the holidays approach, rather than winding down to recharge their batteries. If we look to our ancestral roots to find answers to the “best” sleep practices, we find the tribes in the aforementioned study went to bed earlier during the darker days of winter/rainy season and later in the summer/dry season. Their average bedtime was just after 9:00 pm in the winter months, compared to 10:45 pm in the summer (still, not exactly “night owls” by today’s modern standard).
A lot people struggle to get bed before midnight (laptops, cellphones and TVs don’t help) and usually don’t get to bed earlier in the colder, darker, winter months. As we approach the darkest days of the year, we should be getting more sleep (not less), but holiday parties, travel, and work commitments usually ramp up at this time of year. This lack of sleep is shown in the research to suppress your immune system function, putting you at significantly increased risk of catching a cold or flu.2

The Tribes Wake Up Consistently With Morning Light

Hitting snooze is a morning ritual for a lot of people, as they struggle to find the energy to get out of bed and start their day. While I am sure we can all agree that sleeping in feels pretty good, is it what your body really needs? The tribal groups in this study woke up at virtually the same time throughout the entire year with the morning sun (not surprising if you’re an avid camper!).

Many of your key hormones are produced on a natural daily pattern or circadian rhythm that new research shows gets disrupted if you constantly change your sleeping and waking time. Disrupted circadian patterns have been shown to leave you more prone to fatigue (sound familiar?), inflammation, and even change the balance of “good” to “bad” bacteria in your gut.3

If you struggle with fatigue, insomnia or frequent colds and flus, aim to have a consistent bedtime and waking time this winter. Go to bed earlier (don’t sleep in longer in the mornings) to help kick your snooze button habit in the morning. If you really struggle to wake up, try some gentle stretching/mobility/yoga on the floor to ease your way into the day. (Not only that, research shows the later you get to bed the greater your likelihood for weight gain.4 If weight loss is also a goal, get ahead of your new year’s resolution by tucking in earlier at night).

The Tribes Are Exposed To Lots of Morning Light

It’s difficult to wake in the morning and get outside during the cold days of winter. Fatigue, lack of time and general desire to stay warm keep you huddled up in your house, car, and office. However, not exposing yourself to natural light may be having a significant negative impact on your health.

Modern hunter-gatherer communities get up daily with the morning sun and engage in the vast majority of their physical labor in the morning hours exposed to natural light. In contrast, most people are indoors all morning throughout the winter – commuting in cars and working in buildings – not getting nearly enough exposure to natural light. Even on a cloudy day, the natural light outside provides a whopping 100,000-lux (a measure of light intensity), compared to only 5,000-lux in your office or home.

New research shows that this light exposure is crucial for circadian hormone production and thus your energy levels, health and resiliency.5 It’s easy to find yourself stuck in your car, office or house all winter. Instead, get outside to grab your morning coffee, walk a few blocks to your next meeting, or go outdoors in the morning for a light run/jog to start your day. You’ll feel much better for it!

Often we’re drawn to the “shiny new toy” or exotic and complex solutions to our problems, however the real lasting solutions are typically always found in how you eat, move and lifestyle factors. While a Paleo diet will go a long way to keeping you energized and fighting off colds and flu this winter (check out my article on how to Paleo boost your immunity this fall), looking at your daily patterns of sleeping and waking from an ancestral perspective will likely help you dramatically upgrade your energy and vitality this winter.



  1. Yetish G et al. Natural Sleep and Its Seasonal Variations in Three Pre-industrial Societies. Current Biology. Vol 25, Iss. 21, 2 November 2015, Pages 2862–2868.
  2. Prather A et al. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep Journal. Vol. 38, Issue 09.
  3. Voigt R et al. Circadian disorganization alters intestinal microbiota. Plos One. 2014 May 21;9(5):e97500.
  4. Asarnow L et al. Possible link between bedtime and change in body mass index. Sleep Journal. Vol. 38, Issue 10.
  5. Czeisler C, Klerman E. Circadian and sleep-dependent regulation of hormone release in humans. Recent Prog Horm Res. 1999;54:97-130; discussion 130-2.

The Science Behind Incentivizing Weight Loss | Healthy Wage | Paleo Diet

If you want to lose weight but don’t know where to start, now’s your chance to grab a few friends, family members or colleagues and lose the weight together. Contrary to popular belief, going Paleo isn’t hard and we’ve got something that will make the process of reaching a healthier, leaner you fun and exciting!

We’ve partnered with HealthyWage to offer a The Paleo Diet Jackpot Challenge for our readers and their friends, family and colleagues. HealthyWage is based on some important research out of Harvard, Penn and the Mayo Clinic over the last few years. One widely cited study published by the Journal of the American Medical Association (JAMA) found those who have a financial incentive to lose weight were almost five times more likely to reach their target than individuals with no money at stake. HealthyWage challenges — which include JAMA-like betting and also a team weight loss challenge — are all based on the double-incentivization model. We believe you are more likely to succeed if (1) you stand to lose something if you fail and (2) you stand to win something significant if you succeed.

Every HealthyWage Team has to win as a group, so every member has a stake in the other members’ success. The result is lots of support and positive peer pressure. And, the desire to beat the other teams adds to the excitement and motivation of the competition. A Brown University study concluded  social networks and teamwork play a significant role in enhancing weight loss outcomes in weight loss interventions. In particular, the researchers found that having more social contacts trying to lose weight is connected with greater weight loss intentions, and that changes in physical activity are similar among teammates in a team-based physical activity campaign.

As you can see, the findings speak for themselves, as do the countless HealthyWage success stories. For example, check out HealthyWage success rockstar Anastasia W. who lost 41 pounds by following the Paleo Diet and won $10,000! Click here to read her story. Are you ready to be the next success story?


  1. Each participant puts money into the Jackpot ($20/mo. or $60 total).
  1. Your team will be competing along with all the other teams to lose 6% in three months.
  1. Winners (teams that lose 6% before the end) each get an equal share of the Jackpot.

The sky’s the limit on how big the Jackpot can grow, and each participant’s payout depends on how many people enter and how many people win. Typically, if your team hits the goal, you double your money or more.

Join us for some fun and to see who can win a share of The Paleo Diet Jackpot. Our challenge runs for 12 weeks starting on September 14th, and registration is on now – just click here to sign up!

Eat More Protein For Better Health | The Paleo Diet

New research affirms the hypothesis that protein is much more valuable than we may have previously thought.1 And, to many individuals’ surprise, plant protein seemed to be as beneficial as animal protein. In fact, eating more protein was just as effective as curbing the top four negative health behaviors including smoking, alcohol consumption, salt intake, and leading a sedentary lifestyle.2, 3 Consuming a Paleo diet – which is by nature high in protein, low sodium, and promotes leading an active lifestyle – is highly beneficial for overall health.

The Paleo diet encourages introducing alternative proteins, animal and plant proteins alike, to reap the wealth of nutrients and health benefits from each group. Two of the most important biomarkers tracked (and improved) by more protein consumption were lower blood pressure and arterial stiffness. Though researchers admit that the mechanism for lowering of these biomarkers of health are not yet clearly understood, eating a healthy diet high in real foods is beneficial to our overall health and wellness. In a world where 7 out of 10 people are overweight, and many more are on some form of medication, isn’t this what really matters?4, 5

Americans protein intake is dreadfully low. This is partly why we are caught in a health crisis.6 The real key here is amino acids, which are the building blocks of protein. There is no such thing as essential carbohydrates, but there are essential amino acids.7 Consumption of amino acids is likely the mechanism which underlies the success seen in this particular study. Unfortunately, as mentioned, most of us in the Western world overeat carbohydrates, and skimp out on protein.8, 9 However, if you’re following a real Paleo diet, protein deficiency is virtually impossible if you’re eating a diet with a steady supply of nutrient-rich vegetables and complete proteins.

Athletes on the other hand often can overdo protein. Whereas the women in this study, on average, consumed only 80 grams of protein daily, the fitness community would perceive this startlingly low. The takeaway is balance. Dr. Cordain’s The Paleo Diet for Athletes is a great primer for understanding how best to maintain glycogen stores, a healthy pH, prevent or reduce inflammation, and optimize body weight by obtaining the right amino acids and keep your carbohydrates in check. While many official guidelines still continue to recommend 60 grams of protein daily for women,10 this inaccuracy should soon be addressed and corrected. It is much easier to overconsume calories when your brain does not receive a satiety signal,11 and protein is far more satiating than carbohydrates.12

The new research drives the point home. Protein is essential to overall health and wellness, weight loss, and athletic performance. So keep on eating your salmon and grass fed beef. And don’t pay much mind to the vegans who chastise you for doing so. Instead, point them to this article, or the new study. On a near-daily basis, science is discovering new benefits of the foods we eat, and the more it discovers – the better a Paleo diet seems to fare!



[1] Jennings A, Macgregor A, Welch A, Chowienczyk P, Spector T, Cassidy A. Amino Acid Intakes Are Inversely Associated with Arterial Stiffness and Central Blood Pressure in Women. J Nutr. 2015;145(9):2130-8.

[2] Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol. 2006;33(9):847-52.

[3] Sanders PW. Vascular consequences of dietary salt intake. Am J Physiol Renal Physiol. 2009;297(2):F237-43.

[4] Available at: http://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Accessed September 4, 2015.

[5] Available at: http://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescription-drugs-mayo-clinic-olmsted-medical-center-find/. Accessed September 4, 2015.

[6] Phillips SM. A brief review of higher dietary protein diets in weight loss: a focus on athletes. Sports Med. 2014;44 Suppl 2:S149-53.

[7] Volpi E, Kobayashi H, Sheffield-moore M, Mittendorfer B, Wolfe RR. Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr. 2003;78(2):250-8.

[8] Jenkins DJ, Kendall CW, Marchie A, Augustin LS. Too much sugar, too much carbohydrate, or just too much?. Am J Clin Nutr. 2004;79(5):711-2.

[9] Spreadbury I. Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity. Diabetes Metab Syndr Obes. 2012;5:175-89.

[10] Available at: http://www.choosemyplate.gov/protein-foods. Accessed September 4, 2015.

[11] Ahima RS, Antwi DA. Brain regulation of appetite and satiety. Endocrinol Metab Clin North Am. 2008;37(4):811-23.

[12] Abou-samra R, Keersmaekers L, Brienza D, Mukherjee R, Macé K. Effect of different protein sources on satiation and short-term satiety when consumed as a starter. Nutr J. 2011;10:139.

Obesity | The Paleo Diet

Unfortunately, 70% of the United States is now overweight.1 And nearly half of that 70% is obese – a truly scary prospect for the future of our nation’s health.2 But despite this alarming obesity epidemic (technically it is a pandemic, because the entire world is suffering from this problem) there has never been more debate about what exactly is causing the issue.3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 While this article will cover specific transcription factors and antioxidant pathways, the big bullet points for preventing obesity are simple.26 27 28 29 30 31 32 33 34 35

For starters, we are eating too many calories.36 37 38 39 Secondly, we are eating too much sugar and not enough nutrients.40 41 42 43 44 45 46 47 48 49 50 Third, we are not getting enough exercise.51 52 53 And lastly, we are stressed like never before, and sleeping less than ever.54 55 56 57 58 59 In a way, the rest of the debate is just minutia, because until we fix these four problems, we are not going to be able to stop this boat from capsizing.

Booth FW, Laye MJ. Lack of adequate appreciation of physical exercise’s complexities can pre-empt appropriate design and interpretation in scientific discovery. J Physiol. 2009;587:5527–5539.

But if we are to delve into the details of obesity, there are two dichotomous factors, which are at play. As I mentioned, too much sugar is a cornerstone of our nation’s various health problems. The fructose transporter GLUT5 plays a specific role in this problem, since we are taking in far too much fructose in our collective diet.60 61 62 63 64 By contrast, if we were to eat more vegetables and other healthful foods, we would see better results via the Nrf2 pathway.65 66 67 68 69 70 Most of us are aware that free radicals are categorized as ‘bad’ and antioxidants as ‘good’.71 But the details behind these scientific terms remain elusive, for most of the population.

Evolution of the consumption of high-fructose corn syrup (HFCS) and sucrose in the United States between 1970 and present. HFCS has increased rapidly to replace 50% of the sucrose consumption. Over this period, not only total sugar consumption but also total calorie intake and total fat intake have increased significantly. (USDA)


Fructose metabolism in liver cells. Fructose metabolism (grey arrows) differs from glucose (black arrows) due to 1) a nearly complete hepatic extraction and 2) different enzyme and reactions for its initial metabolic steps. Fructose taken up by the liver can be oxidized to CO2 and then converted into lactate and glucose; glucose and lactate are subsequently either released into the circulation for extrahepatic metabolism or converted into hepatic glycogen or fat. The massive uptake and phosphorylation of fructose in the liver can lead to a large degradation of ATP to AMP and uric acid.60

Summary of the potential mechanisms for fructose-induced insulin resistance.60

The research on fructose has been steamrolling the scientific community since the viral popularity of pediatric endocrinologist Robert Lustig’s lecture, a few years ago.72 73 74 75 Not surprisingly, the food and beverage industry is trying like mad to stop any bad publicity from arising from the scientific community, around their sugary cash cow.76 But the actual, unbiased data has been very damning.77 78 79 80 Take the following chart, which shows that fructose in beverages, which do not list it on the label, often contain quantities of fructose that surpass the amount of the substance in beverages which do list it on the label.

Fructose concentration and fructose-to-glucose (F:G) ratio: juices. Concentration of fructose (g/L) in juices is displayed on the left y axis (open bars) and the F:GAdjusted is shown on the right y axis (solid bars). * Products with high-fructose corn syrup listed as an ingredient on the label. F:GAdjusted, the F:G ratio adjusted for other detected disaccharides.

Walker, R.W.; Dumke, K.A.; Goran, M.I. Fructose content in popular beverages made with and without high-fructose corn syrup. Nutrition 2014, 30, 928–935.

In an evolutionary sense, this level of fructose consumption is out of control and unprecedented.81 82 83 We’ve known for thousands of years, humans consumed about 20g of fructose each day.84 85 Their intake came from fruit and honey,86  vastly different than more concentrated sources of fructose, like soda. For one thing – there is no fiber in soda, which might slow down hepatic absorption of fructose. Oh, and for those curious, we are now consuming about 80g of fructose per day, on average.87 88

Proposed pathways and mechanisms underlying the differential effects of fructose compared with glucose consumption on adipose deposition, postprandial lipid metabolism glucose tolerance/insulin sensitivity.

Stanhope, K. L., & Havel, P. J. (2010). Fructose consumption: Recent results and their potential implications. Annals of the New York Academy of Sciences, 1190, 15–24. doi:10.1111/j.1749-6632.2009.05266.x

But why is fructose so harmful, and how does the GLUT5 transporter factor into this issue? GLUT5 was successfully cloned around 20 years ago and was initially described as a glucose transporter, until it became clear that it was specifically related to fructose.89 The brain and kidneys have both shown levels of GLUT5 mRNA and/or protein.90 This (indirectly) means that by eating too much fructose, your brain processes might be impaired.91 92 93 Since we now know that high levels of HA1c correlate with dementia, this shouldn’t be shocking news.94

Your small intestine has the greatest amount of GLUT5, and it also controls the availability of fructose to other areas.95 Interestingly, intestinal GLUT5 mRNA levels and fructose transport rates are very low until fructose is introduced, or after a few weeks of development (this appears to be genomic).96 97 98 99 The problems start to arise when too much fructose is introduced (via processed foods, usually) too early, creating a baseline of consumption, which seems to need to be satisfied.100 101 102 103 Though the science is still out, this ‘created need’ may force children to overeat, and as a result, become overweight and/or obese.

The GLUT5 transporter has been linked to hypertension, and also to diabetes.104 105 Since the United States spends over $240 billion on diabetes annually, scientific research into the area of GLUT5 should be pushed to the forefront, with the hope being that by better understanding the transport and processing of fructose, we can help improve the rates of disease – if not prevent them entirely.106

For example, diabetes profoundly affects GLUT5 expression in the small intestine.107 By down-regulating GLUT5 protein levels in those with high blood sugar, we may have a mechanism to help diabetics. Of course, there are many potential areas of research, which could be interesting for the GLUT5 transporter. But for the brevity of this article, I will stop here.  I invite those further interested to research the GLUT5 transporter, via easily using a search engine to locate articles on PubMed relating to the topic.

Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307-21.

One of the many issues with fructose is that it helps to cause non-enzymatic glycation – in layman’s terms; fructose helps to age your liver.108 This shouldn’t be surprising. Remember – increased dietary intake of sugar was linked to dementia – premature aging/degradation of brain tissue usually due to excessive buildup of the beta amyloid protein.109

By contrast, activation of the Nrf2 pathway may help to stop aging – not just in your liver, but also throughout the body.110 The Nrf2 pathway helps in regulating over 500 cytoprotective genes, which give your cells multiple layers of protection.111 112 Interestingly, research has found that dietary flavonoids help to activate this pathway, and thus, your diet can truly determine whether you age quickly or slowly.113 It really is this simple. Sort of.

NRF2, p53 and FOXOs support complementary antioxidant pathways.

Gorrini, C., Harris, I. S. & Mak, T. W. Modulation of oxidative stress as an anticancer strategy. Nature Rev. Drug Discov. 12, 931–947 (2013).

You see, in science, one must resist the urge to oversimplify, and in this case we must remember to not forget all the other stressors to our cells. This means sleep quantity and quality, exercise, stress from work, genetics, epigenetics, pollution – it is truly a never ending list. However, we very much have control over what we put in our mouths.

Differential responses to rising oxidative stress.

Stefanson, A. L., & Bakovic, M. (2014). Dietary Regulation of Keap1/Nrf2/ARE Pathway: Focus on Plant-Derived Compounds and Trace Minerals. Nutrients, 6(9), 3777–3801. doi:10.3390/nu6093777

The Nrf2 pathway has been recently found to react to apigenin and luteolin (dietary phytochemical flavones) in a favorable way.114 The antioxidant pathway is activated upon ingestion of apigenin and luteolin, and the flavones may be responsible for vital anti-inflammatory effects.

Schematic representation depicting some of the various cytoprotective proteins that are upregulated by Nrf2. Flavonoid-mediated protection from ischemic/hemorrhagic stroke, traumatic brain injury, and/or other neuropathies may result in large part from Nrf2 regulation of these pathways.113

In fact, activation of the Nrf2 pathway is being studied fairly extensively, in regards to cancer prevention and treatment.115 Since dietary activation is very cheap (especially when compared to pharmaceutical drugs) this research could pave the way for widespread effective change in our world’s health. Mandatory spinach and kale consumption might be a potential guideline – if one was to hypothesize about potential ways this research could be implemented on a widespread basis.

Schematic representation depicting the potential mechanisms by which flavanol-mediated Nrf2 induction leads to activation of cytoprotective pathways after stroke, traumatic brain injury, and/or other neurodegenerative diseases. Flavanols may induce Nrf2 through binding to receptors seated on the plasma membrane and subsequent initiation of intracellular signaling cascades. Alternatively, passive diffusion or active transport through the plasma membrane may permit direct cytosolic dissociation of the Keap1/Nrf2 complex or activation of second messengers that regulate Nrf2 translocation into the nucleus. Upon nuclear translocation, Nrf2 binds to AREs on the promoter regions of cytoprotective genes to regulate heme/biliverdin, glutathione, NAD(P)H, and/or other protective pathways.113

So, if your diet is making you fat, old and sick, you now have some great motivation to affect change. What can be more powerful than that? By loading up on neuro-protective vegetables and healthy fats, as well as quality proteins (which contain essential amino acids) you will be helping to fight back against cellular aging, obesity and illness.

And good news – a Paleo Diet – by its very nature – eliminates all the bad choices for you, and emphasizes all the best foods. The work has already been done. It couldn’t get any easier. You have a path towards obesity, dementia and medication. You also have a path towards health, wellness and vitality. The choice is yours – so choose wisely.


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64 Lustig RH. Fructose: it’s “alcohol without the buzz”. Adv Nutr. 2013;4(2):226-35.

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66 Su ZY, Shu L, Khor TO, Lee JH, Fuentes F, Kong AN. A perspective on dietary phytochemicals and cancer chemoprevention: oxidative stress, nrf2, and epigenomics. Top Curr Chem. 2013;329:133-62.

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Hunger Pangs? Need to Lose Weight? Try Some Spinach | The Paleo Diet
In the journey of healthy living, we eagerly seek options that are not only tasty, but nutritious as well. What if there was an easily accessible vegetable that contains packed nutrients, while curbing your hunger pangs. Introducing spinach, a vegetable, that is familiar to many people following a Paleo lifestyle.

In recent years, there has been a growing awareness of an abundant component of spinach, known as thylakoids.1 Previous scientific studies have shown that thylakoids promote the release of the satiety hormone cholecystokinin (CCK). This hormone signals to your brain that you feel full, after a meal, and affects appetite regulation.1 Additionally these studies also have shown that thylakoids also decrease the body’s insulin response, which prevents postprandial hypoglycemia, the body’s basic decreased glucose level response seen after eating.1

Before bringing out the chopping board to cut up some spinach, let’s breakdown the details behind this discovery.


Now what exactly are thylakoids? They contain chlorophyll and found in green plant cells. Thylakoids are not exclusive to just spinach, they are actually found in the membrane of green plants.2 They consist of hundred different membrane proteins, galactolipids and sulpholipids, including vitamins (A, E and K) and antioxidants like carotenoids, lutein, zeaxantin and chlorophyll.2

Thylakoids are largely responsible for the delay in fat digestion.2 Most importantly, after you eat green-plant membranes, initially prolongation of fat digestion takes place, and, ultimately at the end, the thylakoids are also digested. So this means there are no issues seen with steatorrea, which is when the body gets rid of fat quickly, after you eat thylakoids and/or green plants. This is quite contrary to medications such as irreversible lipase inhibitors which also prolong fat digestion.2


A previous study has shown how a patented extract of spinach with large amounts of thylakoids can have inhibitory effect on lipase activity.3 Lipase is the enzyme responsible for the breakdown of lipids or fats in the digestive system.3 With the delay in fat digestion, there is a noted increase in the production of the satiety hormones cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1).3

Additional studies have also shown that consuming this spinach extract suppresses ghrelin, which is the hormone associated with hunger.3 In simple terms, it means you can eat a green plant such as spinach, it slows down fat digestion, which leads to the release of the hormones and sends a “red light” signal to your brain that you are no longer hungry!

A study conducted on thylakoids showed that intake of thylakoids before breakfast, can reduce hunger by about 21%, and increase satiety (feeling of being full) by about 14%.3 An interesting aspect of this study showed that it can also decrease craving for all snacks and sweets during the day by 36%.3 Those who scored high for emotional eating gained a lot of benefit from receiving treatment, by eating thylakoids. So if you find yourself feeling down on a cloudy day, and wanting to grab a snack throughout the day, you may benefit from a nutritious breakfast that includes spinach. Give Dr. Cordain’s Strawberry-Spinach Salad from The Paleo Diet Cookbook a try for a punch of sweet, leafy goodness.


In summary, from the results of these scientific studies, a diet high in thylakoids such as spinach, will decrease food intake, and prevent the need to snack randomly during the day.

Additionally thylakoids influence the absorption of glucose in the intestine and reduces the glycemic index after eating foods high in carbohydrates.4 Furthermore studies have shown that it also leads to a decrease in LDL-cholesterol, which is a leading risk factor for atherosclerosis which can lead to many conditions such as strokes, heart attacks, peripheral vascular disease and kidney disease.5 This indicates thylakoids could potentially be helpful in preventing not only obesity, but also cardiovascular risk, diabetes, and many other diseases as well.

With no associated risks, what better reason to stock up your grocery cart with an ample supply of spinach.



[1] Stenblom E, Montelius C, Ostbring K, Hakansson M, Nilsson S, Rehfeld J, et al. Supplementation by thylakoids to a high carbohydrate meal decreases feelings of hunger, elevates CCK levels and prevents postprandial hypoglycaemia in overweight women. Appetite. 2013 Sep; 68: p. 118-123.

[2] Montelicius C, Erlandsson E, Vitija E, Stenblom E, Egecioglu E, Erlanson-Albertsson C. Body weight loss, reduced urge for palatable food and increased release of GLP-1 through daily supplementation with green-plant membranes for three months in overweight women. Appetite. 2014 Oct 1; 1: p. 295-304.

[3] Stenblom E, Egecioglu E, Landin-Olsson M, Erlanson-Albertsson C. Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women. Appetite. 2015 August 1; 91: p. 209-219

[4] Montelius C, Szwiec K, Kardas M, Lozinska L, Erlanson-Albertsson C, Pierzynowski S, et al. Dietary thylakoids suppress blood glucose and modulate appetite-regulating hormones in pigs exposed to oral glucose tolerance test. Clinical Nutrition. 2014 Dec; 33(6): p. 1122-1126.

[5] Mayo Clinic. Complications High cholesterol. [Online].; 2015 [cited 2015 Aug 17. Available from: http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/complications/con-20020865.

First Systematic Review of the Paleo Diet | The Paleo Diet

The Paleo diet is the hottest diet in the world. It was ranked as the top diet related term searched in Google for 2013 and 2014. Celebrities are on it. Politicians are on it. It’s on the news. It’s what people are talking about.

It’s also controversial. Paleo advocates selecting foods based on evolutionary theories and principles. This doesn’t make sense to everyone. Some have argued that it’s impossible to know what our ancestors from the Paleolithic era ate. Others have argued that there is no clinical evidence to support Paleo.

A 2014 US News and World report ranking popular diets ranked Paleo tied for dead last, #35. Behind Slim Fast, behind Jenny Craig, behind Volumetrics, behind Ornish. They concluded there was scant evidence, and they were partially correct because there was no systematic review at the time. In an evidence-based healthcare system, it’s evidence that counts, not anecdotes. And the evidence should ideally come from a systematic review of randomized controlled trials (RCTs).

A systematic review and meta-analysis of RCTs can generate robust evidence, particularly when the trials are well-conducted and the outcomes are hard, objective outcomes. Although there have only been four RCTs of the Paleo Diet, they were all well-conducted. The outcomes we examined are the components of the metabolic syndrome, such as blood pressure, glucose, cholesterol, waist circumference, and triglycerides. These are the major predictors of chronic disease risk, particularly cardiovascular disease and diabetes. Our pooled analysis showed that the Paleo diet resulted in greater improvements in these outcomes compared to a standard guideline-based diet. The pooled results were not always statistically significant, but they favored the Paleo diet in all cases.

In the US News and World Report survey, the government-endorsed Dietary Approaches to Stop Hypertension snagged the top spot. Yet our meta-analyses compared Paleo to diets similar to DASH and Paleo came out on top.

Are dietary guidelines around the world recommending the wrong diet? It’s too soon to tell, but our meta-analyses warrant further evaluation of the health benefits of Paleolithic nutrition.
Loren Cordain recently wrote about milestones of research into the Paleo diet. No doubt when Loren updates his summary, he’ll mention our systematic review.

Abstract: Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis

Lose Weight and Keep It Off? | The Paleo Diet

Besides winning the lottery, there may not be a more universally shared goal than losing body weight and keeping it off.1 If this is a goal you are after, you may not want to read the rest of today’s piece! That is because brand new research has pointed out that the odds of going from obese to a normal weight and staying there – are vanishingly slim.2, 3 For men, the odds are 1 in 210, and for women the odds are 1 in 124. That’s less than 1% – no matter what gender you are.

So how do we beat these (very depressing) odds? Quite simply, by following a Paleo diet! By consuming foods that are high in satiety and nutrients, we keep hunger at bay, and our body and brain happy.4, 5, 6, 7 Satiety and nutrition are both absolutely vital if long term, sustainable weight loss is one’s goal. As has been seen in scientific studies, a Paleo diet works better than even condition-specific diets (like those seen in patients with diabetes).8 One study sums it up thusly: “The Paleolithic diet might be the best antidote to the unhealthy Western diet.”9

Combining a great diet with a smart exercise routine (like CrossFit) is a great recipe to start stacking these odds in one’s favor.10 As the CrossFit Games are in full swing, we get to see professional athletes at their absolute peak – hopefully inspiring us to spend less time on the couch and more time at the gym. But you do not need to be a CrossFit Games competitor to enjoy a healthy exercise routine. If you are sedentary, just start walking around your neighborhood every day after work. Get your head in the game with baby steps, you’ll feel the difference.11 Once you’ve mastered that, you can progress to higher feats of fitness.

Lose Weight and Keep It Off? | The Paleo Diet

Erickson, Kirk I. et al. “Exercise Training Increases Size of Hippocampus and Improves Memory.” Proceedings of the National Academy of Sciences of the United States of America 108.7 (2011): 3017–3022. PMC. Web. 27 July 2015.

And even more than exercise, make sure you get plenty of sleep! This overlooked factor allows many to work extremely hard, eat right and still not keep the pounds off. Scientific researchers have known this for years.12 Sleep is an important modulator of neuroendocrine function and glucose metabolism.13 Both are usually disrupted when a person becomes obese, so getting them back in line requires eating well, exercise, and plenty of shuteye!

Sleep loss has also been shown to result in metabolic and endocrine alterations, including decreased glucose tolerance, decreased insulin sensitivity, increased evening concentrations of cortisol and increased levels of ghrelin.14 Bottom line: With all of this at play, our chances of losing weight and keeping it off are very slim! We want our body to be insulin sensitive, cortisol lower in the evening, and to express low levels of ghrelin (a key hunger hormone).

Lose Weight and Keep It Off?  | The Paleo Diet

Beccuti, Guglielmo, and Silvana Pannain. “Sleep and Obesity.” Current opinion in clinical nutrition and metabolic care 14.4 (2011): 402–412. PMC. Web. 27 July 2015.

Lose Weight and Keep It Off? | The Paleo Diet

Patel, Sanjay R., and Frank B. Hu. “Short Sleep Duration and Weight Gain: A Systematic Review.” Obesity (Silver Spring, Md.) 16.3 (2008): 643–653. PMC. Web. 27 July 2015.

Finally, sleep loss leads to decreased levels of leptin (one of the main satiety hormones) and increased hunger and appetite.15 So, the longer you go without sleep, the hungrier you get. Stop the cycle by hitting the pillow earlier.

With our world in an ever-increasing obesity pandemic, think of all the healthy ways you can lose weight and keep it off.16, 17, 18, 19, 20 Put your mind to it, don’t let anything stand in your way, and you’ll be on your way, to a leaner, healthier you!



[1] Why Do You Say You Want to Lose Weight But Then Don’t Do It | Psychology Today. (n.d.). Retrieved from https://www.psychologytoday.com/blog/shrink/201208/why-do-you-say-you-want-lose-weight-then-don-t-do-it

[2] Available at: http://www.sciencedaily.com/releases/2015/07/150716180913.htm. Accessed July 21, 2015.

[3] Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. 2015;:e1-e6.

[4] Westerterp-plantenga MS, Lemmens SG, Westerterp KR. Dietary protein – its role in satiety, energetics, weight loss and health. Br J Nutr. 2012;108 Suppl 2:S105-12.

[5] Paddon-jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008;87(5):1558S-1561S.

[6] Leidy HJ, Carnell NS, Mattes RD, Campbell WW. Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obesity (Silver Spring). 2007;15(2):421-9.

[7] Soenen S, Westerterp-plantenga MS. Proteins and satiety: implications for weight management. Curr Opin Clin Nutr Metab Care. 2008;11(6):747-51.

[8] Jönsson T, Granfeldt Y, Ahrén B, et al. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35.

[9] Klonoff DC. The beneficial effects of a Paleolithic diet on type 2 diabetes and other risk factors for cardiovascular disease. J Diabetes Sci Technol. 2009;3(6):1229-32.

[10] Curioni CC, Lourenço PM. Long-term weight loss after diet and exercise: a systematic review. Int J Obes (Lond). 2005;29(10):1168-74.

[11] Erickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci USA. 2011;108(7):3017-22.

[12] Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008;16(3):643-53.

[13] Van cauter E, Knutson KL. Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol. 2008;159 Suppl 1:S59-66.

[14] Knutson KL. Impact of sleep and sleep loss on glucose homeostasis and appetite regulation. Sleep Med Clin. 2007;2(2):187-197.

[15] Pejovic S, Vgontzas AN, Basta M, et al. Leptin and hunger levels in young healthy adults after one night of sleep loss. J Sleep Res. 2010;19(4):552-8.

[16] Roth J, Qiang X, Marbán SL, Redelt H, Lowell BC. The obesity pandemic: where have we been and where are we going?. Obes Res. 2004;12 Suppl 2:88S-101S.

[17] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[18] Catenacci VA, Hill JO, Wyatt HR. The obesity epidemic. Clin Chest Med. 2009;30(3):415-44, vii.

[19] James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obes Res. 2001;9 Suppl 4:228S-233S.

[20] Pan WH, Lee MS, Chuang SY, Lin YC, Fu ML. Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev. 2008;9 Suppl 1:22-31.

A Brief History of the Contemporary Paleo Diet Movement | The Paleo Diet


In order to appreciate any concept, including the Paleo Diet, it is important to recognize its history and how it came to be. Most of you are aware that Paleo and particularly Paleo diets have recently become very hot, on trend topics.

These ideas have become household words in the past few years; however it hasn’t always been this way. Below is a graph from Google Trends for the words “ the Paleo diet” (Figure 1).  It’s fairly clear from Figure 1 that, except for the past four years, the Paleo diet was virtually unknown to all but dedicated fans. Fortunately, I’ve been in the middle of this worldwide movement from nearly its very beginnings. So, I can personally tell you how it all began and my involvement in it.

Google Trends | The Paleo Diet Over Time

Figure 1. Google Trends. 25 June 2015.

Last October, I approached my 64th birthday with just a little trepidation because I was part of the 60’s generation whose mantra was not to trust anyone over 30, and now I’m twice that age.  As I look back over my life, I can pinpoint a few key events which led me to discover and appreciate what is now almost universally known as the Paleo diet.

I came of age as a track and field athlete at the University of Nevada, Reno in the late 60s and early 70s, and as such was always interested in diet, fitness and athletic performance. Later as a lifeguard at Lake Tahoe, my friends and I read all of the now classic vegetarian diet/health books such as Francis Moore Lappe’s Diet for a Small Planet, Paivo Airola’s Are You Confused? and Dick Gregory’s Natural Diet for Folks Who Eat among others. I even attended a Dick Gregory lecture in Seattle and got to shake this famous comedian’s hand.

My lifeguard friends and I experimented with vegan diets, fasting, and all kinds of vitamins and supplements. Almost everyone seemed to own a juicer. Each summer, instead of shying away from the sun and using sunscreens, we all tried to get the deepest tans possible. We swam in Tahoe’s icy, invigorating, non-chlorinated waters, and decades before Vibram Five Fingers and Nike Frees were the rage, we ran barefoot in the sand along Sand Harbor’s pristine shoreline.

Those 20 memorable summers as a lifeguard at Tahoe heightened my awareness of the outdoor, natural world, sunshine, health, fitness and diet. As my lifeguarding days drew to a close in 1991, Lorrie and I had just begun to eat Paleo. Here’s how it began.


I completed my Ph.D. in exercise physiology at the University of Utah in the spring of 1981 and promptly hired as a young assistant professor in the Department of Health and Exercise Science at Colorado State University. For the first 5-10 years of my career, my research focused mainly upon how diet and exercise affected fitness and athletic performance. I still hadn’t discovered Paleo, but read widely and had a considerable interest in anthropology.

In the spring of 1987, I happened upon Boyd Eaton’s (M.D.) now classic scientific paper Paleolithic Nutrition: a Consideration of its Nature and Current Implications which was published two years earlier in the prestigious New England Journal of Medicine.7 This article made a lasting impression upon me and was the single factor which caused me to focus my research interests upon ancestral human diets from that point forward.

For me, one of the surprising points that Dr. Eaton made in a subsequent paper was that cereal grains were rarely or never consumed by pre-agricultural hunter-gatherers.6  In the days and months after reading Boyd’s groundbreaking paper,7 I became absolutely engrossed in studying ancestral human diets and voraciously read everything I could about the topic. At first, I simply filed all of these scientific papers and documents into a single file folder I labeled “Paleolithic Nutrition.” Early on I realized that this strategy wouldn’t work because of the enormous volume and diversity of topics that materialized.

As I read more and more, patterns began to emerge. Stone Age people did not drink milk or consume dairy products. So, I created a file folder labeled “Dairy.” They also didn’t eat cereal grains, so I created a single file folder called “Cereal Grains.” However, just like the single folder I had originally created for “Paleolithic Nutrition,” it soon became apparent that the topic of cereal grains and their potential for adversely affecting health was an enormous topic that ultimately would require a huge number of file folders.

Over the course of the next seven or eight years, I collected more than 25,000 scientific papers and filled five large filing cabinets – each with hundreds of categories dealing with all aspects of Paleo diet and Paleo lifestyle. In 1994, I eventually mustered enough courage to telephone (no one used email then) the man who was responsible for my collection of articles on anything and everything related to Paleo. Dr. Eaton is a true gentleman and scholar in every sense of the word.  We spoke for almost an hour on that very first telephone call, and he gave me one of the greatest compliments of my life at the end of the conversation when he said, “It sounds to me like you know more about this than I do.”

Boyd and I eventually met in 1995, and two years later he invited me to speak with him at an international conference on fitness and diet organized by Dr. Artemis Simopoulos in Athens, Greece. Artemis was a wonderful hostess for the conference, and during my two week stay in Greece we had many conversations about diet and health. I mentioned that I had written a partially completed manuscript on the nutritional shortcomings of cereal grains. About a year later she asked me if I could complete the paper and submit it for publication in a scientific journal she edited.  I did, and that paper, Cereal Grains: Humanity’s Double Edged Sword, published in 199934 launched my published career in Paleo diets.

The Paleo Diet concept is now taken seriously in the scientific world thanks in part to Boyd Eaton’s pioneering work. There is no doubt in my mind that without Dr. Eaton’s influential 1985 New England Journal of Medicine paper,7 Paleo would continue to be an obscure word known mainly to anthropologists and would not have become the household term now recognized by millions. The Paleo Diet and Paleo lifestyle are clearly much larger than either my writings or Boyd Eaton’s. Hundreds if not thousands of scientists, physicians and people from all walks of life are responsible for creating this incredibly powerful idea that can be used to bring order and wisdom to dietary and lifestyle questions and issues.

Some of the key players who came before Dr. Eaton in the Paleo diet and lifestyle world require no introductions. Charles Darwin’s Origins of the Species was published in 1859 and started it all. It still amazes me that the most powerful idea in all of biology (evolution via natural selection) generally had not been applied to nutritional thought until 126 years later with Dr. Eaton’s classic paper.7  Theodosius Dobzhansky, a well-known Ukranian evolutionary biologist said, “Nothing in biology makes sense, except under the light of evolution.” Indeed, his statement could easily be reworked to “Nothing in nutrition makes sense, except under the light of evolution.5 A similar quote could also be applied to a multitude of lifestyle issues.

One way in which we can look at how and where the Paleo diet and Paleo lifestyle concepts arose would be to examine the contributions of a few of the key players who came both before and after Dr. Eaton’s landmark paper. Obviously, Charles Darwin started it all, but a number of noteworthy people had already recognized the value of ancestral dietary patterns decades before the publication of Boyd’s article.

Perhaps the very first book to achieve notoriety about non-western diets and disease was Weston Price’s Nutrition and Physical Degeneration, A Comparison of Primitive and Modern Diets and Their Effects, first published in 1939.23 Dr. Price, a U.S. dentist, extensively traveled the world in the 1920s and 30s and made detailed observations about diet and health in numerous non-westernized populations including Amazon Indians, Alaskan Eskimos, Australian Aborigines, Canadian Indians, Polynesians and African tribal populations among many others. This book is a real treasure and contains hundreds of photographs of non-westernized people in exquisite health taken in an era when modern processed foods were not universally available. Dr. Price noted that wherever and whenever modern diets were adopted by non-westernized cultures, their health declined. His statement was just as true then as it is today.

An intriguing aspect of early books like Dr. Price’s is that frequently the diet/health observations were correct but the underlying mechanisms about how diet and lifestyle specifically affected health were either unknown or poorly understood.  In the early part of the 20th century before population wide vaccination programs existed, tuberculosis remained a major public health problem responsible for millions of deaths worldwide.  In his book,23 Dr. Price noted that in Europe, heliotherapy (sunbathing) was being effectively used to treat tuberculosis. At the time and even decades later, these kinds of observations were commonly ridiculed by the “best medical minds” because they seemed ludicrous and had no known physiological basis. Let’s fast forward 65 years and put this 1930s observation under new light.

Discoveries made just in the past 5-7 years now show that sunlight exposure might be one of the best strategies to prevent or cure tuberculosis infections.10, 19, 27, 31, 35, 36  When you sunbathe, ultraviolet radiation from the sun causes vitamin D to be produced in your skin. The more sun you get, the more vitamin D is produced. Blood concentrations of vitamin D regulate the synthesis of a recently identified substance called cathelicidin which turns out to be one of the most potent antimicrobial (bacteria killing) peptides that our bodies produce. Cathelicidin shows specific killing activity against bacteria that cause tuberculosis,31, 35, 36 and epidemiological (population) studies confirm vitamin D insufficiency is a risk factor for tuberculosis.10, 19, 37  Most of us have been vaccinated against tuberculosis, so we really don’t need to worry about this disease.

Although Dr. Price’s book23 was advanced for its time, the evolutionary basis for optimal nutrition and healthy lifestyles still lay decades in the future. Other early popular books touching upon ancestral diets and health include:  Arnold DeVries’s Primitive Man and His Food (1952),4 Walter Voegtlin’s The Stone Age Diet (1975),30 Leon Chaitow’s, Stone Age Diet (1987),2 and Boyd Eaton’s The Paleolithic Prescription (1988).8

All of these books are long out of print and except for Boyd’s volume; these books simply fizzled and faded into obscurity because they didn’t have the bigger picture right. Without the evolutionary template correctly in place, these early books were incomplete and inconclusive.  At the time, scientists and the public at large still weren’t quite ready for Paleo diets and Paleo lifestyles.

Prior to the publication of Dr. Eaton’s 1985 paper,7 a few scientists had independently recognized the evolutionary underpinnings for healthful diets and lifestyle, but their work was published in obscure scientific journals that received little or no public notoriety.1, 25, 26, 28, 29, 32, 37 After publication of Boyd Eaton’s influential paper in the New England Journal of Medicine,7 a number of events ultimately set the stage for the worldwide recognition of the Paleo diet as well as the evolutionary basis for modern day Paleo lifestyles.


The basic foundation and logic for the Paleo diet concept lies in a recently recognized discipline called Darwinian Medicine. Following in the footsteps of Boyd’s landmark paper,7 came another revolutionary scientific publication in the Quarterly Review of Biology (1991) by Drs. George Williams and Randy Neese from the State University of New York at Stony Brook.33  The title of this paper was, “The Dawn of Darwinian Medicine.

As you can imagine from its title, it represented the very first scientific publication addressing how our ancestral evolutionary experience affects the manner in which we view and treat modern diseases. Although this paper is now more than 20 years old, its message is finally being filtered down to many physicians, their patients and the public at large.20

Here’s a quote from this paper that sums up Darwinian Medicine, “Human biology is designed for Stone Age conditions. Modern environments may cause many diseases.” Also, another enlightening quote that is totally relevant to this book: “it provides new insights into the causes of medical disorders.” For instance, cough, fever, vomiting, diarrhea, fatigue, pain, nausea and anxiety are widespread medical problems. Many orthodox physicians focus upon relieving short term distress by prescribing pharmaceuticals to block these responses. Darwinian Medicine would say these responses are not necessarily harmful, but rather signify the body’s effort to remedy a problem. In most situations coughing when you are sick is a natural and healthy response because it helps to purge disease causing microbes from your throat and lungs.

Similarly fever increases your body temperature which helps to destroy pathogens that have infected your body. Medications that suppress coughs and block fever may relieve symptoms but may actually prolong the illness. Obviously, certain extreme situations necessitate a balanced approach between our body’s evolutionary response to disease and modern medicine. For example, blocking fever can prevent febrile seizures and stopping vomiting can prevent severe dehydration.

The message is clear. We need to balance our hunter gatherer genetic legacy with the best technology of our modern world.


Having been a faculty member at a Division I Research University for 32 years, I can tell you that your personal experience with the Paleo diet and a dollar will buy you a single cup of coffee in the scientific community. In other words:  no matter how much weight you have dropped on the Paleo diet; no matter how much your blood chemistry has improved; nor how much better you feel, the medical and scientific community will, by and large, not listen to you. Your real world experiences have little or no traction in the academic community of science and medicine.   What they require is not your personal experience (anecdotal evidence), but rather experimental evidence based upon one of the following four scientific methods:  1) animal studies, 2) tissue or organ studies, 3) epidemiological [population] studies or 4) randomized controlled human trials.

When I first published The Paleo Diet in 2002 thousands of indirect experimental studies had supported its general principles in promoting weight loss, improving overall health and curing disease. For instance, a multitude of well controlled experimental studies had already confirmed beyond a shadow of a doubt that low glycemic load diets improved health and promoted weight loss. The Paleo diet is a low glycemic load diet.  Similarly, high protein diets were shown to be the most effective strategy to improve blood chemistry and help you lose weight. Yet again, the Paleo diet is a high protein diet.

Even in 2002, when The Paleo Diet first came into print, you would have been hard pressed to find a single nutritionist who would disagree with the notion that omega 3 fats improved health and well being in almost every conceivable way. Do I need to repeat myself? The Paleo diet is a diet rich in omega 3 fats.

By 2002 when my first book came into print, the thousands of scientific papers were independently verified that certain individual aspects of the Paleo diet normalized body weight and improved health and wellbeing. Nevertheless, at that time, not a single study had yet examined all of the combined nutritional characteristics of the Paleo diet.

Was a diet high in animal protein, omega 3 fats, monounsaturated fats, vitamins, minerals, phytochemicals, fiber and low in salt, refined sugars, cereal grains, dairy products, vegetable oils and processed foods healthy? Was it more healthful than the officially sanctioned USDA My Plate Diet or even the highly touted Mediterranean diet? The direct scientific answers to these questions had yet to be answered in 2002.

Fortunately, in the past eight years a number of scientists worldwide have dared to test contemporary versions of humanity’s original diet against supposed “healthful diets” as seen in Table 1 below.

One of the key figures behind this ground breaking research is my friend and colleague, Dr. Staffan Lindeberg (M.D., Ph.D.) from Lund University in Sweden. Staffan became interested in Paleo diets almost 25 years ago through his medical studies of the Kitavans,14-17 a non-westernized group of 2,250 people living on remote islands near Papua New Guinea. The Kitavans obtain virtually all of their food from either the land or the sea and have little contact with the modern world. Common western foods such as cereals, dairy, refined sugars, vegetable oils and processed foods are nearly absent from their diets.14-17 Predictably, these people represent the epitome of health compared to the average citizen living in the western world.  None of them are overweight, and heart disease and stroke are extremely rare. High blood pressure and type 2 diabetes are non-existent,14-17 and acne is not present among their children or teenagers.38 I doubt that you could round up a random group of 2,000 western people anywhere on the planet without encountering high rates of all of these diseases which are rare or not present in the Kitavans.

In the late 1990s I first began corresponding with Dr. Lindeberg on the then youthful internet.  We soon discovered that we had read almost all of the same scientific papers and were interested in almost all of the same diet/health topics. One study that stood out to both of us was an incredible experiment performed by Dr. Kerin O’Dea at the University of Melbourne and published in the Journal, Diabetes in 1984.21 In this study Dr. O’Dea gathered together 10 middle aged Australian Aborigines who had been born in the “Outback.” They had lived their early days primarily as hunter-gatherers until they had no choice but to finally settle into a rural community with access to western goods. Predictably, all 10 subjects eventually became overweight and developed type 2 diabetes as they adopted western sedentary lifestyles in the community of Mowwanjum in the northern Kimberley region of Western Australia.  However, inherent in their upbringing was the knowledge to live and survive in this seemingly desolate land without any of the trappings of the modern world.

Dr. O’Dea requested these 10 middle aged subjects to revert to their former lives as hunter-gatherers for a seven week period. All agreed and traveled back into the isolated land from which they originated. Their daily sustenance came only from native foods that could be foraged, hunted or gathered. Instead of white bread, corn, sugar, powdered milk and canned foods, they began to eat the traditional fresh foods of their ancestral past: kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey.   At the experiment’s conclusion, the results were spectacular, but not altogether unexpected given what was known about Paleo diets, even then. The average weight loss in the group was 16.5 lbs; blood cholesterol dropped by 12% and triglycerides were reduced by a whopping 72%. Insulin and glucose metabolism became normal, and their diabetes effectively disappeared.

Dr. Lindeberg and I both realized that this type of experiment would probably never be repeated simply because the hunter-gatherer lifestyle is nearly extinct, and very few contemporary people have the knowledge or skills to live entirely off the land. Back in those early days of our friendship, we both had the same vision. This experiment should be conducted in a slightly different manner but not with westernized, former hunter-gatherers. Why not take a group of typically unhealthy westerners and put them on commonly available contemporary foods that mimic the nutritional characteristics of hunter-gatherer diets? Wow, what a great idea! We both knew that this experiment was precisely what Dr. Eaton had in mind with his inspirational paper way back in 1985.7


It took nearly 22 years for Dr. Eaton’s dream of experimentally testing modern day Paleo diets to come true, but it finally happened with the publication of a paper by Dr. Lindeberg’s research group in 2007.18 Staffan followed this publication with two additional papers in 200911 and 2010.13 Good ideas catch on, and two other independent research groups around the world followed suit with similar results – the first in 2008 by Dr. Osterdahl and co-workers at the Karolinska Institute in Sweden22 and the next in 2009 by my friend and colleague Dr. Lynda Frasseto (M.D.) from the University of California San Francisco School of Medicine.9

Although science may move slowly, it eventually does move forward as old ideas are replaced with new and better thoughts and information. I can assure you that this fundamental diet and lifestyle concept based upon evolutionary biology is not a fad and will not fade away.

In his first study in 200718 Dr. Lindeberg and associates placed 29 patients with type 2 diabetes and heart disease on either a Paleo diet or a Mediterranean diet based upon whole grains, low-fat dairy products, vegetables, fruits, fish, oils, and margarines. Note the Paleo diet excludes grains, dairy products, and margarines while encouraging greater consumption of meat and fish. After 12 weeks on either diet blood glucose tolerance (a risk factor for heart disease) improved in both groups, but was better in the Paleo dieters.

In a 2010 follow-up publication,18 of this same experiment the Paleo diet was shown to be more satiating on a calorie by calorie basis than the Mediterranean diet because it caused greater changes in leptin, a hormone which regulates appetite and bodyweight.

In the second ever study (2008) of Paleo diets, Dr. Osterdahl and co-workers put 14 healthy subjects on a Paleo diet. After only three weeks the subjects lost weight, reduced their waist size and experienced significant reductions in blood pressure, and plasminogen activator inhibitor (a substance in blood which promotes clotting and accelerates artery clogging). Because no control group was employed in this study, some scientists would argue that the beneficial changes might not necessarily be due to the Paleo diet. However, as you shortly will see, a better controlled experiment showed similar results.

In 2009, Dr. Frasetto and co-workers put nine inactive subjects on a Paleo diet for just 10 days.9 In this experiment, the Paleo diet was exactly matched in calories with the subjects’ usual diet.  Almost anytime people eat diets that are calorically reduced, no matter what foods are involved, they exhibit beneficial health effects. So the beauty of this experiment was that any therapeutic changes in the subjects’ health could not be credited to reductions in calories, but rather to changes in the types of food eaten. While on the Paleo diet either eight or all nine participants  experienced improvements in blood pressure, arterial function, insulin, total cholesterol, LDL cholesterol and triglycerides. What is most amazing about this experiment is how rapidly so many markers of health improved, and that they occurred in every single patient.

In an even more convincing recent (2009) experiment, Dr. Lindeberg and colleagues compared the effects of a Paleo diet to a diabetes diet generally recommended for patients with type 2 diabetes.11 The diabetes diet was intended to reduce total fat by increasing whole grain bread and cereals, low fat dairy products, fruits and vegetables while restricting animal foods. In contrast, the Paleo diet was lower in cereals, dairy products, potatoes, beans, and bakery foods, but higher in fruits, vegetables, meat, and eggs compared to the diabetes diet. The strength of this experiment was its cross over design in which all 13 diabetes patients first ate one diet for three months and then crossed over and ate the other diet for three months. Compared to the diabetes diet, the Paleo diet resulted in improved weight loss, waist size, blood pressure, HDL cholesterol, triglycerides, blood glucose and hemoglobin A1c (a marker for long term blood glucose control).    From an experimental design perspective, this trial represents a powerful example of the Paleo diet’s effectiveness in treating people with serious health problems.

From 2007 until 2010 only five experimental studies tested contemporary “Paleo” diets in humans (Table 1).  However since then, interest in experimentally testing these diets has grown concurrently (Table 1) with the general public’s explosive awareness of the Paleo Diet concept (Figure 1). Except for a single study, human trials testing modern day Paleo Diets have shown them to be therapeutic and generally more effective in reducing body weight and ameliorating symptoms of the metabolic syndrome (Table 1) than conventional western diets, type 2 diabetic diets, the Mediterranean diet, and the American Heart Association (AHA) diet (Table 1).   Further, contemporary “Paleo diets” are nutritionally more dense in the 13 vitamins and minerals most lacking in the typical U.S. diet when contrasted to the USDA my Plate recommendations,39, 40 the Mediterranean diet, and vegan/vegetarian diets.

Table 1.  Paleo Diet References: Direct Human/Animal Experimental and Epidemiological Studies in chronological order (oldest to most recent).



  1. O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.


  1. Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson Lindeberg S: A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond) 2006, 3:39.


  1. Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.


  1. Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.


  1. Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35
  2. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.


  1. Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85


  1. Carter P, Achana F, Troughton J, Gray LJ, Khunti K, Davies MJ. A Mediterranean diet improves HbA1c but not fasting blood glucose compared to alternative dietary strategies: a network meta-analysis. J Hum Nutr Diet. 2014 Jun;27(3):280-97
  2. Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC.Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013 Jul 29;12:105. doi: 10.1186/1475-2891-12-105.
  3. Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, Hauksson J, Olsson T. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013 Jul;274(1):67-76
  4. Frassetto LA, Shi L, Schloetter M, Sebastian A, Remer T. Established dietary estimates of net acid production do not predict measured net acid excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets. Eur J Clin Nutr. 2013 Sep;67(9):899-903


  1. Fontes-Villalba M, Jönsson T, Granfeldt Y, Frassetto LA, Sundquist J, Sundquist K, Carrera-Bastos P, Fika-Hernándo M, Picazo Ó, Lindeberg S. A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study–Alimentation and Diabetes in Lanzarote–ADILAN.Trials. 2014 Jan 2;15:2. doi: 10.1186/1745-6215-15-2.
  2. Bisht B, Darling WG, Grossmann RE, Shivapour ET, Lutgendorf SK, Snetselaar LG, Hall MJ, Zimmerman MB, Wahls TL. A multimodal intervention for patients with secondary progressive multiple sclerosis: Feasibility and effect on fatigue. J Altern Complement Med. 2014 Jan 29. [Epub ahead of print]
  3. Mellberg C, Sandberg S, Ryberg M, Eriksson M, Brage S, Larsson C, Olsson T, Lindahl B. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr. 2014 Mar;68(3):350-7.
  4. Smith, M, Trexler E, Sommer A, Starkoff B, Devor S.teven (2014) Unrestricted Paleolithic Diet is associated with unfavorable changes to blood lipids in healthy subjects. Int J Exer Sci 2014, 7(2) : 128-139.
  5. Talreja D, Buchanan H, Talreja R, Heiby L, Thomas B, Wetmore J, Pourfarzib R, Winegar D. Impact of a Paleolithic diet on modifiable CV risk factors. Journal of Clinical Lipidology, Volume 8, Issue3, Page 341, May 2014.
  6. Boers I, Muskiet FA, Berkelaar E, Schur E, Penders R, Hoenderdos K, Wichers HJ, Jong MC. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrom. A randomized controlled pilot-study. Lipids Health Dis. 2014 Oct 11;13:160. doi: 10.1186/1476-511X-13-160.
  7. Stomby A, Simonyte K, Mellberg C, Ryberg M, Stimson RH, Larsson C, Lindahl B, Andrew R, Walker BR, Olsson T. Diet-induced weight loss has chronic tissue-specific effects on glucocorticoid metabolism in overweight postmenopausal women. Int J Obes (Lond). 2014 Oct 28. doi: 10.1038/ijo.2014.188. [Epub ahead of print]
  8. Whalen KA, McCullough M, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and mediterranean diet pattern scores and risk of incident, sporadic colorectal adenomas. Am J Epidemiol. 2014 Dec 1;180(11):1088-97. doi: 10.1093/aje/kwu235. Epub 2014 Oct 17.
  9. Toth C, Clemens Z. Type 1 diabetes mellitus successfully managed with the Paleolithic ketogenic diet. Int J Case Pep Images. 2014 5(10):699-703.


  1. Talreja A, Talreja S, Talreja R,Talreja D. The VA Beach Diet Study: An investigation of  the effects  of plant-based, Mediterranean, Paleolithic, and Dash Diets on cardiovascular disease risk. J Am Coll Cardiol Intv. 2015;8(2_S):S41-S41.  doi:10.1016/j.jcin.2014.12.161
  2. Bligh HF, Godsland IF, Frost G, Hunter KJ, Murray P, MacAulay K, Hyliands D, Talbot DC, Casey J, Mulder TP, Berry MJ.Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study.Br J Nutr. 2015 Feb 28;113(4):574-84.
  3. London DS, Beezhold B. A phytochemical-rich diet may explain the absence of age-related decline in visual acuity of Amazonian hunter-gatherers in Ecuador. Nutr Res. 2015 Feb;35(2):107-17.
  4. Masharani U, Sherchan P, Schloetter M, Stratford S, Xiao A, Sebastian A, Nolte Kennedy M, Frassetto L. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Eur J Clin Nutr. 2015 Apr 1. doi: 10.1038/ejcn.2015.39. [Epub ahead of print]
  5. Tóth, C, and Zsófia, C. “Gilbert’s Syndrome successfully treated with the Paleolithic ketogenic diet.” Am J Med Case Reports. 2015 3(4). http://pubs.sciepub.com/ajmcr/3/4/9/
  6. Pastore RL, Brooks JT, Carbone JW. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Nutr Res. 2015; 35:474-479.





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