Tag Archives: supplements

Vitamin D Omega 3 Supplements | The Paleo Diet

Choosing a Paleo diet and eating more in tune with how we’ve evolved provides the body with a robust amount of essential protein, healthy fats, gluten-free carbohydrates and nutrient dense veggies. An ancestral approach to eating also provides your body with key nutrients, vitamins and minerals the way nature intended. Does this mean that supplementation is unnecessary if you’re following a Paleo lifestyle? It’s a complicated question.

Most articles and blogs about supplements inevitably discuss the benefits or drawbacks of multi-vitamins. Research shows that if you eat a diet centered around the most nutrient dense foods – quality meats, veggies and fats – you’ll likely already be achieving a therapeutic dose for most vitamins and minerals. When intake is at a supra-physiological dose (that can never be found in nature), too many vitamins can actually put you at risk of chronic disease. Does this mean if you’re following a Paleo diet you don’t need any supplements?

Let’s look at the two most common instances where supplementation might still be a good idea, vitamin D and omega-3 fats. In both of these cases, although a Paleo diet is a great place to start, for many people this may not be enough.


Vitamin D is classically known as an essential nutrient for bone health and immunity, however new research shows this fat-soluble vitamin has much more profound impacts on your health and well-being.

How important is vitamin D? Dr. Michael Holick, physician and vitamin D expert sums it up. “Imagine what would happen if a drug company came out with single pill that reduces the risk of cancer, heart attack, stroke, osteoporosis, PMS, depression and various autoimmune conditions? There would be a media frenzy the likes of which has never been seen before! Such a drug exists… it’s the sun.”1, 2, 3

Vitamin D is different than other vitamins because it’s created under your skin when ultraviolet light from the sun interacts with a specific enzyme to form cholecalciferol or vitamin D3. However, exposure to daily sunlight is no longer the norm as we are cooped up in cubicles all day and the deeply ingrained ancestral benefits of light exposure are overlooked.

It’s estimated that up to 70% of the American population is deficient in vitamin D (defined as blood levels below 20ng/mL or 50 nmol/L), or suffering from vitamin D insufficiency, a level above a diagnosed deficiency but still not sufficient for good health (measured as 20-32 ng/mL or 50-80nmol/L). 4

If you live in a northern climate with a true winter season, or north of the 49th parallel, it’s very difficult to achieve the required blood levels of vitamin D from food alone. While cold-water fatty fish, eggs and mushrooms are good foods sources of vitamin D, in the dead of winter they’re likely not enough. Adding a supplement can be highly beneficial.

The standard medical recommendation for vitamin D drops is 1,000-2,000 IU per day, however in the darkest winter months you may need a higher dose. Remember, always get your blood levels tested and work with a doctor if you’re thinking of supplementing with more than the recommended dose. The normal range is typically between 32-50ng/mL (80-125nmol/L) and for athletes new research suggests achieving levels greater than 40ng/mL (100nmol/L) to support superior performance and recovery.5 Be sure to take your vitamin D supplement with a meal that includes fat for optimal absorption.


Extra long-chain fats eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the omega-3 ‘all-stars’ when it comes to supporting overall health and combating chronic disease. While most people know the benefits of omega-3 fats for cardiovascular health, many don’t realize they also help reduce the risk of diabetes and depression, protect against mental stress, and even support athletic performance by improving muscle protein synthesis and controlling excessive inflammation.

How important are omega-3 fats? In 2013, the Cardiovascular Healthy Study found that people with the highest omega-3 (e.g. EPA and DHA) levels in their blood had the lowest overall mortality rates.6 In short, the more omega-3 fats you consume, the less chance you have of dying from absolutely any cause. The good news is they are found in abundance in a Paleo diet (e.g. grass-fed meats, wild ocean fish, farm fresh eggs). However, modern day living and long, busy days might mean you’ll benefit from extra support.

If you’re prone to low mood or depression, or cope with regularly high stress levels fish oils could well be an important key to improving your brain health. A study in the Journal of Clinical Psychiatry found people experiencing depression had consistently lower levels of essential fatty acids in their blood. When subjects supplemented with fish oils they had significant improvements in their Hamilton Rating Scale, a recognized evaluation system for depression.7 The British Journal of Nutrition also discovered that supplementing with fish oils helps reduce the adrenal over-activation associated with high levels of mental stress.8

Rates of diabetes and pre-diabetes have never been higher, and constantly being on the go is just one factor that can lead to snacking on convenience foods that are high in processed carbs and sugars. A recent study of fish oil supplementation effects on blood sugar and insulin levels over a 3-week period found significant improvements in insulin function in those with elevated levels.9

Of course, it’s not enough just to increase your omega-3 intake. It’s far too easy to obtain excessive amounts of omega-6 type fats in today’s world, whether from processed foods, restaurant eating, or convenience snacks. The beauty of adopting a Paleo diet is that it often naturally restores this common imbalance. However, the impacts of modern living may still leave you short.

Unless you’re eating 1-2 pieces of cold, deep-water fatty fish daily, it’s best to add an omega-3 supplement rich in EPA/DHA. Fish oil is the richest in EPA and DHA, however krill oil, sea oil, and sea algae are all viable options as well. Aim to supplement with 1,000-1,500mg of combined EPA and DHA daily.

If you’re an athlete and training intensely fish oil supplementation can be a game changer. Supplementation can lead to an amazing 50% increase in the up-regulation of mTOR, the genetic signaling pathway that stimulates lean muscle growth, leading to significant increases in muscle protein synthesis and muscular hypertrophy.10  If you’re serious about your training, adding extra omega-3 fats to your sports nutrition arsenal is important.

A Paleo diet is a great way to cover all your bases on the nutrition front. However, depending on your genetics, where you live, how busy you are, and your lifestyle, diet may not be enough to correct low or insufficient levels of vitamin D and omega-3 fats. Adding these two supplements into your regime, particularly throughout the winter months, may be the fix you need to improve your health, productivity at work and performance in the gym.


  1. Holick M.Vitamin D Deficiency:What A Pain It Is. Mayo Clin Proc 2003 78(12):1457-59
  1. Holick, M. Article Review: Vitamin D Deficiency. NEJM Medical Progress. 2007, 357:266-81.
  1. Holick, M. Shinning A Light On Vitamin D-Cancer Connection IARC Report. Dermato-Endocrinology, 2009 1(1):4-6
  1. Hanley D, Davison, K. Symposium: Vitamin D Insufficiency: A significant risk Factor in Chronic Disease and Potential Disease-Specific Biomarkers of Vitamin D Insufficiency: Vitamin D Insufficiency in North America. J Nutr 2005, 135:332-37.
  1. Koundourakis, N et al. Vitamin D and Exercise Performance in Professional Soccer Players. Plos One. 2014 Jul 3;9(7):e101659.
  1. Mozaffarian D, Lemaitre RN, King IB, et al. Plasma phospholipid long-chain omega-3 fatty acids and total and cause-specific mortality in older adults. A cohort study. Ann Intern Med 2013; 158:515-525.
  1. Su K, Huang S, Chiu C, Shen W. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 2003;13(4):267-271.
  1. Delarue J et al. Fish oil attenuates adrenergic overactivity without altering glucose metabolism during an oral glucose load in haemodialysis patients. Br J Nutr. 2008 May;99(5):1041-7.
  1. Delarue J et al. Interaction of fish oil and a glucocorticoid on metabolic responses to an oral glucose load in healthy human subjects. Br J Nutr. 2006 Feb;95(2):267-72.
  1. Smith GI et al. Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and women. Clin Sci (Lond). 2011 Sep;121(6):267-78.

Carnitine Levels and Muscle Boosters | The Paleo Diet
When we follow a healthy, Paleo diet, we want to make sure we’re covering all bases, not only in terms of getting every last vitamin and mineral, but doing so in a balanced way. As such, entertaining the idea of taking supplements to meet recommended daily value (DV) requirements is natural. In fact, so many of us take supplements that we’re spending billions.

Sales of supplements in 2013 reached $13 billion, as more people turned to the supplements to boost their health and lose weight, despite an investigation that found most didn’t contain herbs listed on their labels, and in some cases, the supplements didn’t even identify potentially dangerous allergens.1

So, do we really need any of them? Doesn’t a real Paleo diet provide all we need? Yes, but there are a couple caveats worth considering including supplementation for:


Most westerners, particularly those living at northern latitudes, do not receive sufficient sunlight exposure required for our bodies to produce adequate blood concentrations of vitamin D.


We could avoid supplementing if we were to eat the entire carcass of animals and fish (brains, liver, marrow, gonads) which are rich sources of EPA and DHA.2

In my experience, I’ve found on an individual basis, clients may need supplements of one kind or another, but rather than going to the nearest Whole Foods and dropping hundreds of dollars in self-diagnosed natural remedies, do yourself a favor and if you feel something is amiss, see your functional medicine doctor3 to get a full work up and determine what you actually need.

What’s the deal with some of the popular supplements that we see advertised all over the place? We already know how to address some of them. Our need for calcium, for example, is adequately met on a Paleo diet, even though we don’t eat dairy.

And, rather than turning to B12 supplements for energy, we can create a naturally balanced blood sugar levels simply by following the low-glycemic eating regime that is inherent to Paleo.

But what about some of the more confusing supplements, such as those designed to help with performance in sport? Carnitine is a perfect example.

L-carnitine is an amino acid that is naturally produced in the body.  Supplements are used to increase levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs, or because they are undergoing a medical procedure that uses up the body’s L-carnitine. It is also used as a replacement supplement in strict vegetarians, dieters, and low-weight or premature infants.4

But can it also give us an edge in sport? Apparently so, according to a recent study published in Cell Metabolism.

“Supplementation with carnitine increases activity of metabolic pathways that helped mice run longer and further than those without supplementation”, said the US-based researchers who conducted a recent study focused on an enzyme, which uses carnitine to boost energy economy.5

Researchers moved to address ways routine activities like mowing the lawn or climbing stairs was becoming problematic due to exercise intolerance. The study concluded that carnitine supplementation did, in fact, work synergistically with the enzyme to optimize energy metabolism during exercise.

But what were the subjects eating? There’s no mention of the diet administered to the mice in the study, and aside from a brief mention that “nutritional and/ or pharmalogical strategies aimed at promoting enzymatic activity could prove useful for offsetting metabolic inertia,” we’re left with a fundamental piece of information, which seems to have been grossly overlooked.

Meat, poultry, and fish, staples of any Paleo diet, are all rich sources of L-carnitine where 63% – 75% is absorbed, whereas only 14% – 20% is absorbed in supplementation.6 Rather than heading straight to the vitamin shop and stocking up on carnitine, do yourself and your wallet a favor and make sure your diet is, in fact, a balanced Paleo approach. L-Cartinine supplementation may prove to be nothing more than the proverbial Band-Aid.



[1] “Americans Are Ignoring the Science and Spending Billions on Dietary Supplements.” Washington Post. The Washington Post, 04 Feb. 2015. Web

[2] “Nutrient Deficiencies and Supplementation | The Paleo Diet.” The Paleo Diet. N.p., 23 Feb. 2015. Web

[3] “Institute for Functional Medicine What Is Functional Medicine?” Institute for Functional Medicine What Is Functional Medicine

[4] “L-carnitine: Uses, Side Effects, Interactions and Warnings – WebMD.” WebMD. WebMD, n.d. Web. 29 July 2015.

[5] Carnitine Supplementation Could Boost Muscle Stamina: Animal Data.” NutraIngredients.com. N.p., n.d. Web.

[6] Linus Pauling Institute. “L-Carnitine.” Micronutrient Information Center. Oregon State Univeristy, 2015. Web.

Gum Disease and Nutrient-Dense Food Supplements | The Paleo Diet

Originally published in the March/April 2015 issue of Well Being Journal

Today, there is a 47 percent prevalence rate of periodontitis among adults in the United States. Periodontitis is the advanced stage of gum disease, where not only are the gums infected but the bone surrounding the roots of the teeth is infected and breaking down. For those who are over 65 years old, the prevalence rate jumps to 70 percent.

I have been a periodontist (a dentist who specializes in gum disease) for forty years. For the first thirty-five years, I treated advanced gum diseases the way most periodontists do: by performing traditional gum surgery, which was somewhat successful but relatively uncomfortable for patients. Several years ago, I learned a better way for my patients. In 2010, I became licensed in a laser procedure called LANAP® (Laser Assisted New Attachment Procedure) that kills harmful bacteria, helps grow new bone, and creates overall better results without the use of a scalpel or sutures. Most important, patients don’t experience the pain or swelling that has been part of traditional gum surgery.

In 2013, I started to become educated about the importance of ancestral nutrition and nutrient-dense foods, and how they affect dental and overall health. I attended a five-day nutrition course for health professionals, held at Kripalu Center for Yoga and Health and, several months later, a four-day Food As Medicine conference. This education was life changing for me and has been life changing for many of my patients. I personally became reenergized, and I reengineered my periodontal practice.

With all this new information pertaining to lifestyle, I also wanted to know what science had to say about nutrient-dense, unprocessed foods specifically for gum disease. I researched PubMed, which is the U.S. National Library of Medicine’s database of published medical research from around the world. I found one study regarding gum disease and Paleolithic nutrition  and several recent studies involving nutrition and gum disease. However, I could find no studies on how specific nutrient-dense foods affected the progress of gum disease. So, in March of 2014, I decided to create a study using my own patients who wished to be a part of my research. I enlisted the help of Ramiel Nagel, researcher and author of Cure Tooth Decay, who designed the study with me. Now my research is completed, and the results are in.

Selection of Patients

The specific criteria for patient selection were:

  • The patient could not have been on any antibiotic during the last three months.
  • The patient had not undergone active gum treatment (including deep cleaning or a general cleaning by the hygienist) in the last three months.
  • Infected gum pockets (the spaces between the gum and tooth) bled when a periodontal probe (a gum-pocket measuring instrument) was gently inserted into the gum space.
  • The gum pockets had a depth of at least 4 mm (1-3 mm without any bleeding while being measured with a periodontal probe is considered healthy).
  • No more than four individual teeth per patient who met the criteria were selected for the study.
  • Participants were instructed not to change any habits, lifestyle activities, dietary regimens, or medications during the course of the thirty-day study.


We selected thirteen patients who met the criteria above for the study. They agreed to take a variety of nutrient-dense real food supplements for thirty days to find out if these supplements would be effective in reducing some of their manifestations of gum disease. I examined and measured 41 teeth within this group of thirteen patients.

I gave these patients three different nutrient-dense food supplements in capsule form, containing various micronutrients, which they took almost every day. The micronutrients are identified in websites referenced below.A synergistic effect exists from taking this combination of supplements.

Here are the doses for each of the supplements:

My patients took these nutrient-dense supplement capsules along with their normal foods for thirty days. For the first five days of the study, they gradually transitioned into taking the full doses, in order to help their bodies acclimate to these nutrient-dense foods. If they had taken the full doses on day one, they might have had nausea or diarrhea, since their bodies were not used to these supplements. Also, they did not take any capsules on every seventh day, which was a rest day for their guts. As I mentioned, they did not change anything else in their diets or daily routines. They followed the same schedules and lifestyles as they had before the study—the only difference was that they took these nutrient-dense supplements.

For more information, author bio, and references see the full article in the print, or digital download version of the Well Being Journal.

“Gum Disease and Nutrient-Dense Food Supplements: Results of an In-Office Study,” by Alvin Danenberg, D.D.S., is reprinted by permission from the March/April 2015 issue of Well Being Journal, Volume 24, Number 2; see more at //wellbeingjournal.com.

Dr. Alvin DanenbergDr. Danenberg is a periodontist in South Carolina who has been in practice for 40 years. Within the last 4 years, he has included Laser Periodontal Therapy as his primary treatment for periodontal disease. The procedure is called “Laser Assisted New Attachment Procedure” or “LANAP”. The last two years he has incorporated a lifestyle program for all his periodontal patients including an ancestral diet to enhance their overall body’s health and function. In July of this year he was awarded the designation, “Certified Functional Medicine Practitioner.” For more information,  please visit www.DrDanenberg.com. 

Vitamin and Nutritional Supplements Increase Chronic Disease Morbidity

The Nutritional Supplement Mentality

When you start eating Paleo, you simply won’t require vitamin or mineral supplements.13 In fact, except for fish oil and vitamin D, if you choose to take antioxidant and/or B vitamins, you will increase your risk of cancer, heart disease and dying from all causes combined.

One of my first jobs after high school was with the U.S. Forest Service on a wild fire crew in Markleville, California. During the summer of 1969 I bunked with eight other fire fighters in a rustic shack where we shared a communal kitchen and bathroom. As an 18-year-old barely out of my parent’s house, I had to buy groceries to last me a week before my days off. Being young and naïve, my food choices were not that good to begin with, but I did manage to purchase a box of Total Cereal, thinking this was a sensible food to help me obtain 100% of my daily vitamins and minerals.

Forty years later, I now realize that my naïve food choice constituted part of a much larger, unwise global perspective on diet that had emerged since World War II. Instead of focusing upon natural, healthy foods in my diet, I was suckered into focusing upon nutrients. Until only recently this perspective has dominated scientific as well as lay thought on healthful elements that made up nutritious diets.24, 30

To quote a recent study by Drs. Lichtenstein and Russell24 from Tufts University which appeared in the prestigious Journal of the American Medical Association, “The most promising data in the area of nutrition and positive health outcomes relate to dietary patterns, not nutrient supplements. These data suggest that other factors in food or the relative presence of some foods and the absence of other foods are more important than the level of individual nutrients consumed.”

If we read just a little between the lines, you can see that one of the key points brought up is that our overall nutritional quality is most dependent upon the foods we don’t eat.24, 30 No amount of vitamins, minerals or supplements added to breakfast cereals will ever make them a healthful food. Similarly, athletic drinks boasting of vitamins, amino acids and additives are nothing more than liquid candy. The food processing industry “fortifies” highly processed foods, like breakfast cereals, soft drinks, designer yogurts, granola, mayonnaise and orange juice with various nutrients and then re-characterizes them as “nutritious” or “heart healthy.” These marketing ploys not only cause widespread adverse health effects, but they also propagate the misleading idea that nutrients (vitamins and minerals) are more important than foods. We need to get back to healthy eating patterns characterized by traditional foods such as fresh fruits, vegetables, seafood and grass produced meats that have nourished and sustained our species from the very beginning.

When we eat real, living foods there is little or no need to supplement our diet with any vitamin, mineral or single nutrient thought to be protective against disease.13 The mentality that has dominated nutritional thought in the post-World War II era since vitamins and supplements became widely available was: if a little bit is good, more must be better.

If you visit your local pharmacy or health food store and decide to buy a mixed B vitamin formula, or even a multivitamin, you are immediately met with a staggering number of choices. Do you want the 10 mg version, the 50 mg form, or the 100 mg variety? You ask the clerk, and she says go with the 100 mg version because you’re getting more vitamins for your buck, and we all know that B vitamins are water soluble; so what you don’t use will simply be excreted in your urine. You agree, and don’t give it a second thought.

Evolutionary Insight

If we follow the evolutionary template, it will provide us guidance about all aspects of healthful human diet, including vitamin and nutritional supplements. For our hunter gatherer ancestors, micronutrients (vitamins, minerals, and phytochemicals) have always been consumed in a range of concentration that was available through diet only. Further, processed foods were not on the menu, nor were vitamin supplements or fortified foods. Accordingly, our ancestral vitamin, mineral and nutrient intake would have always fallen within a narrow range – not too low and not too high. Additionally, the relative levels of one B vitamin to another or any single nutrient to another1, 20, 21, 36, 38 would have also fallen within a range determined by the types of unprocessed plant and animal foods that were consumed. I can tell you right now that it would have been impossible for any hunter gatherer to ever obtain 10 times the DRI for any B vitamin, much less 100 times this value. Similarly, the natural ratio of one B vitamin to the next or any nutrient to another would never have been exactly one to one as it is in most modern vitamin formulations.

OK. What am I getting at? Paracelsus, one of the greatest Renaissance physicians of 16th century Europe is credited with this quote, “dose makes the poison.” And indeed, this ancient wisdom is now coming back to haunt us in the 21st century as we indiscriminately lace our food supply with artificially produced vitamins, minerals and supplements that we perceive to enhance our health and prevent disease. Below is a graph known as a “U” shaped curve that depicts how numerous isolated vitamin and mineral supplements affect health and well-being.9, 16 Notice that when nutrient intake is low it increases our risk for disease, but this really isn’t news to most of us. What may surprise you is that excessive intake of many so called, “safe” vitamins and minerals have increasingly been shown to be harmful and actually cause illness.

Supplementation U-Shaped Curve | The Paleo DietOur hunter gatherer ancestors rarely or never would have ingested too few or too many nutrients that caused disease by landing on either the left or right hand extremes of the “U” shaped curve. Prior to the Agricultural Revolution, it would have been difficult or nearly impossible for any forager to develop a vitamin or nutrient deficiency by falling on the left hand side of the curve. Wild plant and animal foods are rich sources of all known nutrients required for optimal human health. When these foods or their modern counterparts are regularly consumed, nutrient deficiencies never develop. Only in the post-agricultural period could people have wound up on the left side of the “U” shaped curve. Vitamin and mineral deficiencies became commonplace in early farmers as nutrient poor cereal grains replaced wild meats, fish, fruits and vegetables. With the industrial revolution and introduction of refined grains, sugars, vegetable oils, canned foods and eventually processed and junk food, the consumption of nutrient depleted foods became the norm. It’s high time that we return to the foods to which our species is genetically adapted – by doing so you will never have to worry about landing on the left side of the “U” shaped curve.

Nutritional Supplements: Too Much of a Good Thing

Perhaps more alarming to many of you is not the left side of the curve, but rather its right side. I realize that many of you may be taking high doses of B and antioxidant vitamins because you think they provide protection from cancer and heart disease. Nothing could be further from the truth, and in fact this practice will increase your risk of dying from cancer, heart disease and all causes combined. Except for fish oil and vitamin D, supplementation is a total waste of your time and money. It’s high time to dismantle the myth of nutrient supplementation as our guiding light to health and well-being and replace it with the truth of nutrient dense, “real” foods.24, 30

Folic Acid Supplementation and Fortification

I have previously written an extensive blog post on folic acid supplementation. Starting in 1998 the U.S. Food and Drug Administration mandated that all enriched wheat flour was to be fortified with folic acid. Because most commercial wheat products (breakfast cereals, bread, cookies, cakes, crackers, doughnuts, pizza crust, hamburger and hotdog buns, wheat tortillas etc.) are made with enriched wheat flour, essentially the entire U.S. population began to consume folic acid in 1998. As I and others have pointed out this practice produced marginal reductions in neural tube defects, but moreover increased the risk for breast, prostate and colorectal cancers for the entire U.S. population.

Antioxidant Supplements do More Harm than Good

Of all the supplements people take, antioxidants are one of the most popular, particularly with seniors and cancer patients. The most commonly supplemented antioxidants are beta carotene, vitamin A, vitamin C, vitamin E and selenium. About 11% of the U.S. population supplement their diets with antioxidants on a daily basis, whereas this number rises to almost 20% in adults 55 years of age and older.27 A near universal perception with most antioxidant consumers is that these nutrients increase longevity and may prevent cancer, heart disease and whatever else ails them.34, 35 It goes without saying – more is almost always thought to be better.

Let’s examine the “U” shaped curve once again. If people are deficient in these nutrients, there is little doubt that health will suffer. On the other hand more is definitely not better. Biological systems, like our bodies operate optimally when nutrients are supplied to them in the ranges for which they were designed. If you underinflate a tire, your car performs poorly – if you overinflate it, the tire ruptures. Just like tires, our body’s natural defense against disease as well as the rate it ages is dependent upon just the right amount of antioxidants from our diet – not too little, but also not too much. I invoke the “U” shape curve and Paracelsus once again, “dose makes the poison.

The idea behind antioxidant supplements is that they capture and inactivate free radicals. These are highly reactive particles formed within our tissues as byproducts of metabolism. Excessive free radicals may damage cells and tissues in many ways. In animal experiments, high free radical production can promote cancer, heart disease and premature aging. Our bodies use dietary antioxidants to disarm free radicals and thereby prevent damage to cells. We also manufacture antioxidants within our bodies which work together with dietary antioxidants to keep free radicals at bay.

An often overlooked fact when it comes to free radicals is that they are necessary components of normal body function and a healthy immune system. Free radicals are used by the immune system to destroy cancer cells, kill invading microorganisms and detoxify cells. If we overload our bodies with massive doses of antioxidants, these essential functions are impaired as normal free radical activity is suppressed. Alternatively, supra normal doses of antioxidant vitamins upset other delicate aspects of cellular machinery which can actually turn antioxidants into pro-oxidants and ultimately increase free radical activity.

In 1994 one of the first inklings that high doses of antioxidants may be harmful surfaced with the completion of the ATBC study, a randomized, placebo controlled experiment of 29,133 male smokers.2 The idea behind this experiment was to determine if beta carotene or vitamin E supplementation could reduce lung cancer incidence in this group of heavy smokers. Following 5 – 8 years of supplementation, the researchers were shocked – treatment with beta carotene actually increased lung cancer rates by 16 –18% and overall death rates by 8%. Further, the men taking vitamin E suffered more hemorrhagic stroke than those taking placebo pills.2 A similar randomized placebo controlled trial known as the CARET study had been on-going concurrently with the ATBC study. In the CARET trial smokers and former smokers received beta carotene (20 mg) in combination with high doses of vitamin A (25,000 I.U.) for an average of five years.31 The men who received the antioxidants experienced a 28 % greater incidence in lung cancer and a 17% higher death rate than those taking an inert placebo pill. The CARET trial was immediately stopped when the results of the ATBC trial were reported.

In the years since the ATBC and CARET trials, more convincing data have verified the harmful effects of antioxidant supplementation. A 2007 meta analysis of 67 randomized controlled trials studies involving 232,606 participants showed that supplementation with either vitamin E, beta carotene, or vitamin A increased overall death rates.5 In 2008, a large randomized controlled trial (The SELECT study) of vitamin E and selenium supplementation in 35,533 men was prematurely halted when it was discovered that these two antioxidants increased the risk for prostate cancer and type 2 diabetes.23 A large m eta analysis involving 20 randomized controlled trials and 211,818 subjects revealed antioxidant supplementation (beta carotene, vitamin A, vitamin C, vitamin E and selenium) did not protect against gastrointestinal cancer, but rather increased overall death rates.3

A series of recent meta analyses (combined results from many studies) show that high vitamin E intake may be particularly dangerous. Dr. Miller and colleagues at Johns Hopkins School of Medicine analyzed 19 randomized trials that included more than 136,000 subjects and stated, “High-dosage (> or =400 IU/d) vitamin E supplements may increase all-cause mortality and should be avoided.” 28  In a meta analysis of 118,765 people and 9 randomized controlled trials evaluating the effects of vitamin E on stroke, Dr. Schurks and co-workers at Harvard Medical School concluded, “In this meta analysis, vitamin E increased the risk for haemorrhagic stroke by 22% . . . indiscriminate widespread use of vitamin E should be cautioned against.”37

Even the once acclaimed and vaunted vitamin C may have little therapeutic value for cancer or heart disease. In The Physicians’ Health Study, a randomized, placebo-controlled trial of vitamins E and C in 14,641 male doctors, the authors summarized, “. . . neither vitamin E nor C supplementation reduced the risk of prostate or total cancer. These data provide no support for the use of these supplements for the prevention of cancer in middle-aged and older men.”14 The situation for cardiovascular and vitamin C and other antioxidants appears to be the same as for cancer – they are a waste of your money as Dr. Bleys and colleagues have demonstrated in a meta analysis of 11 randomized controlled trials. His concluding remarks were as follows: “Our meta-analysis showed no evidence of a protective effect of antioxidant vitamin-mineral or B vitamin supplementation on the progression of atherosclerosis. . . Our findings add to recent skepticism about the presumed beneficial effects of vitamin-mineral supplementation on clinical cardiovascular endpoints.7

Here’s one final point regarding vitamin C supplementation that may be of interest. If you are an athlete a series of recent human and animal experiments suggest that mega doses of vitamin C may have detrimental effects upon your performance.12, 15, 33 Surprisingly, supplementation with vitamin C may decrease training efficiency, cancel beneficial effects of exercise on insulin sensitivity, and delay healing after exercise. In addition, vitamin C supplementation did not decrease free radical damage to DNA that may occur following exercise18

These kinds of studies further cement the notion that fitness, vitality and well-being can never be achieved by single isolated nutrients, supplements or fortified foods. In fact, the available evidence conclusively shows these compounds are harmful by causing nutritional imbalances within our bodies.4, 6 The Paleo Diet has never been about supplements, but rather about real, wholesome living foods.

A closing thought. Supplementation can also be hazardous to our children’s health as well. A number of studies have demonstrated that multivitamin supplementation29 increases the risk for food allergies and asthma as do supplements of vitamin A, D, E and C.17, 22


Loren Cordain, Ph.D., Professor Emeritus


1. Alcock N, Macintyre I. Inter-relation of calcium and magnesium absorption. Clin Sci. 1962 Apr;22:185-93.

2. ATBC Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med. 1994 Apr 14;330(15):1029-35.

3. Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Systematic review: primary and secondary prevention of gastrointestinal cancers with antioxidant supplements. Aliment Pharmacol Ther. 2008 Sep 15;28(6):689-703

4. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD007176.

5. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007 Feb 28;297(8):842-57. Review. Erratum in: JAMA. 2008 Feb 20;299(7):765-6

6. Bjelakovic G, Gluud C. Surviving antioxidant supplements. J Natl Cancer Inst. 2007 May 16;99(10):742-3

7. Bleys J, Miller ER 3rd, Pastor-Barriuso R, Appel LJ, Guallar E Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2006 Oct;84(4):880-7

8. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010 Jul 29;341:c3691. doi: 10.1136/bmj.c3691

9. Chiang EC, Shen S, Kengeri SS, Xu H, Combs GF, Morris JS, Bostwick DG, Waters DJ.Defining the Optimal Selenium Dose for Prostate Cancer Risk Reduction: Insights from the U-Shaped Relationship between Selenium Status, DNA Damage, and Apoptosis. Dose Response. 2009 Dec 21;8(3):285-300

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Commonly Asked Questions | The Paleo Diet

Commonly Asked Questions

1. What is the most potential danger following The Paleo Diet?

There are no known adverse health effects of the diet in most people.  Pregnant women should not exceed 25% of their calories from protein, as the liver is less able to detoxify protein during pregnancy.

2. There is no Vitamin D consumed in the Paleolithic Diet. In your article, “The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups,” you write that sunlight is the only way our ancestors got Vitamin D. Today, with all the new research, how do you suggest we get our Vitamin D?

I suggest taking between 2,000 to 4,000 IU of vitamin daily if you cannot obtain regular sun exposure.

3. Since there is no calorie counting in the Paleolithic Diet, how can a person lose weight?

Refined sugars, refined grains, refined vegetable oils and dairy comprise 70% of the calories in the US diet.  By reducing these foods and replacing with fresh fruits, vegetables, grass produced meats, fish and seafood, we can make our diets more nutritionally dense and increase the satiety value of our foods — both of which will help to promote weight loss, along with elimination of processed foods.

4. If there really is “no limit” on how much to eat, how do you approach a healthy balance of the allowed foods?

Real foods such as grass produced or free ranging meats, fish, seafood and fruits and vegetables are self-limiting.  Your body gives your brain signals to stop eating with these foods when you are full,  whereas it is quite easy to overeat nutrient depleted processed foods made from refined sugars, grains and vegetable oils, etc.
5. If a person has never shown a hypersensitivity to milk, legumes or grains will they feel the benefits of The Paleo Diet?

Yes.  These foods contain a variety of antinutrients and nutritional qualities which may adversely affect health in a manner that is not always obvious to the consumer.

6. What is your opinion on the use supplements for vitamins and minerals?

Except for vitamin D and fish oil (if you don’t regularly eat fatty fish), most antioxidant vitamins and minerals actually increase mortality from all causes.  See my most recent book, The Paleo Answer, for further information.

7. Do you think there are enough resources for our entire country and world to sustain a strictly Paleo Diet?

No.  But in the US and other countries, we are not suffering from diseases of under-consumption, but rather from diseases of over consumption.  Hence, most middle class US citizens can afford to eat high quality foods such as fresh fruits, vegetables, grass produced meats and poultry, fish and seafood.

8. In your opinion, what is the main reason people choose not to go Paleo?

They are either unaware of the concept, or shy away from it because they have pre-conceived notions that it is “too restrictive.”  In fact, these are the same people who consume 70% of their calories from only 4 foods (refined sugars, refined grains, refined vegetable oils and dairy).  When prospective Paleo dieters remove these 4 foods, they will suddenly find themselves eating a more varied and nutrient rich diet than they ever, as fresh fruits, vegetables, grass produced meats, and seafood become their staples.

9. The Paleo Diet cuts out a lot of foods from the average human diet.  What do you think is the most important food for us to cut out of our diets? Sugar, dairy products, grains, legumes, unhealthy fats/oils, etc.? Or, is this question impossible answer since each of these foods affects our health differently?

As I pointed out in the previous question, these same 4 foods comprise 70% or more of the calories in the typical Western diet.  I think you would be hard pressed to find a nutritionist anywhere who would not believe that we could improve our health by reducing our intake of refined sugars, refined grains, refined vegetable oils and processed foods made from a combination of these ingredients.  Remember that in addition to reducing or eliminating these nutrient poor foods, the Paleo Diet also encourages people to eat more fresh fruits, vegetables, fish, seafood and grass produced meats and poultry.

10. How has the Paleo diet personally effected (sic) your life?

It is most gratifying for me to see how people worldwide have improved their health and well-being and in achieving their personal fitness and health goals.

11. Is there anything you would like to add?

Give the diet two weeks and see how you feel.  Also, have your blood drawn before and after two weeks on the diet and show your results to your physician.


Loren Cordain, Ph.D., Professor Emeritus

Adverse Effects of Whey Protein | The Paleo Diet

Dear Dr. Cordain,

Could you please provide some details on the benefits/detriments of whey protein supplementation? I am a weight trainer/powerlifter and supplement with whey protein, which is currently touted as the best/most health-conscious choice there is. I have read in your newsletter about the inflammatory aspects of dairy products – is whey protein included in this? Is it better or worse than other dairy products?

Many people interested in the Paleo Diet who are also into strength training and fitness would be interested in your thoughts on this. Any pointers re: inflammation and supplementation of protein would be very well received. Thank you, in advance.

Best regards,

Dr. Cordain’s Response:

Dear Karl,

Unfortunately, at this point, most of the research has focused on the beneficial effects of whey. It basically revolves around whey’s high BCAA content, its use as a post-workout recovery drink ingredient, and its capacity – due to cysteine – to increase Glutathione, a powerful endogenous antioxidant enzyme.

Nevertheless, we believe that whey protein can have some potential adverse effects, because it greatly elevates insulinemia – although it can be therapeutic for diabetics in the short term. We suspect that whey protein could be detrimental long term, as hyperinsulinemia can down-regulate the insulin receptor and lead to insulin resistance. Insulin resistance underlies the Metabolic Syndrome, and is implicated in various other diseases, such as Acne, Alzheimer, various cancers, Coronary Heart Disease, Myopia, PCOS, etc.).

But to be completely sure, we would need intervention studies with whey protein with a relatively long duration in people genetically prone to insulin resistance, or who are in fact insulin resistant.

Also, there is the matter of hormones in milk: estrogens, DHT precursors, Insulin, IGF-1 and the hormone Betacellulin (BTC), which Dr. Cordain has discussed in a previous edition of this newsletter. These are some of the possible mechanisms for which there is repeated epidemiological evidence associating milk consumption with some cancers – especially Prostate Cancer.

We know that these hormones are present in milk and – in the case of BTC – it is present in whey too. Nevertheless, the real content of all these hormones in commercial milk-derived products is an open question that deserves proper and urgent study. So while we don’t know for sure, and since and we have alternatives, I would follow the old saying: do no harm!

Finally, if you have an auto-immune disease or allergy to Beta Lacto Globulin (protein that exists in bovine milk, but nonexistent in human milk) I would stay away from whey. Whey contains not only Beta Lacto Globulin, but also Bovine Serum Albumin. Some peptides from this protein have structural homology with peptides from our own tissues, and BSA has been implicated in Multiple Sclerosis, Rheumatoid Arthritis and Type 1 Diabetes.

In conclusion, I would follow the evolutionary template until all these issues are resolved. which states that recently introduced foods may have potential adverse effects to humans, especially long term. Non-human milk was only introduced in the human diet ~10,000 years ago. Therefore, given the potential health hazards of milk that science is revealing, I would use another protein source. Lean meat and seafood are very good sources of BCAA. If you want a protein drink immediately after strength training to speed recovery and increase muscle mass, I would suggest ~9 grams of essential amino acids, along with a banana.

I hope this helps.

Pedro Bastos

Editor’s note: the following blog posts also discuss whey protein:

Q: I started the program and I was wondering if Whey Protein or protein powder in general is against the diet?

Q: I like drinking protein shakes in the morning, but I noticed some of the protein sources in my protein shake are made from milk or dairy products. Is there an alternative that is available in the market place?

Q: I am just trying to figure out your feelings and thoughts on protein powders.

Additional reading: Hyperinsulinemic diseases: more than just Syndrome X.



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