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Weighing In on The Paleo Diet

By The Paleo Diet Team
October 13, 2014
Weighing In on The Paleo Diet image

Professor Syd, please weigh in some more.

A response to the BBC online Capital “Syd weighs in” article by @SydFinkelstein

If you have not yet read it, the BBC’s Capital, recently featured an article by Professor Sydney Finkelstein recommending against following the “fad” Paleo Diet. The original title, “Eat like a caveman. Manage like one, too?” has since changed to “Mythbusting: Fads we’ve got all wrong.” However, regardless of the title change, like most articles critical of the Paleo Diet, it lacks substance and support.

I have previously rebutted a more detailed critique of the Paleo Diet without further dialogue with the author. This approach, however, may not be the most beneficial to the reader since confusion often occurs when one party says one thing and the other party simply disagrees without any debate ever occurring. Consequently, I thought this response might be an opportunity to ask Professor Finkelstein to “weigh in” some more by answering a few questions and provide any additional evidence that supports his position.

A quick review of Dr. Finkelstein‘s background clearly indicates he is an educated, intelligent man. So how can it be that he takes a position opposite to those of us that research, clinically work with, and advocate for the Paleo Diet? I can only surmise that Professor Finkelstein is simply unaware of the published research and the clinical results obtained by following a Paleolithic dietary template.

Before asking some questions, let me provide a little background on my experience with Paleolithic nutrition. My doctorate is in cardiovascular disease, and so, I have an obvious interest in nutrition. Despite the assertion that the Paleo Diet is a fad diet, my exposure to this way of eating began in 1988 when I first met Professor Cordain, the Founder of the modern Paleo movement. Since that time, I have recommended to, and worked clinically with, thousands of clients adopting the Paleo way of eating. I have also lectured to thousands of healthcare professionals about adopting the Paleo Diet with their patients and clients, who, in turn, have successfully done so. In all these years, I have never had any client or healthcare professional say the diet did not provide health benefits and, in many cases, the results have been exceptional. I also closely followed the scientific publications on Paleolithic nutrition despite the assertion that “the “research” behind these recommendations is subject to considerable dispute”.

So my first question of Dr. Finkelstein would simply be, how much research has he conducted on Paleolithic nutrition? While Professor Finkelstein’s curriculum vitae is impressive, the only connection to nutrition I can find is a reference to him being a “foodie” on his Twitter account, which, on its own, would not qualify someone to critique a well-researched field of nutritional science. Because of the Paleo Diet’s popularity, there are obviously going to be plenty of poor resources available for critique – something that Dr. Cordain has even done himself. It is not, however, appropriate to rely upon blogs, popular books, or magazines to formulate an argument against Paleolithic nutrition; rather, one should primarily rely on the scientific literature and; perhaps, secondarily, on the clinical findings of healthcare professionals.

There are now a number of published experimental studies that demonstrate the numerous health benefits of adopting a Paleolithic Diet1-10 and it is noteworthy that there are none showing a deleterious effect. In terms of other research that supports the Paleolithic dietary template (i.e., elimination of grains, dairy, legumes, and processed foods), Dr. Cordain’s latest book, The Paleo Answer, has over 900 references to the scientific literature within its text – research that is published in journals such as the American Journal of Clinical Nutrition and the American Journal of Cardiology, to name just two. So, in this instance, I would have to ask, is the legitimacy of these journals being questioned with the use of “research” within the article? With the large body of literature explaining why it is beneficial to eliminate or at least reduce the consumption of grains, dairy, legumes, and processed foods in one’s diet (leaving the consumption of lean animal protein, vegetables, fruits, nuts and seeds as the main sustenance; a.k.a., The Paleo Diet), I find it a useful exercise to ask those that critique this approach to provide the benefits of not doing so. In particular, argue the health benefits of consuming grains, dairy, and legumes, the foods that are not on the Paleo menu. So, for purposes of beginning a discussion, it would be very useful if Professor Finkelstein did just that.

The only argument actually made in the article against the Paleo Diet was with respect to the life expectancy of humans in the Paleolithic period. “Do we really want to eat like people who died when most of us are just finishing the first third of our lives nowadays?” This frequently used argument is incorrect as most followers of Paleolithic research are aware. While the average lifespan of Paleolithic humans may well have only been 25, we do not “know for sure that most cavemen died by age 25.” The average age of death is drastically different from the more pertinent number, the average age of the living population, as conceded by Professor Finkelstein’s own words “It’s true that high infant mortality was a dramatic contributor to this pattern.” In fact, until the late 18th century, in “civilized” nations, life expectancy seldom or never exceeded 25 years, and in London in 1667, it was only 18.11

Then, without any referenced support, Professor Finkelstein makes the statement “but the fact remains that few made it anywhere close to the modern day life expectancy of 75 to 80 in western countries.” However, published data does not support this position. The Kitava Study, conducted by Dr. Staffan Lindeberg, demonstrated that nearly 7% of the pre-agricultural population from Kitava, Papua New Guinea is between 60-96 years old and are virtually free of western disease.12,13,14 It has also been reported that a significant proportion of the Ache tribe in Paraguay reach 60 and 70 years of age15 and similar findings have been shown for the Hadza tribe of Tanzania.16 All of these findings are in spite of a major contributor to mortality that Dr. Finkelstein does not address in his article, that of the harsh living conditions and the predators modern humans essentially no longer face. Interestingly, the adoption of farming and settled living actually appears to have adversely affected longevity, precipitating a substantial decline to about 20 years.11 Notwithstanding that, regardless of what the expected lifespan actually was in the Paleolithic era, this popular argument would still not justify the dismissal of the evolutionary approach to preventive medicine.17

“The disconnect between recommendations and results is striking,” is the next unsubstantiated statement. There are now hundreds of thousands of physicians, naturopaths, nutritionists, chiropractors, conditioning coaches, and other healthcare professionals who advocate the Paleo Diet and rely on results for their businesses to be successful. As a consequence, millions of people have benefited from adopting this way of eating. There is no possible way this gigantic movement towards a Paleolithic nutritional template would have gained the traction it has if it didn't produce successful outcomes.

With respect to the egg and saturated fat examples given, they are out of place in a criticism of the Paleo Diet. The same would be appropriate in a criticism of the typical high carbohydrate, low saturated fat diet recommended by the AHA and CDC that has provided the sad state of health in so many people. As for it being “easier to “eat like a caveman” than to carefully monitor their daily diet with what they have in the fridge already,” I would ask what clinical experience provides this opinion as it is the complete opposite of my experience and those of my colleagues?

So in sum, there is zero analysis in the article on any aspect of the Paleolithic diet that supports the position that it is a fad diet that does not work. That being said, I hope that Professor Finkelstein takes the opportunity to defend his position further.

Dr. Mark J. Smith


1. 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 Aug; 63(8): 947-55.

2. 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 Jul; 8: 35.

3. 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; 7(1): 85.

4. 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.

5. 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.

6. 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.

7. 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

8. 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.

9. 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.

10. Mellberg, C., Sandberg, S., Ryberg, M., Eriksson, M., Brage, S., Larsson, C., et al. (2014). Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr. 2014 Mar; 68: 350-357.

11. Eaton SB, Strassman BI, Nesse RM, Neel JV, Ewald PW, Williams GC, Weder AB, Eaton SB 3rd, Lindeberg S, Konner MJ, Mysterud I, Cordain L. Evolutionary health promotion. Prev Med. 2002 Feb; 34(2): 109-18.

12. Lindeberg S, Lundh B. Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: a clinical study in Kitava. J Intern Med 1993; 233: 269-75.

13. Lindeberg S, Nilsson-Ehle P. Terent A, Vessby B, Schersten B. Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease-the Kitava study. J Intern Med 1994; 236: 331-40.

14. Lindeberg S, Berntorp E, Carlsson R, Eliasson M, Marckmann P. Haemostatic variables in Pacific Islanders apparently free from stroke and ischaemic heart disease. Thromb Haemost 1997; 77: 94-8.

15. Libertini G. Evidence for aging theories from the study of a hunter-gatherer people (Ache of Paraguay). Biochemistry (Mosc). 2013 Sep; 78(9): 1023-32.

16. Sherry DS, Marlowe FW. Anthropometric data indicate nutritional homogeneity in Hazda foragers of Tanzania. Am. J Hum Biol. 2007 Jan-Feb; 19(1): 107-18.

17. Eaton SB, Cordain L, Lindeberg S. Evolutionary Health Promotion: A Consideration of Common Counterarguments. Prev Med. 2002 Feb; 34(2): 119-23.

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