Why Paleo Should Be Ranked #1 of All Weight Loss Diets

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Earlier in January, US News & World Report issued its annual ranking of the best diets to follow for several different goals and health conditions, including weight loss. As you may know, the Paleo diet was ranked last in the “Best Diet Overall” category of the 32 diets they reviewed. This review may have caused you question the benefits of the Paleo diet, and perhaps you even have concerns about its safety.

But are these rankings reliable? And should you take them seriously?

The #Paleo diet should be the top-ranked diet for weight loss. Here’s why.

The experts reviewing the diets suggested that a Paleo diet is restrictive and difficult to follow. However, these reviewers believe a Paleo diet to be primarily lean meat and vegetables, and nothing else, which is far from accurate.

Most Paleo experts advocate a wide range of foods, including meats (not exclusively lean), fish, nonstarchy vegetables, starchy plants like potatoes and sweet potatoes, nuts and seeds, and even modest amounts of “non-Paleo” foods like full-fat dairy, dark chocolate, and alcohol when they are well tolerated.

Using this approach, my patients have been able to eat delicious, real food as their appetite dictates and watch the pounds fall away.

Why Paleo is Superior to Many Other Diets

So what makes Paleo a superior diet compared to the other diets on the list?

In my experience as a clinician, I’ve watched hundreds of patients transition to a Paleo diet and end up enjoying their diet more than they ever have in the past. One of the primary reasons my patients love Paleo is that they don’t have to eat bland, tasteless food with little to no salt or fat. This is in stark contrast to the DASH and TLC diets – both ranked at the top of the US News list – which restrict the amount of sodium, fat, and cholesterol you’re allowed to eat.

Just looking at a daily menu for one of these top-ranked diets demonstrates how unappetizing most of the food is. There’s no reason to suffer through tasteless food simply to lose weight or gain health benefits, especially since restricting both salt and fat is not necessarily the healthiest dietary strategy for most people. Plus, when your food tastes good, you’re more likely to stick to the diet long term.

Another reason my patients love the Paleo diet is that they don’t have to count calories or macronutrient ratios (i.e., the percentage of fat, carbohydrate, or protein they eat). Unlike the Atkins and South Beach diets, you don’t have to restrict carbohydrates to lose weight on a Paleo diet. And unlike the Ornish and TLC diets, you are encouraged to eat plenty of healthy fats that can help you stay full longer. Not having to count every morsel of food that passes your lips is one of the great benefits of a Paleo diet.

When my patients switch to Paleo, they’re glad they don’t have to remove foods they love like red meat and eggs, which are eliminated on many of the diets on the US News list, including the vegan and Engine 2 Diet. Animal foods are highly nutrient dense; according to this study on the nutrient density of common foods, these are the most concentrated food sources of the vitamins, minerals, and protein the body needs to function properly. Diets that restrict or eliminate meat and eggs and emphasize grains and legumes are ultimately lower in certain easy-to-digest nutrients, potentially leading to deficiencies in the long run.

Your “Healthy” Diet Shouldn’t Kill You!

Speaking of nutrient dense foods, my patients are relieved that they no longer have to starve themselves with powdered shakes and meal replacement bars, the types of foods recommended by diets such as Slim Fast, ranked at #13 on the US News and World Report list.

These highly processed, chemically-laden diets may provide the recommended levels of nutrients (or at least those we’re aware of), but they’re chock full of synthetic ingredients and fillers that not only do not provide the nutrition of a real food diet, but may also lead to negative health outcomes in the future, including cancer and diabetes.

Losing a few pounds isn’t worth the risk of developing a lethal disease in the future!

Paleo – Even Better Than The Mediterranean Diet?

One of the few highly ranked diets that has been shown to be effective in treating a variety of health conditions and promoting weight loss has been the Mediterranean diet. You may be surprised to learn, however, that a traditional Mediterranean diet that promotes longevity and good health is similar to a Paleo diet.

While our American imitation of the Mediterranean diet may be high in grains and legumes and low in fat, the truth is that the most beneficial components of this diet are found in foods that are frequently eaten on a Paleo diet, such as fatty fish, olive oil, nuts, full fat dairy, and a variety of fruits and vegetables.

In fact, many of my patients follow a Mediterranean-style Paleo diet. In my book, Your Personal Paleo Code, I encourage readers to eat many of the same foods that are found in a traditional Mediterranean diet, without all the grains and legumes that don’t provide the nutrients that help support optimal health and metabolism. (And despite the popular media portrayal, you won’t just be eating huge slabs of raw steak at every meal.)

Further, research has shown that Paleo is more satiating per calorie than a Mediterranean diet, meaning you’ll feel more satisfied on a Paleo diet.

Thousands of Years of Human Experience

Finally, you can feel confident that the Paleo diet is effective because it’s the diet humans have been thriving on for thousands of years. Research studies demonstrate that hunter-gatherer populations eating their traditional diets are free of obesity and other chronic diseases like diabetes and heart disease, and are typically lean and quite fit. And when tested in controlled studies, the Paleo diet has been shown to be more effective than the Mediterranean diet and the recommended Nordic diet for weight loss and metabolic improvements.

While we need more long term studies on the effectiveness of the Paleo diet for weight loss, my experience as a clinician makes me confident that this method of eating is effective and sustainable, as well as enjoyable and environmentally-friendly.

For these reasons, I believe the Paleo diet should be ranked at the top, rather than the bottom, of the list of the best diets for weight loss and overall health. (And I have hundreds of patients who I think would agree with my assessment!)

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Comments Join the Conversation

  1. Robert says

    More long-term studies are needed? The studies comparing Paleo with the Mediterranean and Nordic diets were 12 weeks and 2 years. Hardly what you’d call long-term.

      • Wilhelmina says

        Who says Mediterranean and Nordic are GMO? There are so many foods for sale in the USA which are totally forbidden here in Scandinavia! But looking at what my Swedish early ancestors would have been eating, it can’t have been dates, coconuts and bananas. It must have been fish, berries, meat and roots mainly.

        • Honora says

          I suspect the issue with regional foods is due to the species of gut bacteria etc. that we were inoculated with when we were born, mainly inherited from our mothers and their foremothers.

          I think this explains why Koreans and Japanese are able to digest and utilize seaweed more effectively rather than having mutations affecting enzymes involved in processing the food or ability to handle lactose. Aside from drinking raw milk, apparently the lactose-intolerant can acquire tolerance from expose to bacteria in fermented milk e.g. yogurt and kefir.

          • Wilhelmina says

            No matter how it may be, I function better on a ‘diet’ with roots (excluding the potatoes) and porridge then anything else. Not only does it give me enough energy to do my things, including workouts, it also has a more positive effect on my weight loss. I guess it is like Honora said, I am just more adapted to the Nordic diet.

  2. Jeremy says

    I’ve found with the paleo diet I effortlessly maintain a healthy weight and I’m never hungry. This is a stark contrast from my stint on a vegan diet with which I was constantly snacking and never felt satisfied.

    Bacon is better…

    • Kevin says

      Check you cholesterol and get back to me on the health benefits of bacon. If you eat leaves you will be hungry. But a salad that has carbs from legumes and grains and fats from avocados, will not leave a person hungry.

      • Jeremy says

        Thats the best part of it. The only reason I ever took notice of my diet was because of my elevated LDL. I decided to pursue a vegetarian diet, then a vegan diet all while completely avoiding processed foods and sugars, and my numbers got worse and worse. I switched to the paleo diet plan and my numbers returned to what they were when I was a teenager.

        • Robert says

          A plant-based diet increased your LDL? I’m calling BS on that one! If however you are referring to lowered HDL and raised TGs then yes, that does happen on a low-fat vegan diet BUT raised TGs and lowered HDL is irrelevant when your total cholesterol is < 150mg/dl.

          • charles grashow says

            I call BS as well. Post the numbers that show this increase. Also, what were you eating on your vegetarian/vegan diet?

            • Jeremy says

              Its true. But not because it was plant based. I would still call my diet plant based on the paleo diet since vegetables still make up the bullk (mass not caloric) of my diet. The problem was I had trouble keeping weight off eating the vegetarian diet which of course is the cause for the elevated lipids. On the paleo, high fat low carb diet, I’ve kept off the weight, and quite easily. The problem with my vegan diet was it was high carb low fat. Doesn’t a flat stomach have more to do with LDL than diet?

                • Jeremy says

                  I could take the time to scan and post my lab results from the last 4 years, but that would prove nothing since you would then need proof that I was in fact following a vegan diet when my numbers rose. I’m just thrilled to finally find a diet that I can live with without feeling deprived and that keeps my waist thin and my energy levels up.

          • Honora says

            How your body handles different types of fats depends on your Apo E genotyping and no doubt other genotypes. Mine is Apo E3 which indicates a diet incorporating saturated fat has beneficial effects by reducing the amount of small dense LDL. Those with Apo E4 will have a greatly increased amount of these bad guys and need to be on a low fat diet. Fish oil for these folks will reduce TG, drop the small dense LDL’s markedly but also the HDL’s but raise the larger LDL’s.

        • DianaVP says

          Way to go Jeremy! My triglycerides at last test were around 43. All blood work is fantastic. I eat high quality meat and veggies. And yes. Bacon!
          Too many people have gut issues, as do I, to be recommending grains and legumes, when denser nutrients are found in good quality meats and veggies! :)

          • charles grashow says

            “My triglycerides at last test were around 43. All blood work is fantastic.”

            Would you mind posting your fantastic blood work? LDL, HDL, LDL-P (if you took the NMR test), etc

            • EvilTaco says

              It won’t matter if they do, you’re going around questioning everyone who has the gall to say paleo’s worked for em. I’m sure no evidence will appease you.

            • Robin Willcourt says

              I have watched many patients lipid profile normalize after eating a high fat Paleo diet. In any case the lipid panel is another useless item in trying to assess CVD risk. We still have no idea what the mechanisms that seem to involve oxidised LDL are. Triglycerides are a somewhat useful indicator of the sugar content of the diet and that can lead to appropriate dietary advice.
              I have a few vegans in my practice and typically, to quote Martin Berkhan, “I see weak people.”

      • Akimajuktuq says

        Robert: continue researching about cholesterol. Your knowledge about it is limited (as is everyone’s) and based on old propaganda… that we were all led to believe in error. Cholesterol in and of itself, including dietary cholesterol, has little bearing on health. I eat a fat/meat based diet, which means that they make up most of my calories, but veggies fill up most of my plate. I have resolved far too many health problems to think for one second that my animal based, nutrient dense diet is harmful. I had 20 years + of proof that a grain, sugar, processed food diet most definitely was killing me. (I live amongst Inuit whom had a fat/animal based diet completely yet had no disease/illness-aside from food shortage/infection-until they started eating a grain, legume, sugar, processed food diet… and that’s even with eating far more vegetables now than they ever did historically.)

        • Akimajuktuq says

          Robert and Kevin, I meant to say. And the cholesterol counts (especially total cholesterol or just HDL/LDL) are not predictive of health, and generally, are quite meaningless. Ratios maybe, and triglycerides are better predictors.

            • Robert says

              Don’t buy that nonsense about particle size. It gives those with high LDL a false sense of security. You don’t want elevated amounts regardless of the particle size.

      • Steve says

        I’ve been following a plant based paleo diet (veggies are the bulk of the food mass) for about 2.5 years now. Before that, I was your typical SAD diet, obese person. For the past 2 years, I’ve basically eaten eggs and bacon everyday for breakfast (usually 2 eggs, 2 slices of bacon, and then some form of veggie–e.g, sweet potato “hash” with onions and peppers). After those 2 years of consuming bacon just about everyday, I had my numbers clinically checked and, as it turns out, were practically ideal:

        Total Cholesterol: 164 mg/dL
        HDL: 60
        LDL: 96
        TGs: 42 mg/dL

        So say all you want, but you can’t argue with actual numbers shown in a real life “test.”

        • Robert says

          My numbers were horrible eating bacon and eggs every day. MY cholesterol reached its highest levels (for me) on such a diet.

          That’s the result of MY real life “test.”

          • Steve says

            What was the remainder of your diet like though? Like I said, the bulk of my diet is veggies. So for lunch I’d eat a big salad with tons of veggie toppings and some protein (chicken, sardines, etc.). I’ve also cut out grains/flours, most dairy, and legumes out of my diet.

            You never actually said you actually followed some form of paleo or not, so I would have to take this with a grain of salt.

            • Robert says

              Ok, your diet was less meat centric than mine. I ate cheese, eggs, bacon, beef, chicken, etc. I ate low starch veggies. This was how I ate for several months in 2007. It was like an Atkins style diet so no grains or legumes either. I used a low-fat lacto-vegetarian diet to lower my numbers. It was quite successful at doing just that. Today my diet is not low fat per se. It is low saturated fat but I use olive oil and take fish oil supplements. Fish and seafood would be my primary meat sources. I eat lots of vegetables including potatoes, legumes, some grains and of course fruit. Not Paleo but more Mediterranean. I eat dark chocolate (Lindt Excellence 90% cacao) and red wine now and then. Very satisfying and tasty! Its low in sodium and high in potassium.

          • Honora says

            With results like that, you may need to get your Apo E genotype checked out. This may be indicative of Apo E’s 2 or 4. Then you can tailor make your fats in accordance with your genotype. Fish Oil is greatly beneficial for Apo E2 for example.

      • Brenda Evans Lytle says

        I am a follower of Dr. Fuhrman’s “Eat to Live”food plan having changed my health and wellness dramatically in three months. It is a plan rich in fruits and vegetables with good fats, whole grains, and some chicken and fish. Limited animal products and no processed foods. The real taste of fruits and vegetables is also amazing when you remove the excess oils , butter salt etc. No more dieting for me!

      • says

        I’ve been eating bacon and eggs since I was a kid, maybe 4 or 5 yrs old or so. I haven’t had any cholesterol, heart disease, vein clogging, etc, etc. I’m 54 yrs old and still eat three eggs and bacon/ham every single day. God is my witness. I also eat poultry/fish/meats every single day. Have a salad daily, and drink nothing but water. I left the sugar, grains, etc. and I am a healthy person without the damage I’ve done for my drinking and smoking all those years. My diet content hasn’t harm me in any way. That’s the way God made us. We come from earth and from there is where we should supply our bodies. I also Take supplements to help for whatever damage I may had cause for my drinking/smoking. God bless U, always…

  3. Wenchypoo says

    Here’s an interesting twist I read on another website as to why the Paleo diet SHOULD remain at the bottom of the list: if it gets too popular and world-renowned, then the foods used to carry out the diet will become expensive and in short supply due to overwhelming demand.

    Yes, it would cause farmers, ranchers, and food producers to narrow their focus and go where “the money” was…or that’s what you’d think, anyway, but no–most of the current food (or rather, FAKE food) infrastructure is still glued at the hip to those government subsidies that seem to make the political world go round.

    The way I see it, the current food suppliers of Paleo diet foodstuffs can name their price, and let US decide how we’re going to vote with our food dollars, and how we’re going to rearrange our lives so that their food is our utmost priority.

    As long as we keep voting for them with our food dollars, they’ll keep crankin’ it out no matter HOW MANY OF US are eating it! If more people gravitate toward the diet, and buy/eat the food, the producers won’t have to work so incredibly hard to make their money–that’s what it means to me.
    The ones who will have a hard go of it will be the ones who decide to make the move from conventional to organic/pastured/grass-fed, because the knowledge base for them has been destroyed to the point of having to start from scratch, which is an expensive process with a heck of a lot of playing catch-up involved.

    Our way of raising food is sustainable in the LT, but the government is also LT, although not necessarily sustainable. As long as government exists, count on the same old game of subsidies and politics scratching each other’s backs.

    Eventually, the subsidies/Obamacare game will come to a grinding halt, because the people will one day wake up and learn to make better choices (vote) with their food and health care dollars–maybe by then, they’ll realize that the two are inextricably linked.

    • EvilTaco says

      To be fair, it’d be pretty hard to cause a huge price spike on simple things like meat and vegetables. I’d hope the opposite, if it got popular enough it’d be economically viable to cut costs on real food, rather than the mass produced crap we pass off as food nowadays.

      I know the beef industry would love an upswing in paleo dieting.

    • Honora says

      yes, I can see them cranking up the price of liver and bones. In fact, it’s happening already over here in New Zealand. And having the savvy Asians doesn’t help as they’re on to paleo-type nutrition with their ubiquitous bone broths and consumption of collagen-bearing chicken feet and heads.

  4. Kevin says

    People that follow the engine 2 diet are not nutrient deficient. People that say they are vegan and eat chips and salsa may become that way. I would love to see a documentary for the paleo diet that shows the health benefit for the engine diet. And yes you can gain strength and muscle eating plants,

    • says

      Vegans/vegetarians are undoubtedly more healthy than those eating a typical American diet BUT, you have to be kidding yourself to think they are obtaining enough EPA/DHA or B12 in their diet. ALA to EPA to DHA conversion is less than 10%. How many flax seeds or chia are you willing to eat? Or how much are you willing to spend on a Marine Algae supplement? Hey it’s only the major fatty acid in the cell membranes are their brains and retina’s, that’s all. To each their own. Anyone that locks in on only one philosophy is sure to miss valuable information. There will always be room for improvement;) Cheers to an open mind!
      http://www.SubjectiveSustenance.com

      • Kevin says

        I don’t think you have to break the bank to find adequate sources of those things. Really for any diet, there is conflicting information. In researching some of your comments I found info talking about the dangers of too much EPA/dha. I’ll be open minded enough to say that scientists clearly don’t have all of the answers. I actually agree with a lot of things about the paleo diet. While I think it’s stupid to not eat legumes because some guy that grunted to speak couldn’t figure out how to farm, overall I can see benefits to the diet. I run across a lot of people at crossfit that talk about eating garbage and that it’s “paleo”. Possibly they aren’t following the diet correctly. However I don’t believe that consuming mass quantities of bacon lowers your cholesterol. I honestly don’t believe small amounts of meat in moderation will hurt a person. There are many paths to getting fit. Rich froning has been said to not follow the paleo diet. Frank medrano follows a plant based diet. Many fit people do follow a paleo diet. I think there is a difference between being fit and healthy. While some may have phenomenal physiques, they may develop health problems. There are some key things I disagree with on the paleo diet. However I think it’s a much healthier diet than something like Atkins.

    • Chris Kresser says

      Newer studies using more sensitive methods of detecting B12 deficiency have found that 68% of vegetarians and 83% of vegans are B12 deficient. http://chriskresser.com/what-everyone-especially-vegetarians-should-know-about-b12-deficiency

      Several other studies have shown that both vegetarians and vegans are prone to deficiencies in calcium, iron, zinc and the long-chain fatty acids EPA & DHA.

      On paper, calcium intake is similar in vegetarians and omnivores (probably because both eat dairy products), but is much lower in vegans, who are often deficient. http://www.ncbi.nlm.nih.gov/pubmed/21139125

      Along the same lines, although vegetarians eat a similar amount of iron to omnivores, the bioavailability of the iron they consume is much lower. Non-heme iron found in plant foods is not only less bioavailable, it is also inhibited by other substances. This explains why vegetarians and vegans have lower iron stores than omnivores, and why vegetarian diets have been shown to reduce non-heme iron absorption by 70% and total iron absorption by 85%. http://www.ncbi.nlm.nih.gov/pubmed/7956998 http://ajcn.nutrition.org/content/78/3/633S.long

      Vegetarian diets tend to reduce zinc absorption by about 35% compared with omniovorous diet. Thus, even when diet meets or exceeds RDA for zinc, deficiency may still occur. One study suggested that vegetarians may require up to 50% more zinc than omnivores for this reason. http://ajcn.nutrition.org/content/78/3/633S.long

      While it is possible for some alpha-linolenic acid from plant foods to be converted into EPA & DHA, that conversion is poor in humans: between 5-10% for EPA and 2-5% for DHA. 28 Vegetarians have 30% lower levels of EPA & DHA than omnivores, while vegans have 50% lower EPA and nearly 60% lower DHA. Moreover, the conversion of ALA to DHA depends on zinc, iron and pyridoxine—nutrients in which vegetarians are more likely to be deficient. http://ajcn.nutrition.org/content/82/2/327.abstract

      Perhaps the biggest problem with vegetarian and vegan diets, however, is their near total lack of two crucial fat-soluble vitamins: A, D. Vitamin A promotes healthy immune function, fertility, eyesight and skin. Vitamin D regulates calcium metabolism, regulates immune function, reduces inflammation and protects against some forms of cancer.

      These important fat-soluble vitamins are concentrated, and in some cases found almost exclusively, in animal foods: primarily seafood, organ meats, eggs and dairy products. Some obscure species of mushrooms can provide large amounts of vitamin D, but they contain the D2 form which is of questionable value compared to the D3 form found in animal foods. (This explains why vitamin D levels are 58% lower in vegetarians and 74% lower in vegans than in omnivores.) http://www.ncbi.nlm.nih.gov/pubmed/21139125

      The idea that plant foods contain vitamin A is a common misconception. Plants contain beta-carotene, the precursor to active vitamin A (retinol). While beta-carotene is converted into vitamin A in humans, the conversion is inefficient. For example, a single serving of liver per week would meet the RDA of 3,000 IU. To get the same amount from plant foods, you’d have to eat 2 cups of carrots, one cup of sweet potatoes or 2 cups of kale every day. Moreover, traditional cultures consumed up to 10 times the RDA for vitamin A. It would be nearly impossible to get this amount of vitamin A from plant foods without juicing or taking supplements. http://www.westonaprice.org/fat-soluble-activators/vitamin-a-on-trial

      • Robert says

        High serum ferritin is not healthy. Its another risk factor for heart disease so having serum ferritin (SF) towards the lower side of the normal range is probably better for most people, excluding premenopausal women of course. I use to have high SF but I lowered it quickly by a) eating less meat, especially red meat and b) donating blood, which is the quickest way to lower SF.

  5. rs711 says

    Hey Chris,

    I retweeted the article, good stuff!

    Have you tried this in your patient population or heard of any case reports of people transitioning from a SAD diet to a Paleo diet more akin to one studied by Lindberg in Kitava or Tokelau? If so, what were the results? Are there any case reports of the sort that you can direct me to?

    Thanks!

    • Tracy says

      I have followed every other diet and I hated counting calories. I’ve never felt that my body ran mathematically and the more I tried to control it the more difficult it became.

      I feel liberated on the Paleo diet. I don’t count calories, I don’t overeat and I eat foods that I completely enjoy! What makes sense about the Paleo diet to me is that I know the ingredients of the food I am putting in my body.

      • Robert says

        Counting calories? I eat a plant-based diet that could best be described as a low-meat Mediterranean diet. I keep saturated fats low so the predominant fats in my diet are MUFAs and PUFAs (in the form of omegas). I don’t count calories. I eat until just satisfied. Paleo isn’t the only way to feel satisfied.

  6. Tavy says

    I just started Paleo (I was previously eating healthy-meaning organic food, no bread, quinoa, beans, but I did drink red wine and was eating sweets with honey). I did my blood work in December and my LDL was elevated, I was low on vitamin D and had a few other slightly abnormal results. I will redo my blood work in March after following the Paleo diet for 90 days. I’m good with being strict and that shouldn’t be a problem. However I’m a little nervous about eating all this fat and meat despite reading Chris’s book. I was previously eating mostly fish and once in a while chicken.
    I need some feedback on people with similar experiences like mine. Thank you!

    • Geoff says

      I too was concerned when i went for my Over Fifties check up here in UK. I have a friend who was told by his doctor to go down the “traditional” route of cutting out saturated fats, no eggs, no butter more grains etc – poor bloke. Since i have been on the Paleo diet – about 2 years now, i have been nervous about my blood results and it is quite natural to start to question yourself when you get close to having the results back – what if my cholesterol is sky high – does that mean the “traditional” doctors are right after all? But every time all my blood results are in the green and my waist is now 34″ rather than 37″ that it was before (a new measurement that they are now doing here – should be under 36″). And I’m loving the food and my poor friend is having a miserable time.

    • EvilTaco says

      Oh, you totally can. Just don’t shy away from oily fish like tuna or salmon. Personally, I find a more fish-based paleo diet to make more sense, anyway. Foragers wouldn’t always be able to take down an animal, but anyone with a sharpened stick can catch a fish.

  7. Jess says

    I have to admit that I’ve lost a great deal of respect for the US News & World Report ever since it gave the Paleo diet such poor ratings. Very disappointing.

  8. April says

    I don’t know any of the science behind the Paleo. I have 2 autoimmune diseases. Celiac and Hashimoto’s. This I do know: After a diagnosis of hiatal hernia (sorry comma not working) gastritis yada yada yada and over 10 grand in medical bills I got I mean NO RELIEF from the medical establishments. The ALMIGHTY PILL would take care of everything. And I’m talking about your finer hospitals in the Boston area. The experts so they are called. I’ve been on modified Paleo for one year. Friends…proof is in your bowels a.k.a. immune system. So whatever science is not proving….my bowels are!! My cholesterol is supposedly a little high but I have solid bowel movements (not 16 a day). For those of us who have seen our reflection of death in the toilet bowl we know it works. We do not care about the science…only our quality of life. If grains were not poison to us..we would eat them. After a year of bringing myself back I would never destroy myself again with so-called healthy grains. The grains my grandparents ate are not the grains we eat. They have taken them into the lab and made them Frankenfood. I am not cured…but I am not on medication and can say that the Paleo diet (that is restriction of grains) is an anti-inflammatory diet and well isn’t that what they are all screaming about. Keep the inflammation down. That’s what I’m trying to do. Most of the naysayers are the ones that have never been ball-and-chained to the toilet so they can rant all they want. When your down on the floor with your head against a cold porcelain toilet seat praying for death then we can debate. OK?? Paleo works. BOOM!!!

  9. Chuck says

    Who cares what “they” say, eat our good fats, veggies & fruit and stay slim, healthy and satisfied. And don’t forget the dark chocolate.

  10. ValerieH says

    Chris, I’m having trouble understanding this line, “Unlike the Atkins and South Beach diets, you don’t have to restrict carbohydrates to lose weight on a Paleo diet.” It seems like you are trying to promise everything to every one. Paleo is carb restricted in general.

    Most of the paleo diets I have read, including your program which I did in 2012, said that restricting carbohydrates is best for people who want to lose weight. Your program said this, “Those with insulin resistance, hypoglycemia or reactive hypoglycemia, and those wishing to lose weight, should limit fruit and starchy vegetables. The total amount eaten each day should equal roughly 50 grams per day of carbohydrate, which is the amount contained in 2 servings of low-glycemic fruit (berries) and 1-2 servings of starch (i.e. sweet potato, taro, yucca, etc.).”

    For some people that is a carb restricted diet. Atkins and South Beach only have very restricted beginning phase for two weeks. After that people add carbs to their diet as long as they can still lose weight but it is very much lower than the SAD.
    That being said, I enjoy your blog. Keep up the good work!

    • says

      Please don’t forget there is no ONE definition of what is Paleo. At this point we understand the best way to lose weight for metabolically deranged individuals coming from a Standard American Diet would be to eat lower carb. The reality is this. The REAL MAGIC isn’t in manipulating macronutrients per say. It is quality sourced, nutrient dense whole foods while removing or at least mitigating all the processed refined sugar/, vegetable/seed oils, wheat/rye/barley/soy and hopefully most other nutrient shallow grains and legumes. Then throw in some sunshine for vitamin D, earthing for its countless benefits and some movement for the body. You’d make some serious moves towards optimum health;)

    • rs711 says

      @ValerieH,

      LDL cholesterol (not the LDL protein(s) that carry the cholesterol in them) is one of the most variable ‘health’ markers. It’s never good to ignore it of course, but considering how much of a poor predictor of health outcome it is compared to other markers, I wouldn’t invest too much worry into it.

      Remember how the Kitavans (a modern hunter-gather population) were found to be lean and without cardiovascular or metabolic diseases? And 3/4 of them were smokers??

      [from 1 of the studies on these people: http://www.ncbi.nlm.nih.gov/pubmed/8077891
      “In males LDL/HDL and apoB/Al are no different compared to Sweden, and in females of all ages they are higher in Kitavans”

      Truth is, we’re still trying to understand why ‘low’ cholesterol levels seem to decrease overall mortality risk in certain younger age groups (or in certain populations) and ‘high’ cholesterol seems to increase long-term survival in older age groups (or other populations)…

      Try to measure other marker like, blood sugar, triglycerides, lipoproteins, inflammatory markers (HS-CRP &/or CRP) and others….also, not only lab markers. Broadening your scope is like hedging your bets and not constraining you to put too much stock in one idea.

      Chris is right, the macronutrients aren’t the most important aspect of nutrition but they certainly play a role and it’d be nice to pin that down more precisely…

      PS: I’m also looking into explanation for my cholesterol levels – CONFUSION be the word matey!

      • says

        To be honest the problem with “man” is that he continually searches for n=1 answers. If there is one place he won’t find it; it is going to be in health. There are so many conflicting studies as “man” is trying to draw correlations between different factors. Or he see’s a different set of factors that seem to be the trigger in one study and a different set in another. There is “NO SINGLE WEAPON OF MASS DESTRUCTION” health. It’s a combination of factors and anyone of them can appear to be the trigger given the subjects and their given genetics. Nobody has the same genetics except twins but even they have unique environmental factors which invariably causes differences in their genes as well.

        Ideally, quit looking back over your shoulder for what might catch you in life and enjoy whats ahead with the assurance you are doing your best in all areas of health;)

        Focus your diet on real food sure to provide all essential nutrients.

        Sync your circadian. Get proper sun exposure and adequate sleep

        Contact the Earth

        Enjoy life it’s short;) smile-erradicate stress

    • Chris Kresser says

      The average carb intake on the Standard American Diet is 400g a day. It would be very difficult to get that much carbohydrate just from eating fruit and vegetables (including starchy veggies) which are the sole significant carbohydrate sources on a Paleo diet. So Paleo will be lower in carb than a Standard American Diet, but no effort or counting carb calories is required to get there.

      Many people lose weight on Paleo without paying any attention to carbohydrate intake at all. I’ve seen this in numerous patients. We also have studies of hunter-gatherer populations that were lean and fit despite relatively high carbohydrate intakes (from fruits and veggies). The Kitavans and Tukisenta are two examples.

      Some people may get even better results by restricting carb intake while doing Paleo, which is why I suggest it as a strategy in my book. But that doesn’t mean it’s absolutely necessary, and the studies on the Paleo diet which found it was effective for weight loss did not require participants to follow a very low-carb approach.

      • rs711 says

        @Chris Kresser

        You said some of your patients lose weight without paying attention to their carbohydrate intake level – do you have an estimate as to the percentage of carbohydrates in their diet? (I know it’s very hard to estimate accurately) In those people, were they more fruit heavy or tuber heavy?

        I’m fascinated by the idea of being able to lose weight on a Kitavan/Tukisenta style Paleo diet. If you have any case reports (anonymous of course), could you publish these?

        Thanks

  11. Kelley says

    My biggest beef with the strict Paleo diet per se is the fact that our hunter-gatherer ancestors usually were dead by about age 35; and nearly everyone was dead by age 50. Of course there were no chronic diseases associated with middle and old age back then; no one survived into old age! (What we would consider old age anyway.)

    Of course, I recognize that many of those chronic disease states are occurring in younger and younger populations these days, a phenomenon I attribute primarily to the advice we’ve received over the last 40 years to reduce dietary fat and increase carb intake.

    In sum, I’m certainly not anti-Paleo. I use “Paleo friendly” as code when I’m looking for, say, a health-care provider who’s not married to the “low-fat/high-carb” formula– that is, who’s not afraid of saturated fat and who’s willing to question conventional nutritional wisdom dished out by the ADA, USDA, etc. But Paleo as my nutritional Bible? I’m not a purist. (About this or pretty much anything else, actually.)

    • Robert says

      I have similar beefs. Drawing conclusions from Paleolithic populations is ridiculous. People seem to think it was the “best” diet for our species. First of all, diets would have differed depending upon the region/environment. Secondly, our ancestors ate whatever was available, not what was best. Also, most of our evolving took place in Africa, not Northern Europe and certainly not the Arctic. Consider *that* when chowing down on a 32oz steak.

      • Geoff says

        You wouldn’t be able to eat a 32oz steak if you were following a Paleo diet.. Your brain would say to stop. You eat less because what you are eating is much more satisfying. Your body re-programs itself – strange but true!

    • AnnieLaurie Burke says

      Kelly, like many people who state that Paleolithic people were mostly dead by 35 years old, you are confusing average lifespan with individual longevity. Infant mortality, as well as accidental death, and childbirth mortality were high in Paleolithic times because the environment in which people lived was more dangerous; because there were no antibiotics to treat might succumb to infection from a wound or infectious agent; because childbirth, even into the late 19th century, was dangerous for mother and child due to the evolved configuration of the female body vs. the size of a human infant’s head; Paleo gatherers were more likely to die accidental deaths from animal attacks; Paleo hunters could easily be wounded by the animals they were hunting; and similar factors. Did you know that life expectancy in Greek and Roman times, the Late Medieval era, and the Victorian era was only 35 – 40 years. It was only in the early 20th century that global human lifespans started to rise beyond the 30 – 40 year range. As far as Paleo longevity, the “grandmother theory” of the female lifecycle of modern humans postulates that we progressed due in part to the increasing longevity of women in the population. And, no, they didn’t have kids at 14 years old and become grannies at 30 in Paleo times, based on evidence from hunter-gathers in historic times (although this was the pattern in some agricultural societies). In fact, if you read historic accounts of European explorers encountering pristine hunter-gather peoples, they often remarked on their height, good health, strength, and excellent physiques.

    • raydawg says

      This is utter nonsense. The died at 35 myth is actually an average which includes very high infant mortality and predation by large cats, bears, predators, and the occasional broken leg. This does not and should not reflect on the results of their diet.

      Hunter Gatherers are known to be very long lived. see: http://www.marksdailyapple.com/bone-dating-life-span/

      Your personal beliefs which you’ve picked up from anecodal heresay aren’t relevant. What science has discovered is what is relevant.

      • Robert says

        So your proof is a link to another Paleo blogger? I followed the link and found a few comments which had no references to any anthropological research. Such references would have added some credibility to your argument. Personally, any documentaries I’ve watched or scientific articles I’ve read, such as those published in National Geographic for example, have never identified any long-lived human ancestors. This was based upon various dating methods used upon skeletal fossil remains. To claim that our ancestors would have lived longer lives had they not had to face such adverse conditions is speculation without evidence and that is not science. Go find some fossil remains that clearly indicate longevity and you’ve got an argument, otherwise you’ve got nothing but “what if’s”.

  12. Jeremy says

    On a less serious note… My wife loves my switch from veganism to the paleo styled diet because since giving up all the whole grains, bran, flax, beans and soy products, I’m not a walking flatulence anymore!

  13. charles grashow says

    @Jeremy

    Just post the numbers (including the LDL) while you were on the vegan/vegetarian diet – I’m not interested in your “proving” the type of diet you were on – I’ll take your word for it.

  14. Maria says

    My family has been paleo for several years now. I am a teacher and when kids and staff are dropping like flies with whatever virus is going around, I stay healthy. Also, my husband who is diabetic (type 2) now has a sugar reading between 5 and 6 each day. Recently he went for annual blood tests and received a call from his GP’s office that very day. Naturally he was concerned. However, all his GP wanted to tell him was how wonderful all his tests results were. “Whatever you are doing, keep doing it” he told him. Had I been a GP I would have been asking him for his secret!!!

    Also, I used to be a distance runner and had to give it up some years ago as my knees were so bad. I really felt I would be a candidate for knee reconstruction. Three weeks into going paleo and the pain was completely gone.

    Interestingly too, I received an email from a friend of mine asking for information on paleo as one of her friends has a daughter whose ADHD has almost disappeared on a grain-free diet.

    Last week I had some friends over for dinner. I served a ‘cheesecake’ for dessert which was delicious and yes, within the paleo constraints.

    Am I wedded to paleo? Let’s put it this way. If we visit friends we eat whatever we are given. if we eat out (not often these days for obvious reasons) then we try to minimise carbs. Do we have a glass of wine with dinner? Yes! Otherwise everything is made from scratch and is paleo inspired.

    • Geoff says

      Maria – very similar experience to you. My wife was diagnosed Type 2. Thanks heavens i was in touch with a personal trainer who i knew was very interested in diet. He introduced us to Paleo and we haven’t looked back. Her blood sugars went from 13 to under 7. I went Paleo as the bread was going mouldy and there were no potatoes in the house and i haven’t looked back. The sad thing is that when she saw the doctor (young and very overweight by the way) to be given her dramatic reduction in glucose levels he showed no interest at all in how she did this. Doctors in UK, i understand, get paid for “looking after” their list of diabetics and running clinics proposing low fat/high carb diets. What chance for the future?

  15. Thomas Bihn says

    I find it funny how threatened vegans are with paleo. It seems like there are a lot of vegans that go to this website to attack a healthy lifestyle. It strikes me as odd, especially given that one of the main reasons people choose to be vegan is due to the inhumane treatment of lifestock in CAFOs. A little digging will reveal that people that identify with paleo tend to try to eat wild-caught fish and grass-fed, pastured animals that were humanely treated. Further digging still will reveal that paleo is really more of a general term and focuses on consuming mostly vegetables.

    The fact that vegans seem to be so abrasive makes me wonder if not eating meat makes them cranky. I know I would be if I didn’t have my salmon, free-range chicken, or grass-fed beef.

    • Robert says

      I hear you but how many people do you honestly believe are buying wild salmon, free-range chicken and grass-fed beef. I know of no suppliers of free-range chicken in my area and it is harder and harder to find salmon that isn’t farmed. I go without if I can’t find wild caught. As far as grass-fed beef, the suppliers are extremely limited in my city. I do live within 30 minutes of an elk farm however but how many people can say that?

      • Thomas Bihn says

        I go to Aldi and Kroger mostly. I drive about 45 minutes to a farmer’s market on Saturdays when I have a chance and buy locally though. While there, I stop in at a Trader Joe’s to pick up some items I can’t get easily or as cheaply as Kroger’s.

        Aldi sometimes has the grass-fed beef and always has wild-caught frozen salmon filets. Kroger’s is adding a lot of organic produce and quality meats to even the smaller stores. While not ideal, you can get organic eggs from “chickens that enjoy the outdoors” from most supermarkets as well. I get my grass-fed cow’s milk (not paleo, I know) from a local grocer. It’s whole milk, which is much better.

        Look for CSAs in your area and visit the farmer’s markets when they start up this spring. There you’ll get lines on local farmers that have grass-fed and organic meats.

        I’ll admit that you spend more for these better meats, but you get so much better quality. Using a slow cooker and a $20 pork shoulder, you can get about 10-12 servings of pulled pork from one 8 hr span on a Sunday. :)

        You can also try ordering through one of the many paleo blogger’s websites. I see ads for them on those. I thought I had bookmarked more, but hopefully this can help get you started:

        http://www.eatwild.com/products/index.html

        http://www.eatingwell.com/food_news_origins/green_sustainable/where_to_find_grass_fed_beef

          • Thomas Bihn says

            Try starting here: http://farmersmarketsontario.com/RegionMap.cfm

            http://ontariofarmfresh.com/locator/

            You can also try different reddit and other Internet forums. There is likely a farmer available in a reasonable distance, but it may take some digging.

            I don’t know what’s happening in Canada regarding the trend, but in America there is an observable shift towards eating whole foods – whether they call it paleo, Weston A Price, perfect health, vegan, juicing, or whatever. Whole Foods and Trader Joe’s have led the charge so far, but other major chains, including Kroger’s and Walmart, are starting to increase their offerings. Best of luck to you finding them.

      • raydawg says

        I certainly am. Just because you didn’t bother to look for proper sources of food doesn’t mean others won’t. Look /beyond/ your supermarket Bob.

    • Robert says

      Good god what a long-winded video!!! I’ve taken the bullet for the people in this forum, meaning I listened to the whole thing. Its the old “Five foods you should never eat” video. They are:

      1. Orange juice.
      2. Margarine.
      3. Bread (whole wheat and others).
      4. Soy (tofu, soy milk & other highly processed soy foods).
      5. GMO corn.

      There you have it. I saved you the pain of listening through this seemingly endless video whose purpose it is to relieve you of $47.00 of your hard-earned money.

      • Tony Rideout says

        Some of your points may be valid but as the old saw goes, the proof of the pudding is in the eating. I switched to Paleo, or something like that, a few years ago and I have never felt better. Keeping weight off is easy and I have energy to burn. Notwithstanding, I think you might have a more receptive audience if you changed your tone; you sound snarky.

  16. Thomas Bihn says

    It has now been nearly a year since I saw a video of the authors of The Great Cholesterol Myth pushing their book on Dr. Oz. Their points were pretty convincing, but I bought the book in audio and print. I listened to it, read it, then re-read it looking up all the many references. There were a couple places where the references weren’t strong, but for the main arguments, they made too much sense. I had been on a statin for about 9 months and decided to stop taking it, cut out sugar and flour and processed meat, and increase my consumption of vegetables. I targeted keeping my glycemic index low to reduce the amount of insulin sent to my bloodstream. As time progressed, I continued to search for information. I found an organic farmer locally that supplied antibiotic free bacon, free-range organic chicken eggs and chickens, and grass-fed, organic grain-finished beef (not perfect, but better than supermarket beef). He introduced me to the term GMO.

    Reading about the correlations of red meat didn’t stop me from eating it entirely, but definitely ensured I’d eat it in moderation and watch not to cook it at too high of temperatures. After all, epidemiological studies tend to show correlations among typical groups of people and let’s face it, paleo is an atypical demographic.

    I digress.

    As I was getting more and more into this lifestyle, I learned that what I had been eating was closer to a paleo template with some elements of a ketogenic diet. My cholesterol numbers all improved within 3 months of starting this. By November, I was pretty happy with my results.

    June 2012 (was previously on a non-statin cholesterol drug, began Vytorin immediately after this)
    VLDL: 47 mg/dL
    LDL: 182 mg/dL
    Trig: 236 mg/dL
    HDL: 39 mg/dL
    Glucose: 100 mg/dL
    Total Chol: 245 mg/dL

    May 2013 (3 months after discontinuing cholesterol medication)
    VLDL: 24 mg/dL
    LDL: 179 mg/dL
    Trig: 118 mg/dL
    HDL: 41 mg/dL
    Total Chol: 243 mg/dL

    November 2013 (NMR Lipoprofile)
    VLDL-C: not listed on report
    LDL-C: 143 mg/dL
    Trig: 45 mg/dL
    HDL-C: 72 mg/dL
    Total Chol: 224 mg/dL
    LDL size: 21.0 nm
    LP-IR score: 14 (insulin sensitive)

    hs C-RP: 0.27 mg/L (range 0.0 to 3.0, low is less than 1.0)

    I’m also completely off any medications. I stopped taking my blood pressure medicine in October. I’m now normalized on my blood pressure as well.

    So far, so good. I feel physically terrible if I eat junk food now and can’t see myself ever changing how I eat from this – barring some convincing research otherwise.

    • Thomas Bihn says

      I forgot to mention the most relevant point to this article. Start weight was around 275 lbs. My weight is now 185 lbs. I started doing body weight exercises in mid-October and I’m noticeably stronger now as well.

      In other words, about 90 lbs lost in a year. My weight has been pretty stable over the past few months.

        • Thomas Bihn says

          Thanks Robert. It really underscores the main point in the human diet – that the primary purpose of eating is to nourish the human body to maintain or improve health. If everyone did that rationally, the world would be a vastly different place.

          I believe weight loss should never be the primary goal of diet. The primary goal should be to improve health. I lost those 90 lbs as a side effect of my intent to minimize inflammation.

    • rs711 says

      @Thomas Bihn

      Fantastic! Congratulations.

      Some people will start moaning at how your LDL hasn’t budged (not in statistical significance parlance), all the while conveniently ignoring the onslaught of positive changes in markers with more meaningful predictions vis-a-vis health/survival outcomes!

      Would you mind giving us an example of your ‘typical meal’?
      Basic movement/exercise pattern in addition to sleep?
      It’s always nice to complement markers with lifestyle changes.

      Thanks & again, congrats!

      • Thomas Bihn says

        @rs711

        For quite a while now, my breakfast has consisted of only coffee with butter and MCT oil blended into it (a.k.a. a bulletproof coffee). I find I’m satiated longer doing this alone than if I eat even protein-based food along with it, such as bacon and eggs. I tend to eat a large amount of vegetables with at least one meal, but I have to admit that when I eat bacon and eggs as my “fast food”, I don’t do such a great job incorporating veggies. So breakfast is usually all fat or fat and protein with little to no carb intake.

        My lunches and dinners are pretty much share a formula of some meat and an extra large serving of vegetables. The big salad bowls I’ve found aren’t enough and I prefer to fill a plate with leafy greens.

        I also will saute kale, spinach, and/or other veggies in bacon fat or butter. I’ll lightly steam sometimes then smother in melted grass-fed butter. For perspective, I usually use between 1/3 and 1/2 of a typical prewashed bag of vegetables. I try not to let vegetables sit in my refrigerator for very long and do my best to force myself into. I try not to eat too much raw spinach or kale because of the higher oxalate levels and my desire not to get kidney stones. Other veggies I like are chard, arugula, asparagus, brussel sprouts, broccoli, cucumbers, cauliflower, carrots, celery, an occassional sweet potato now (but until I saw i was insulin sensitive, I was more restrictive on the starchy vegetables). In the summer, I get all my vegetables once a week from a farmers market.

        When I eat a salad, I try to add some colorful peppers in there. I found that unsweetened coconut flakes and a handful of nuts to become a staple of my salad making process. I use extra virgin olive oil and vinegar then add some herbs and spices on top. Flax seeds or almond meal make a good topper too. I also add cheese to nearly all my salads.

        Meats I will eat: chicken – mostly dark meat, pork chops, pork shoulder – love to make the pulled pork, salmon, sardines, hamburger patties with cheese, steak, chicken patties from the farmer’s market, bratwurst.

        Fruits – Blueberries, strawberries, mixed frozen berries, sometimes grapes, apples, peaches. Avocados are my #1 fruit I consume and half an avocado goes on just about every salad.

        Dairy – grass-fed whole milk, Greek Gods plain yogurt with a little honey and blueberries added, cheese. I know, it’s not paleo, but I don’t seem to have a problem with it.

        Snacks – almonds or mac nuts where cottonseed oil and canola oils are not in the ingredients, dark chocolate 70% . Another non-paleo thing I sometimes enjoy, but have to avoid buying due to overindulgence – organic peanut butter. I find dipping a dark chocolate square in peanut butter and washing down with milk is my best answer to indulging and satisfies any craving that may come up. With that said, if I have it in the house, I will go to it too often, so I don’t buy it too much. The same can be said for Greek Gods Honey yogurt – I’ll overeat that if it’s in the house.

        When I travel, I eat more salads. I eat farm-raised salmon on trips instead of eating the red meat that has been in a CAFO. I love to get sushi at least once on a trip if possible – even with the rice. i travel between 25 and 50% of the time.

        I tend to try to limit myself to about enough meat to fit into my fist and fill the rest of the plate with vegetables. I don’t eat fruit regularly, but tend to add the blueberries and avocados to salads regularly.

        I’m not restricting myself to what I’ve listed here. These are just the things that came to mind as I was typing this up. I eat primarily above-ground vegetables and am conscientious not to eat too many nightshades or red meat. I don’t worry too much about saturated fat intake, even despite the cochrane study. (http://summaries.cochrane.org/CD002137/cutting-down-or-changing-the-fat-we-eat-may-reduce-our-risk-of-heart-disease#sthash.gzBaFNlL.dpuf). I believe that it is just indicating that saturated fat combined with other factors likely increased the risk in those studied. Like I said before, this lifestyle, unfortunately, is pretty atypical.

        Movement: Until April, I didn’t do anything. Starting mid April, I began to walk a few days a week, about 20 minutes. In May through July, I walked more frequently – adding in a 10 minute walk in the mornings and also did some light jogging. I continued this until mid October when I started doing body weight resistance training such as pushups, dips, squats, lunges without weight and continued to walk 10 minutes in the morning. My workouts are a 10 minute warmup, which usually involves me walking, followed by about 20 to 30 minutes of doing a circuit. I now have resolved to park the farthest away from building entrances than anyone else in the parking lot. This adds another 60 seconds of total walking to every trip to Walmart and 20 seconds to trips to IGA or Aldi. I’ve shoveled my driveway and left the snow blower in the garage this snowy Ohio winter.

        One final note – I started by simply giving up sugar, flour, and processed meats. I ate whole wheat wraps until I noticed the amount of carbs were the same as in the bread and as table sugar. By March I had eliminated bread completely. I won’t touch bread now. I also ate a lot of carby vegetables like carrots early on. I still eat carrots some, but this was my way of coping with the withdrawal of cutting out sugar. The grapes helped too. I also don’t eat those much any more.

      • Thomas Bihn says

        Regarding the LDL, I wouldn’t currently consider that high anymore. I also wouldn’t consider my overall cholesterol high. Above “normal”? Yes, but given that half the people that experience a primary incident have low cholesterol, I don’t think it’s all that great a predictor of CVD. I would also point out that my first reading (the highest) was while taking cholesterol meds. The second one was 3 months after discontinuing statins and not being on any cholesterol-lowering meds. The third one was even lower and was after going to a higher fat content in my diet (with the introduction of the butter and MCT oil into my coffee). Another thing I’d note is the VLDL dropped precipitously. I only wish I had my cholesterol tested immediately upon stopping. I was still losing a lot of weight in May obviously. In November, I had slowed to a plateau.

        • rs711 says

          @Thomas Bihn

          Thanks for the thorough detailing!
          Your diet is quite similar to mine for the most part.

          I love dairy but have been avoiding it for a few weeks to see how it affects my rhinitis and because it’s the only food that I may overindulge in every once in a while (an ongoing n=1 @ this point). I’d point out though, in general, that many ‘PRO’ dairy arguments can be made – despite its potential for allergenicity/immunity/inflammation character – but IMHO, exclusively raw/unpasteurized unskimmed dairy should be considered. The skimmed stuff starts to look alarmingly close to sodas in terms of sugar content and the lack of pasteurisation essentially robs it of its naturally occurring enzymes to aid in digestion + its bacterial composition is destroyed which adds to a ‘sterile environment’ [see the Old Friends hypothesis]. And….the real stuff tastes WORLDS better :).

          I’d eat pork much more often if I could find non grain-fed pork. I live in the South of France and can’t find ‘real’ pastured ones – despite being ‘outside’, they’re still fed grains. I’m not interested in such quantities of omega-6s & don’t wish to encourage grain feeding in general.

          Green/red peppers taste great, but I don’t digest them fully – maybe I’ll reintroduce them in a few months.

          As for chocolate: my tip (if people can find it) is to buy 100% dark chocolate & dip it in honey if they want that sugar taste accompanying it..But I’ll eat 85% dark chocolate too, every once in a while.

          From a chemical & medical perspective, it’s hard to make a case against the consumption of saturated fat. For every ‘downside’ you can find 10 ‘upsides’. Funnily enough, whether Kitavans or Inuits, Paleo groups spanning the entire food spectrum still tend to consume substantial amounts of saturated fat (Kitavans around 17% according to Lindberg et al.!).
          As for red meat – are we talking about pastured raised, grass-fed/finished animals or typical McD’s meat? If it’s the former, I wouldn’t waste worrying about it impacting your health negatively. However, there may be reasons to increase/decrease consumption not because it’s bad, but because you might need to make place for something else that is healthful, such as fish/seafood (for example). Although you seem pretty set in that area as well!

          [I’m 24, 1m82, 73kg, probably 8-10% body fat]
          About 3yrs ago I changed the way I eat for not particular reason…funny thing is, with time I realized I actually did have many good reasons to seek improvements: emaciation due to being sedentary following a knee surgery, unresolved childhood asthma (an autoimmune condition unbeknownst to me), chronic rhinitis, moodiness, unstable energy levels, sub-par skin presentation, excessively ‘light’ skin, slight joint pain, severe allergy to shellfish and generally ‘allergy prone’.

          Keep in mind, had you asked me before my dietary/lifestyle changes, I’d have only pointed to asthma and a runny nose as issues worth resolving.

          My lab markers took a strange turn, but I’m generally ‘happy’ with them. Unfortunately I had no labs before I changed my diet, although the one lab I did do indicated ‘high cholesterol’ but nowhere close to what I have now. Your response seems more typical.

          In my case, my HDL improved, trigs are LOW, inflammatory markers are great, my thyroid doesn’t appear dysregulated and all subjective/objective aspects of appetite, mood, sleep, strength, stamina, ‘aesthetic looks’, dental health etc. are much better.

          HOWEVER, my apoB levels are in the ‘very high’ range (2.27g/L @ Sept. 2013), as is my LDL (approx. 8mmol/L) & TC (around 10mmol/L). While my fasting BG is around 80-90mg/dL & my Hba1c under 5.5% —> interestingly, a very expensive oxidised LDL panel confirmed that I have low levels of oxidized LDL particles (58ng/mL).

          There are other ‘lifestyle’ variables I won’t go into detail here (for the sake of length) but these likely played a role in my strange numbers (I stopped mixing in tobacco with w33d a few months ago, now only the sticky icky).

          Yes, I’ve been told by several doctors to go on a statin. Always refused. I did the genetic testing for familial hypercholesterolemia = NEGATIVE (4% chance it’s a mutation that wasn’t sequenced).

          Depending on the ratios you chose to use (trigs/HDL or LDL/TC) I may be considered a model of health or someone on the brink of a heart attack. So goes medicine…

          The hypothesis I’m trying to falsify is: can 2-4 negative lab markers outweigh several other positive measures/markers of healthfulness when transitioning from a non-SAD but ffaaarr from healthful diet to a whole foods, low-carb, Paleostyle diet with the addition of improved sleep patterns and exercise components?

          Hopefully my Msc studies in Molecular Biology + the online blogosphere + discussions with doctors will provide hints. So far, only the first 2 were helpful.

          • charles grashow says

            “HOWEVER, my apoB levels are in the ‘very high’ range (2.27g/L @ Sept. 2013), as is my LDL (approx. 8mmol/L) & TC (around 10mmol/L). While my fasting BG is around 80-90mg/dL & my Hba1c under 5.5% —> interestingly, a very expensive oxidised LDL panel confirmed that I have low levels of oxidized LDL particles (58ng/mL).”

            LDL = 309.36 mg/dl
            TC = 386.70 mg/dl

            My guess is with your ApoB level your LDL-P is <2000

            With these levels AND testing negative for FH I would be very concerned about these levels.

            What are the levels for trigs and HDL?

            • rs711 says

              @ charles grashow

              Got lab tests done today (07-Feb-2014)

              Trigs = 0.31 g/L
              HDL-C = 0.71 g/L
              Trigs:HDL-C ratio = 0.436

              LDL-C = 2.99 g/L
              TC = 3.76 g/L
              TC:LDL-C ratio = 1.257

              TSH = 1.33 microUI/mL
              fT3 = 5.22 pmol/L
              fT4 = 13.53 pmol/L

              [on ~18hr fast - I use the Precision Xtra Blood Glucose meter]
              11am (fasted) = 79 mg/dL
              Lab BG measurement around mid-day (still fasted) = 99 mg/dL
              My BG measure 2min after the lab drew my blood = 89 mg/dL
              My BG measure 5min after 15min of intense body-weight circuit training = 140 mg/dL
              My BG measure 1h15min after the workout (still fasted) = 89 mg/dL

              As far as I understand it, there is 1 apoB apolipoprotein per LDL particle and so measuring apoB or LDL-P is the same thing (simply different names). Yes, I know there are many other lipoproteins on LDL and other cholesterol carrying particles as well, but counting apoB’s *should* reflect the number of cholesterol carrying LDL particles.

              I am trying to work with Endos & other docs to get additional tests to more directly measure my inflammatory state &/or vascular health with: LPP2A plaque test, myeloperoxidase & artery calcium score (CT scan).
              It’s crazy: young guy trying to practice preventative medicine on himself, but can’t because he’s not considered to have a serious disease. Duh! Thank you medical system, thanks!

          • charles grashow says

            http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-iv

            “Why LDL-P matters most

            You may be asking the chicken and egg question:

            Which is the cause – the apoB containing LDL particle OR the immune cells that “overreact” to them and their lipid cargo?

            You certainly wouldn’t be alone in asking this question, as many folks have debated this exact question for years. The reason, of course, it is so important to ask this question is captured by the Robert Burton quote, above. If you don’t know the cause, how can you treat the disease?

            Empirically, we know that the most successful pharmacologic interventions demonstrated to reduce coronary artery disease are those that reduce LDL-P and thus delivery of sterols to the artery. (Of course, they do other things also, like lower LDL-C, and maybe even reduce inflammation.)

            Perhaps more compelling is the “natural experiment” of people with genetic alterations leading to elevated or reduced LDL-P. Let’s consider an example of each:

            Cohen, et al. reported in the New England Journal of Medicine in 2006 on the cases of patients with mutations in an enzyme called proprotein convertase subtilisin type 9 or PCSK9 (try saying that 10 times fast). Normally, this proteolytic enzyme degrades LDL receptors on the liver. Patients with mutations (“nonsense mutations” to be technically correct, meaning the enzyme is somewhat less active) have less destruction of hepatic LDL receptors. Hence, they have more sustained expression of hepatic LDL receptors, improved LDL clearance from plasma and therefore fewer LDL particles. These patients have very low LDL-P and LDL-C concentrations (5-40 mg/dL) and very low incidence of heart disease. Note that a reduction in PCSK9 activity plays no role in reducing inflammation.
            Conversely, patients with familial hypercholesterolemia (known as FH) have the opposite problem. While there are several variants and causes of this disease, the common theme is having decreased clearance of apoB-containing particles, often but not always due to defective or absent LDL receptors, leading to the opposite problem from above. Namely, these patients have a higher number of circulating LDL particles, and as a result a much higher incidence of atherosclerosis.

            So why does having an LDL-P of 2,000 nmol/L (95th percentile) increase the risk of atherosclerosis relative to, say, 1,000 nmol/L (20th percentile)? In the end, it’s a probabilistic game. The more particles – NOT cholesterol molecules within the particles and not the size of the LDL particles – you have, the more likely the chance a LDL-P is going to ding an endothelial cell, squeeze into the sub-endothelial space and begin the process of atherosclerosis.”

            “What about the other apoB containing lipoproteins?

            Beyond the LDL particle, other apoB-containing lipoproteins also play a role in the development of atherosclerosis, especially in an increasingly insulin resistant population like ours. In fact, there is some evidence that particle-for-particle Lp(a) is actually even more atherogenic than LDL (though we have far fewer of them). You’ll recall that Lp(a) is simply an LDL particle to which another protein called apoprotein(a) is attached, which is both a prothrombotic protein as well as a carrier of oxidized lipids – neither of which you want in a plaque. The apo(a) also retards clearance of Lp(a) thus enhancing LDL-P levels. It may foster greater penetration of the endothelium and/or greater retention within the sub-endothelial space and/or elicit an even greater immune response.”

            “In summary

            The progression from a completely normal artery to an atherosclerotic one which may or may not be “clogged” follows a very clear path: an apoB containing particle gets past the endothelial layer into the sub-endothelial space, the particle and its cholesterol content is retained and oxidized, immune cells arrive, an initially-beneficial inflammatory response occurs that ultimately becomes maladaptive leading to complex plaque.

            While inflammation plays a key role in this process, it’s the penetration of the apoB particle, with its sterol passengers, of the endothelium and retention within the sub-endothelial space that drive the process.

            The most numerous apoB containing lipoprotein in this process is certainly the LDL particle, however Lp(a) (if present) and other apoB containing lipoproteins may play a role.

            If you want to stop atherosclerosis, you must lower the LDL particle number.”

            Again – if it were me I would be VERY concerned

            • rs711 says

              @ charles grashow

              From what I’ve seen in the literature and other peoples interpretation of it, much more is understood about overall risk of death by keeping an eye on Trigs, HDL and Blood Glucose than LDL-P alone.

              [At this moment, baring new information..] All other things being equal, I’d still prefer: excellent trigs + HDL + Blood Glucose & poor apoB scores

              than: excellent apoBs but horrible Trigs + HDL + BG scores.

              IDEALLY, I’d prefer my apoBs to come down and the rest to maintain, obviously!

              We certainly are on the cutting edge here….
              But before being “VERY concerned” I’d like to better assess – as DIRECTLY as possible – my general inflammatory & immune state via the tests I mentioned above (LPP2A, myeloperoxidase & a CT Scan)

              One thing is patently clear; it seems nearly impossible to suffer from CVD without inflammation + a lot of people get CVD (& other diseases) with apparently ‘great’ cholesterol &/or lipoprotein levels.

              Game on science/medicine!

              [ Chris Kresser - feel free to jump in here :) ]

        • rs711 says

          I forgot to specify: I eat bone marrow, brains, liver, kidneys, tripe, ‘skin/gelatin’ and the bones of small fish (like sardines) many times a week (usually…).

          It’s hard for me to understand when people pull away from these things – I get the ‘cultural’ argument, but I don’t buy that it ‘tastes weird’. Same way bread doesn’t taste weird to modern man/woman but would more than likely be very weird for a hunter-gatherer tasting it for the first time.

          Maybe Stephan Guyenet would like to weigh in on the palatability/reward mechanism of foods when discussed through the lens of ‘cultural preference’? :)

  17. says

    We get frustrated when people make negative remarks about paleo…as they have probably not even tried it.

    We all know that everyone’s paleo is different but the reason we all follow the lifestyle is because we feel good and see so many diverse benefits.

    We look back and can’t keep count of the number of diets we have tried… because they were diets that didn’t work, that we were never satisfied by and that didn’t nourish our bodies.

    We have lived paleo since 2012 and haven’t looked back. Never felt better physically and mentally. Our energy isn’t wasted on feeling guilty about food choices…we now use the energy to blog about paleo and promote it! We lost weight, our skin cleared, our moods are more level, we are more aware of our being!

    Going paleo. Best. Decision. Ever.

    Emma + Carla

    • charles grashow says

      “We get frustrated when people make negative remarks about paleo…as they have probably not even tried it.”

      I tried it – my lipid profile became very problematical on it.

      You know what happens when you make assumptions don’t you?

        • charles grashow says

          Blood test – 3/12
          Lipids (VAP Test)
          Total Cholesterol – 324
          HDL Cholesterol – 84
          Cholesterol/HDL Ratio – 3.9
          LDL Cholesterol (Calculated) – 230
          Lipids (VAP Test)
          Total Cholesterol – 324
          HDL Cholesterol – 84
          Cholesterol/HDL Ratio – 3.9
          LDL Cholesterol (Calculated) – 230
          Iranian LDL Cholesterol Calculation – 186
          Triglycerides – 54
          VLDL Chlosterol (Calculated) – 11
          Triglycerides/HDL ratio – .64
          Pattern size – A – large and bouyant

          Sub Class infomation
          HDL-2 (Large, Bouyant; most protective) – 31 Ref range >10 mg/dL

          HDL-3 (Small, dense; least protective) – 54 Ref range >30 mg/dL

          VLDL-3 (Small Remnant) – 10 Ref range <10 mg/dL

          GlycoHgb (A1C) – 5.2 Ref range 5.0-6.0% mg/dL
          Estimated Average Glucose – 102.5 mg/dL
          Fasting Glucose – 79 Ref range 65-99 mg/dL

          Berkeley Heart Lab test results – 10/12
          TC – 274 mg/dL
          LDL-C (Calculated) 199 mg/dL
          HDL-C 76 mg/dL
          Triglycerides 41 mg/dL
          Ap- B 104 mg/dL Reference Range <115 mg/dL
          LP(a) <2 mg/dL Reference Range 0-30 mg/dL

          Lipid SubClass Detail
          Berkeley Lab analyzes LDL for 7 sub classes from large buoyant to small dense

          LDL I, IIa and IIb are considered large buoyant – As a % these 3 totalled 82.5% – LDL I=51.1%, LDL IIa=16.2% and LDL IIb=15.2%
          LDL IIIa+b, LDL IVa and LDL IVb are considered small dense with IVb being the smallest. As a % these totalled 17.5% – LDL IIIa=11.2%, LDL IIIb=3.8%, LDL IVa=1.8% and LDL IVb=0.7%
          LDL IIIa+b=15% Reference Range=13.6-43%
          LDL IVb=0.7% Reference Range=1.7-9.8%
          LDL IIIa=B = 17.9 mg/dL Reference Range=12.0-32.1 mg/dL
          LDL IVb=1.0 mg/dL Reference Range=1.5-11.2 mg/dL

          HDL is analyzed for 5 subclasses

          HDL2b=34%, HDH2a=24%, HDL3a=20%, HDL3b=14% and HDL3c=8%
          HDL2b Reference Range 7-30%

          HA1C – 5.6
          Fasting Glucose – 100mg/dL Ref Range 65-99 mg/dL
          Estimated Average Glucose – 114.5 mg/dL

          LDL-P 1430 nmol/L
          Small LDL-P 132 nmol/L

          Started 10mgs/day Atotvastatin in 7/13
          Blood test 10/13

          TC 126 mg/dL
          LDL 71 mg/dL
          ApoB 64 mg/dL
          HDL 48 mg/dL
          TG 36 mg/dL
          Vitamin D3 – 46 with normal 30-100

          I made some small changes to my diet in addition to the statin

          I still eat 8-12 ounces of raw grass fed ground beef/day, 1-2 raw eggs (including shells in my smoothie, eliminated coconut milk, olive oil and reduced the amount of butter consumed. I also eat fresh/frozen fruit, nuts, seeds, raw cacoa powder, fresh/frozen veggies, etc.

          I also take certain supplements but 200mgs/day of CoQ-10 and 1,000 mgs SloNiacin are essential

          I will be taking a NMR, Fatty Acid Profile, Essential (C12-C22), Serum and a Cardio IQ™ Lipoprotein Fractionation, Ion Mobility on 2/21

          the Cardio IQ™ Lipoprotein Fractionation, Ion Mobility includes

          LDL Phenotype; LDL Phenotype, Risk; LDL Particle Size; LDL Particle Size, Risk; LDL, Total; LDL, Total, Risk; LDL, Very Small; LDL, VS, Total, Risk; LDL, Medium and Small; LDL, M and S, Risk; HDL, Large; HDL, Large, Risk;
          Total Particles HDL (Total, HDL; Total HDL, Risk; Total LDL; Total, LDL, Risk; Total, Non-HDL; Total, Non-HDL, Risk);
          HDL Particle Subfractions (HDL Small; HDL, Small, Risk; HDL Large; HDL, Large, Risk);
          LDL Particle Subfractions (LDL, Very Small-d; LDL, Very Small-d, Risk; LDL, Very Small-c; LDL, Very Small-c, Risk; LDL, Very Small-b; LDL, Very Small-b, Risk; LDL, Very Small-a; LDL, Very Small-a, Risk; LDL, Small; LDL, Small, Risk; LDL, Medium; LDL, Medium, Risk; LDL, Large-b; LDL, Large-b, Risk; LDL, Large-a; LDL, Large-a, Risk);
          IDL Particle Subfractions Small (IDL, Small; IDL, Small, Risk; IDL, Large; IDL, Large, Risk);
          VLDL Particle Subfractions Small (VLDL, Small; VLDL, Small, Risk; VLDL, Medium; VLDL, Medium, Risk; VLDL, Large; VLDL, Large, Risk)

          • rs711 says

            @charles grashow

            Thanks for the lab link but I live in France.

            Woah! You kinda threw a bunch of numbers at me here. I did a little sorting and came away with:

            TC = 274 mg/dL —-> 324 mg/dL —> 126 mg/dL
            LDL-C (calc.) = 199 mg/dL —> 230 mg/dL —> 71 mg/dL
            HDL-C = 76 mg/dL —> 84 mg/dL —> 48 mg/dL
            Trigs = 41 mg/dL —> 54 mg/dL —> 36 mg/dL
            ApoB = 104 mg/dL —> ? —> 64 mg/dL
            HbA1C = 5.6% —> 5.2% —> ?

            Please correct me on the values if necessary.

            Everything seemed to have gone up, and then back down – but lower than the 1st reading…maybe except ApoB &/or HbA1c since I seem to be missing 2 values?

            What reason are you taking the statin for?

            I ask because the statin (in some respects) is highly antagonistic in its mechanisms compared to those exerted by the healthy foods you’re eating. Your latest cholesterol values aren’t high at all, maybe even a bit low (depending on who you ask). Maybe it’s worth reconsidering all the potential negative side-effects that statins have been clearly shown to exert and weigh those against your latest lipid readings. You’ve got excellent ratios as far as I can see, very decent HbA1C % – adding a statin in the mix seems to be a large gamble for, at best, a measly reward.

  18. Jacqueline Petrosky says

    Walked into a cafe in Tahoe today and requested that my sandwich meat be wrapped in lettuce not in a bun. The owner overheard my order and proceeded to negatively comment to her cohort that she couldn’t believe all these “paleo-people” are ordering the way they are. I was dumbfounded that the proprietor would comment within earshot; I was faminished enough not to care and still patronized her business. Anti-paleo-lady, boo!

    • Robert says

      Whether or not one believes in the Paleo diet that doesn’t sound like a very smart thing to do from the business side of things. If its trending then a wise business person would make an effort to address that market, not make fun of it. Just makes good business sense.

  19. Amelie says

    losing weight is ideal for everybody. If you do it dedicatedly. It is not a business, it is a work that you do for yourself.

  20. says

    Hi Chris- Do you have any statistics on your weight loss clients long-term success (ie, keeping the weight off for more than 1 year, 5 years, etc? Look forward to hearing back. Thanks.

  21. Nathan says

    Its funny how the “new” Paleo diet has morphed into what some call a “Standard American Diet”. Maybe this is due to lack of long term repeatable studies. First it was carbs, dairy and nuts/seeds are the cause of all modern disease. Now these all can be part of the diet. Sometimes its “we need to eat what our ancestors ate” then when someone points out the ridiculousness of that its “we are not saying to eat strictly like our ancestors”. I guess if you keep changing your opinion you can never be wrong. Read paragraph 3 & 4, then read “Thousands of Years of Human Experience” near the end, flip flop much?

    Truth is, the general message from nutrition experts to eat a balanced diet has never changed and is still the best way to eat. Any medical resource telling you to eat processed foods, lots of sugar or remove fats from your diet all together is a bad resource, doesn’t mean the whole establishment is bad. The government is not trying to kill you but they do allow freedom of choice, the food industry is responding to the wishes of the masses, which is a get-healthy quick type of mentality. Doesn’t work in the long run and no medical professional worth their designation was trying to sell that.

    However, if you want to go “Paleo” and sound really pretentious at dinner parties, then you will probably live a great life (just like the millions of others on a “Standard American Diet”). But please stop talking about it like its the second coming of Christ. You are not better than everyone else, you don’t have the key to all diseases and you will die just like everyone else….likely of one of these causes http://who.int/mediacentre/factsheets/fs310/en/

    • Joel says

      Nathan, you call people following paleo pretentious but you are extremely quick to judge a large cohort of people that have chosen to eat differently then the established wisdom and their doctor’s advice and found great success.

      To say that nutrition experts’ message has never changed is willful ignorance of the subject. Nutritionists’ obsession with low fat diets in the 80′s to 90′s is undisputed and only recently have eggs, nuts and “good” fats come back into fashion. Low fat dairy is still recommended even though full fat dairy is superior in the majority of studies; wait for this one to turn:

      http://www.npr.org/blogs/thesalt/2014/02/12/275376259/the-full-fat-paradox-whole-milk-may-keep-us-lean

      Higher protein is now recognised as being satiating where as it previously was not so important (all those oatmeal breakfasts with skim milk were not very satisfying!) Soy protein is still considered “good.” Coconut oil is making a strong comeback from “experts”, if only because its not animal sourced so this is Politically Correct. The list is long.

      Your whole post basically states that a “balanced” diet is best and let’s not even try to improve on that. What a defeatist attitude. You sound like you’re happy with your diet and are healthy; don’t begrudge other people from trying to improve their diet and health no matter what paradigm they choose to follow.

    • Robin Willcourt says

      Interesting… I am not sure what your point is but you are right about the changing ideas with food then you seem to disparage Paleo. Perhaps I am wrong. In any case, Paleo is clearly the most obvious way to go but there is clearly some room for modern variations to what is a diet that we cannot know for sure except, perhaps, the meat part. We evolved on a diet that has left a deep DNA footprint. We should pay attention to that. Most modern fruits and vegetables are nothing like those found 20,000 year ago but it doesn’t mean that they are “bad.” Wheat and dairy do cause issues for many humans and that should come as no surprise. Thus, the closest approach to ancient foods the better- as best as we can do.

  22. Robin Willcourt says

    To those suggesting that a “vegetarian” diet cannot have as high an LDL as a meat based one- you are dead wrong. I have a large clinical practice that includes vegans and while they often have low cholesterols/LDLs, so do many of my meat/fat eaters. Since most people who have heart attacks have normal or even low LDL, it should come as no surprise that I do not stress these numbers with my patients. I do pay attention to the triglyceride and homocysteine levels!

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