Paleo pitfalls

| By Dr. Ronald Hoffman

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OK, so you’re going to take the plunge. Captivated by articles extolling the benefits of the Paleo Diet—perhaps inspired by my accounts of my test-drive of the Whole30—you’re going to give Paleo a whirl. Fine. You’re likely to shed unwanted pounds, improve your focus and concentration, enjoy boosts in your athletic performance, or reverse a nagging chronic medical condition.

But, if you go Paleo, beware these common pitfalls.

Paleo pitfallsWhich Paleo? There are various iterations of the Paleo Gospel, depending on which apostle is interpreting it. There’s the original Paleo Diet as outlined by Loren Cordain; the Wahl’s Diet, the Whole30, as well as other variations. Some exclude nightshade vegetables, which may be problematic for those suffering from arthritis (the Whole30 does not); some are higher in animal protein; others are quasi-vegetarian; some keep starchy vegetables to a minimum; others allow generous portions of winter squash, potatoes and sweet potatoes. The Wahl’s Diet specifically includes organ meats (see The Offal Truth, below).

The fact is, we can only vaguely reconstruct what our Paleo forebears ate, and it might have varied widely according to geography, climate, and environmental conditions. Which Paleo will it be? The high-protein, high-fat diet of the Arctic Inuit, rich in Omega 3s and almost devoid of carbohydrates, or the relatively starchy, protein-spare menu of desert dwellers like the aborigines of Western Australia or the Bushmen of South Africa?

For a while during human evolution, large mammals like mammoths, giant bison and sloths ranged across the savannahs, before human hunters drove them into extinction. But it’s likely Proto-humans derived a lot of their calories and protein from such yuckables as beetles, ants, termites, rodents, and earthworms; animal bones, blood, hooves and snouts; snails, tree bark, cactus leaves, and wild plant roots; the steaming stomach contents of freshly-slaughtered herbivores; and sour berries, chewy grasses and leaves. It’s pretty hard to replicate these food sources with modern diet equivalents!

The truth is that Paleo diets are just modern facsimiles of our ancestral menu, riven with sometimes arbitrary inclusions and prohibitions. My choice? The Whole30.

Too Much Meat: Mention the Paleo Diet, and you conjure images of Fred Flintstone firing up the grill to prepare a humongous brontosaurus steak. But, except for sporadic hunting coups, the diet of hunter-gathers was far more prosaic, consisting mostly of locally-gathered small game and vegetation.

And modern meat is hardly a Paleo equivalent. Grain-fed factory-farmed meat can be upwards of 40% fat by weight whereas wild meat is 10-15%, but only at specific times of the year when the animals are the fattest. Additionally the saturated fat content of wild meat is much lower, and the beneficial Omega 3 and CLA content much higher, owing to consumption of natural grasses by herbivores (“You are what what you eat eats!”).

Another potential pitfall of reliance on too much lean protein to the exclusion of fat on a low-carb diet is that, theoretically, it could lead to a deterioration in blood sugar control. This seems counterintuitive because, in the absence of carb sources, how can protein create a blood sugar response? The answer lies in a term called gluconeogenesis (literally, the spontaneous generation of sugar from protein). In carb-restricted states, up to 60% of protein is converted into glucose to maintain blood sugar. This may also result in an insulin response, encouraging metabolic syndrome and resultant Type 2 Diabetes.

The answer is to dial back on protein, while encouraging (horror of horrors!) fat consumption to support a ketogenic state, wherein fat-derived ketones replace glucose as the body’s energy source (see below section Not Enough Fat).

Finally, modern meat—unless it’s organic, grass-fed, or naturally-pastured—is a repository for environmental toxins.

So, use meat liberally in your Paleo Diet, but make sure it’s natural, and balance it with other Paleo fare.

Not Enough Veggies: A corollary to the above, don’t forget to include plenty of vegetables and some fruit in your Paleo menu-planning. The fiber will help fill you up, will nourish your microbiome, and the natural alkalinizing effects of vegetarian foods will offset the acidity caused by excess animal protein. A good idea is to consume your meat, fish, poultry or eggs in big salads; alternatively, you can garnish vegetables like Brussels sprouts or collards with chunks of bacon or ham; try adding leftover chicken to soups; make vegetable stews with ground beef or lamb; or create sumptuous veggie omelets or frittata.

The Offal Truth: If your Paleo animal protein consists of just boneless/skinless chicken breasts, filet mignon, pork chops, and canned tuna fish, well, it’s not really Paleo. Primitive hunter-gathers like Native Americans consumed the WHOLE animal, innards, bones, skin, fat and all.

It’s been conclusively demonstrated that the amino acid composition of organ meat (offal) is more complete than that of just skeletal muscle, which is predominantly just branched-chain amino acids—the kind that are more prone to gluconeogenesis.

So while tripe, kidneys, tongue, brains, chicken feet and pigs’ knuckles—still prized in much of the world—might seem a little gross, try sautéing organic liver with onions, or make a delicious soup stock from leftover chicken or meat bones (a great source of collagen).

Carb Confusion: Paleo isn’t necessarily low-carb. It’s just prohibits refined sugar, grains, and most of the time, starchy legumes. But if your goal isn’t rapid, dramatic weight loss, or reversal of Type 2 diabetes, you can add carbs from potatoes, sweet potatoes or yams, winter squash, and some fruit. I did when I undertook the Whole30 Diet because I’m endowed with a fast metabolism and I expend a lot calories with exercise. I still lost some weight. However, if your weight loss goals are stymied, look to more stringent carb restriction.

Not Enough Fat: A common sticking point with Paleo. We’ve been so successfully propagandized with the low-fat diet party line that it’s hard for some of us to shake our fat phobia. Generous portions of healthy fats are key to compliance with the restricted Paleo regimen. And by healthy fats, I mean not just monounsaturated fats from olive oil and avocados, and Omega 3s from fatty fish, but also plentiful saturated fats from (untrimmed) meats and poultry, coconut oil, macadamia nuts, ghee, chicken and duck fat, and even lard.

Yes, it sounds heretical, but new scientific evidence exonerates these once-stigmatized fats. Inclusion of generous amounts of fat in the Paleo diet will firewall you from carb cravings; without them, just protein alone won’t extinguish your sugar and starch dependencies.

Paleo-Sort Of: OK, going Paleo sounds cool, lots of your friends are doing it now, and there are even some trendy eateries to explore. But it’s too much to ask to forego that splash of milk and a teaspoon of sugar in your coffees, an occasional cheese cake or ice cream for dessert, or a few servings per week of rice, pasta, or delicious French bread.

What harm could a little departure from complete dietary fidelity do? To start with, you’re not really eating Paleo! The potential benefits of eliminating possible problem foods or allergens will be obscured by your mixed dietary pattern. Your body won’t achieve the “reset” that Paleo often facilitates.

What’s more, if you add refined carbohydrates to all that rich, fatty food that’s encouraged on Paleo, your weight could balloon! You can’t have it both ways.

Paleo “snack food”: We’ve seen this before. Every sound diet trend lends itself to exploitive commercialization. The austere Macrobiotic Diet of the Seventies begat technically legal Macro “treats” like tofutti ice cream, Rice Dream, and yummy rice syrup confections; Atkins ushered in caloric sugar-alcohol bars and “low-carb” fried pork rind snacks; the gluten-free craze has flooded the market place with wheat-free clones of cookies, bagels and pastry that are even more caloric than the products they’re intended to supplant. So, too, with the Paleo “brand.”

Already, delectable coconut and veggie chips, Paleo donuts, fruit and nut bars, and luscious sugar-free dark chocolate desserts are flooding the health food marketplace. Intended as an occasional treat, they should form no more than 5% of overall caloric intake on Paleo. But they’re convenient—and addictive. Our Paleo forebears would just shake their heads in amazement. And since snacking is a modern phenomenon—proto-humans were compelled by bouts of scarcity to forego eating for long periods of time (Intermittent Fasting)—they undermine the premise of Paleo eating.

Too Many Nuts: While technically “legal” on most Paleo diet plans, nuts are savory, addictive, convenient, and caloric. Some of my patients who can’t lose weight on Paleo are enticed to over-indulge with nuts and nut butters.

Paleo Couch Potato? A major overlooked aspect of Paleo dieting is the enormous caloric expenditure involved in food-gathering. Ancient tribes walked long distances tracking game and foraging for plants. Much exertion was required to pound and knead tough, fibrous raw materials to render them palatable. Transporting and butchering meat also provides a workout. Sourcing Paleo products conveniently stocked at your local natural foods grocer is in no way comparable. Therefore, weight-bearing and endurance exercise, and lots of walking are necessary accoutrements to any Paleo Diet plan.

Pay attention to these Paleo pitfalls, and your Paleo diet experience is far more likely to yield profound and lasting health benefits.


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