The Paleolithic diet, also known as the Stone Age diet, the Caveman diet, or simply “Paleo,” is unlike the ketogenic diet because it is not used as a conventional medical nutrition therapy to treat disease. Instead, the idea of Paleo diets as a health promoter stems largely from the evolutionary discordance hypothesis, the belief that we could prevent many of the diseases of civilization if we ate in a manner similar to how our ancestors ate prior to the beginnings of the Agricultural Era, over 10,000 years ago. If you believe that you may be able to optimize your health by eating more like hunter-gatherer groups may have eaten in the Paleolithic Era, this article is going to interest you.
Since Paleo is not a medical nutrition therapy, and since anthropologists cannot say for sure which foods comprise an “evolutionarily appropriate diet,” there is no one strict protocol that defines this way of eating. Instead, many adherents of Paleo determine which specific foods should be added or eliminated based on how the foods make them feel and their individual needs. There are also several well-known “Paleo gurus” that offer guidance to those who need it.
By the end of this article, you’ll be well-acquainted with all of the essential information regarding Paleo. You’ll learn about the differences between the Paleo-style diets promoted by the most well-known figures in this movement, as well as the benefits and pitfalls that can happen with this way of eating. Here are the questions that will be answered:
- What does Loren Cordain, the founder of The Paleo Diet® Movement, promote?
- How does Robb Wolf’s definition of Paleo differ from Cordain’s?
- How does Mark Sisson’s Primal Diet fit into all of this?
- What are 3 major benefits of adopting a Paleo diet?
What does Loren Cordain, the founder of The Paleo Diet® Movement, promote?
Loren Cordain, Ph.D., is the author of the book The Paleo Diet and is described as the founder of The Paleo Diet® Movement. He offers a simple graphic on his website that provides clarity on his interpretation of Paleo. It can be summarized as follows:
- Include these foods: grass-produced meat, seafood, eggs, fresh fruits and vegetables, nuts, seeds, and “healthful oils” (examples given are olive, walnut, flax, coconut, avocado, macadamia).
- Exclude these foods: cereal grains, legumes (including peanuts), dairy, refined sugar, potatoes, processed foods, refined vegetable oils, and salt.
Though Paleolithic diets are often grouped with low-carbohydrate eating plans, it is important to note that this way of eating is not necessarily low-carb. The fruits and starchy vegetables included in the Paleo diet may provide plentiful carbohydrates to adherents, depending on the amounts of these foods that the person consumes.
How does Robb Wolf’s definition of Paleo differ from Cordain’s?
Robb Wolf is the well-known author of The Paleo Solution. His version of Paleo is very similar to Cordain’s, except he explicitly adds starches and alcohol to the “avoid” list. He emphasizes that “all of this is highly individual,” and those starchy vegetables (including white potatoes) may fit into this plan, depending on the person’s preferences.
There is an argument made on Wolf’s site that people may feel better with Paleo because the diet cuts out common allergens. However, half of the top eight allergens (eggs, tree nuts, fish, and shellfish) are permitted on Paleo diets, so that does not provide a full explanation for why someone might feel better eating this way.
How does Mark Sisson’s Primal Diet fit into all of this?
Mark Sisson is the author of The Primal Blueprint and the founder of Mark’s Daily Apple. Sisson’s Primal Diet includes foods common to the Paleo diet, plus dairy (if tolerated), rice, peanuts, and possibly potatoes. Both the Paleo Diet and Mark Sisson’s Primal Diet fall under the umbrella category of “ancestral diets” because they are all more greatly aligned with the diet of our ancestors, as compared to the typical American diet.
Of the three plans outlined above, my preference is for the Primal Diet, because it includes a greater range of foods for adherents to choose from. Including some dairy products in the Primal Diet makes it easier to meet calcium recommendations, as compared to those following a Paleo pattern. This is an important consideration because calcium is a nutrient of concern with this way of eating, as will be discussed below.
What are 3 major benefits of adopting a Paleo diet?
Perhaps it is not surprising, but there are a lot of good things that can be said about Paleolithic nutritional patterns. Getting familiar with the advantages can help you determine whether this way of eating is appropriate to help you meet your goals.
The Paleo diet focuses on nourishing whole foods. Though the Paleo diet does not align with the current Dietary Guidelines for Americans because it eliminates the grains group and (most likely) dairy, that does not mean it cannot be a healthy eating plan.
There are many advantages to focusing on obtaining nutrients from minimally processed whole foods rather than enriched and fortified foods. Unlike many ultra-processed foods, whole foods are rich sources of non-essential nutrients that may promote health, such as the polyphenols and the omega-3 fatty acid DHA. Often, these nutrients will behave in more beneficial ways in the body when consumed as part of their natural food matrix, as opposed to when they are consumed as isolated nutrients.
In addition, over 70% of the sodium that Americans consume currently comes from processed foods and restaurant foods, not the salt shaker. Sticking with minimally processed food choices, such as with a Paleo diet, may help those who are on medically prescribed low-sodium diets.
The Paleo diet eliminates many of the foods that people may overeat, potentially making maintaining a healthy weight more easily achievable. This diet eliminates the white sugar, refined grains, and industrial seed oils that are highly prevalent in the grain-based desserts that Americans tend to overeat. Displacing these foods with nutrient-rich whole foods that contain plenty of satiating protein, fiber, and water may help to promote healthy weight management.
For those who are trying to maintain a healthy weight and need additional support, a health-minded Paleo community can be found within many Crossfit programs, as well as conferences such as Paleo f(x). It is also a good idea to work with a dietitian who is supportive of your goals.
Though many bogus claims have been made online regarding the health benefits of adopting a Paleo diet, there are some indications in the scientific literature of Paleo’s potential to improve health. For example, a 2015 systematic review and meta-analysis found greater short-term improvements in the components of metabolic syndrome in those following a Paleolithic nutritional pattern compared to those following guideline-based control diets.
The components of metabolic syndrome are high waist circumference, elevated blood pressure, low HDL cholesterol, high triglycerides, and high fasting blood sugar. Improving these factors, whether through a Paleo diet or other means, may help to reduce a person’s long-term chronic disease risk, particularly for heart disease, type 2 diabetes, and stroke.
A 2019 systematic review and meta-analysis provides additional support for the 2015 findings, linking the Paleolithic diet to the lessening of certain cardiovascular disease risk factors. However, the authors caution readers that “the evidence is not conclusive and more well-designed trials are still needed.”
Since physical health is only one component of overall wellness, it is also important to note that a 2019 study found those following a Paleo diet to have more positive psychological characteristics compared to a group without food restrictions. The Paleo group reported lower levels of eating disorder symptoms, food cravings, emotional eating, and negative affect. Though this is cross-sectional data that we cannot infer causation from, it does provide some insight into psychological risk factors (or lack thereof) in persons who choose diet patterns that restrict food types.
What are the 3 major pitfalls of Paleo, and how can they be avoided?
To make the most of any diet pattern, it is important to be aware of both the positive and negative factors. If you are interested in this way of eating, educating yourself on the potential pitfalls is one of the best ways to avoid (or minimize) them.
Calcium may be a nutrient of concern for those following Paleo, but a well-planned Paleo diet can meet your needs. Because Paleolithic diets typically restrict dairy products, health practitioners are cautioned to warn patients about the risk of under-consuming calcium on this diet.
The recommended dietary allowance (RDA) for calcium is 1,000 mg for both men and women aged 50 and younger. Though foods like yogurt and cheese that may fit a Primal Diet contain plenty of calcium, there are other calcium-rich foods that align better with the Paleo way of eating. These include:
- Sardines canned with the bones
- Salmon canned with the bones
- Calcium-fortified dairy alternative beverages and calcium-fortified juices (if these fit the person’s diet)
- Turnip greens
Many of the greens that contain calcium and are most common in the United States, such as spinach and collard greens, contain high levels of oxalic acid that inhibit the absorption of calcium. These foods should not be relied on as the primary source of calcium in the diet.
Ensuring that you are not vitamin D deficient can help your body to increase calcium absorption from the above foods. While 30-35% of dietary calcium is absorbed in a person with sufficient vitamin D status, this absorption rate drops to only 10-15% in those who are vitamin D deficient.
Few foods naturally contain vitamin D, though salmon, sardines, and tuna are some Paleo-friendly options. If you have limited sun exposure due to living in a northern latitude or spending little time outdoors, supplementation of vitamin D may be needed to prevent deficiency of this essential vitamin.
Without grains and legumes, there is a risk that fiber intake may not meet recommendations. Though the B vitamins from the grain group can largely be obtained from meats, poultry, and fish, it can be more challenging to replace the fiber found in grains and legumes.
The recommended intake for fiber for women aged 50 and under is 25 grams per day, while for men aged 50 and under it is 38 grams. Luckily, there are plenty of Paleo-friendly foods that are rich in fiber, and by including some of these foods in your diet daily, you can ensure that you are getting enough fiber with this way of eating. Here are some fiber foods to focus on:
- Pumpkin seeds (and other seeds, such as chia seeds)
- Almonds (and other tree nuts)
- Collard Greens
- Sweet potatoes
Need additional ideas to help you boost your fiber intake? A more extensive list of food sources of dietary fiber can be found on the website for the Dietary Guidelines.
There are criticisms that the Paleo diet may be costly to both your wallet and to the environment. Cost modeling suggests that the Paleo diet is about 10% more expensive than a comparison diet with similar nutrient value, likely because some of the most inexpensive whole foods (legumes, grains, dairy) are eliminated on Paleo. Adherents to this way of eating can use smart shopping strategies, such as bulk buying, to help bring food costs down.
Additionally, though environmental sustainability is a complex topic that is beyond the scope of this article, there is some research showing that a Paleo diet may have a larger carbon footprint than diet patterns which are more plant-based. If it is within your means, shifting your diet towards choices that result in lower greenhouse gas emissions (e.g., more plant foods, choosing grass-fed beef over conventionally raised) may help you to achieve a more planet-friendly version of Paleo.
Even though there is insufficient historical evidence to support the Paleolithic diet, a well-planned diet comprised of minimally processed whole foods is likely to be a far better choice than the standard American diet, no matter which Paleo figure’s guidelines you adhere to. Finally, if you need healthy recipe ideas to support the Paleo way of eating, don’t miss our suggestions in the recipe section of the website. You’ll be on your way to better health, caveman style, in no time.
Summer is a registered dietitian located in Avon, Connecticut where she specializes in weight management, special diets, general nutrition, and avoidant/restrictive food intake disorder (ARFID). She is the developer and content creator behind the Summer Yule Nutrition website, where she shares evidence-based information on hot topics in food and nutrition.