Paleo Diet Overview

Scorecard

Overall
Weight Loss Short-term
Weight Loss Long-term
Easy to Follow
Nutrition
Safety
For Diabetes
For Heart Health

Scores are based on experts' reviews

Pros & Cons

  • Carnivore approved
  • Very low in sodium
  • Goodbye to grains and dairy
  • Pricey

Do's & Don'ts

Don’t: Eat bread—or anything made with grains See more Do's & Don'ts

Overview

Type:

Low-carb.

Resembles these U.S. News-rated diets:

Atkins, Eco-Atkins

The aim:

May include weight loss and maintenance, and prevention or control of many “diseases of civilization,” like type 2 diabetes and heart disease.

The claim:

You’ll lead a healthier, fitter, disease-free life.

The theory:

Our highly processed, carb-obsessed eating pattern is the culprit behind many of our biggest health ills, so why not go back—way back—to the Paleolithic period of more than 10,000 years ago, when our diet wasn’t full of junk food and pasta? Paleo advocates say we should eat the way we ate when we were hunting and gathering: animal protein and plants.

How does the Paleo Diet work?

Paleo diets are based on a simple premise—if the cavemen didn’t eat it, you shouldn’t either. So long to refined sugar, dairy, legumes, and grains (this is pre-agricultural revolution); hello to meat, fish, poultry, fruits, and veggies. What you eat and how much depend on your goals or the specific program you’re on, if you choose to follow one.

You can find most of what you need to know online, but a book makes a handy reference. The Paleo Diet, for example, outlines basic Paleo principles and offers three “levels” that allow for different degrees of cheating—three “open meals” per week on the “entry level” plan, two on “maintenance,” and just one on “maximal.” Depending on the level, you might also get “transitional” condiments (low-fat dressing and salsa) and drinks (coffee, beer, or wine in moderation) to wash down the meat and plants. You can use the levels as you like. Start with the first and move gradually to the more restrictive—or just stay put. For more dramatic changes, head right to the third.

Will you lose weight?

No way to tell. Paleo diets haven’t yet drawn the attention of many researchers. One tiny study that looked at weight loss found that 14 participants lost an average of about 5 pounds after three weeks on a Paleo regimen. (But even the researchers called their study “underpowered.”) Still, if you build a “calorie deficit” into your Paleo plan—eating fewer calories than your daily recommended max, or burning off extra by exercising—you should shed some pounds. How quickly and whether you keep them off is up to you.

Does it have cardiovascular benefits?

Unknown. While some studies have linked Paleo diets with reducing blood pressure, bad “LDL” cholesterol, and triglycerides (a fatty substance that can raise heart disease risk), they have been few, small, and short. And all that fat would worry most experts.

Can it prevent or control diabetes?

Unknown.

Prevention: Being overweight is one of the biggest risk factors for type 2 diabetes. If reverting back to the Paleo era helps you lose weight and keep it off, you’ll stand a better chance of staving off the disease.

Control: One small study comparing a Paleo and a traditional diabetes diet in 13 type 2 diabetics showed the Paleo diet resulted in lower levels of hemoglobin A1C, a measure of blood sugar over time. The approach needs to be studied more before strong conclusions can be drawn, but most diabetes experts recommend a diet that includes whole grains and dairy products.

Are there health risks?

Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients. Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems.

While there are no specific dieter restrictions, you’ll want to consider talking with your doctor before making changes to your meal plans.

How well does it conform to accepted dietary guidelines?

Fat. At about 39 percent of daily calories from fat, a sample Paleo menu exceeds the government’s 35 percent cap by a bit.

Protein. The government recommends 10 to 35 percent of daily calories come from protein; the Paleo diet clocks in around 38 percent.

Carbohydrates. At 23 percent of daily calories from carbs, it’s far below the government’s 45 to 65 percent recommendation.

Salt. The majority of Americans eat too much salt. The recommended daily maximum is 2,300 milligrams, but if you’re 51 or older, African-American, or have hypertension, diabetes, or chronic kidney disease, that limit is 1,500 mg. You won’t have trouble staying under either goal; cavemen didn’t have table salt and high-sodium processed foods, and fresh produce is virtually sodium-free.

Other key nutrients. The 2010 Dietary Guidelines call these “nutrients of concern” because many Americans get too little of one or more of them:

  • Fiber. Getting the recommended daily amount of 22 to 34 grams for adults helps you feel full and promotes good digestion. With such a heavy emphasis on fruits and veggies, you’ll exceed your target.
  • Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss, and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) The majority of Americans take in far too little. A sample Paleo diet was nearly double the government’s suggested goal—one of few diets that manages to do it.
  • Calcium. It’s essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 to 1,300 mg. Because you’re not allowed dairy or fortified cereals, you’ll likely only get about 700 mg. from a Paleo menu.
  • Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. You’ll have no trouble meeting the recommendation—fish and meat are B-12 powerhouses.
  • Vitamin D. You’ll get very little or none, so you’ll either have to supplement (the non-caveman way) or just make sure you spend enough time in the sun to get the 15 micrograms recommended. Some experts suggest five to 30 minutes of sun between 10 a.m. and 3 p.m., twice a week and without sunscreen, to meet the recommendation, according to the National Institutes of Health.

Supplement recommended? Up to you, but The Paleo Diet recommends vitamin D supplements if you don’t get a decent dose of sun regularly. Fish oil capsules are suggested if you don’t like fish or shellfish. Some sources also suggest a calcium supplement.

How easy is it to follow?

Can you get used to the idea of breadless sandwiches? Or having your milk and cookies without either milk or cookies? Diets that restrict entire food groups are difficult to follow. On the flip side, you can determine how primal you want to be, working in some cheat meals if you want.

Convenience:

Recipe sites and cookbooks are abundant, but you can also incorporate eating out into your Paleo plan. Alcohol is discouraged but OK in moderation. You’ll have lots of sites and books for support.

Recipes. Free sites like Paleo Diet Lifestyle serve up recipes. There’s even The Paleo Diet Cookbook, Everyday Paleo, and The Primal Blueprint Cookbook.

Eating out. Sure, if that means dinner at your neighbor’s cave. While there were no restaurants to tempt our Paleolithic ancestors, you’re free to decide how you’ll work them in. If (or rather when) you do, The Paleo Diet recommends simplicity: Order lean meat or seafood with veggies and fresh fruit and call it a night.

Alcohol. Not part of a true Paleo diet. Following The Paleo Diet, though, you can have the occasional glass of wine or beer during a cheat meal. (Alcohol only adds empty calories anyway, and if you’re trying to lose weight, every calorie counts.)

Timesavers. None, unless you hire somebody to plan your meals, shop for them, and prepare them.

Extras. The Paleo Diet offers sample meal plans and recipes, lists of approved foods, and tips on sticking to the plan while eating out and traveling. You’ll find even more help online, including money-saving tips, quick-start guides, and shopping lists.

Fullness:

Nutrition experts emphasize the importance of satiety, the satisfied feeling that you’ve had enough. You shouldn’t feel hungry on this diet—protein and fiber are filling, and you’ll get plenty of both. One small study of 29 participants published in Nutrition and Metabolism in 2010 found Paleo dieters felt just as full but consumed fewer calories than their Mediterranean counterparts.

Taste:

You’re making everything, so if something doesn’t taste good, you know who to blame.

How much does it cost?

It may be pricey—the produce section and meat counter are among the priciest corners of the grocery store.

Does the diet allow for restrictions and preferences?

Not everyone can follow this approach—choose your preference for more information.

With such a heavy emphasis on meat, this diet isn’t vegetarian- or vegan-friendly.

The diet emphasizes foods that are naturally gluten-free.

You should stay well under even the most restrictive sodium limit.

Yes, you have the freedom to use only kosher options.

Yes, but it’s up to you to ensure your food conforms.

What is the role of exercise?

Recommended. Although they didn’t think of it as “exercise,” hunter-gatherers of the Paleolithic were always on the move.

If you’re following the basic Paleo approach, try to get at least 2½ hours of moderate-intensity activity (like brisk walking) each week, along with a couple days of muscle-strengthening activities. The Centers for Disease Control and Prevention offers tips to get you started.

The Paleo Diet suggests a similar approach, and offers tips to sneak in exercise throughout the day (i.e., getting off the subway a stop early) while reminding you exercise can be fun—if you’re doing something you like.

The author of "The Paleo Diet" comments:

The diet is described as having only been scientifically tested in “one tiny study.” Five studies, including four since 2007, have tested ancestral–or Paleo–diets and have found them superior to Mediterranean diets, diabetic diets and typical Western diets in regards to weight loss, cardiovascular disease risk factors, and risk factors for type 2 diabetes. These studies are peer-reviewed, conducted by various scientists from a large variety of institutions, and published in reputable scientific journals, including the European Journal of Clinical Nutrition, Nutrition and Metabolism, and Cardiovascular Diabetololgy. Many of the studies were not “tiny” and in fact involved the participation of numerous people. A full rebuttal is at http://robbwolf.com/2011/06/11/us-news-best-diets-rebuttal-2/.
—Dr. Loren Cordain, Professor of Health and Exercise Sciences, Colorado State University

The editors respond: U.S. News reviewed the five cited studies and referenced four of them in this profile. The studies were small and short, making strong conclusions difficult. The “one tiny study” related only to weight loss, not to the Paleo diet broadly.


Last updated by Kurtis Hiatt | December 12, 2013

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