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Paleo Diets: The Good, The Bad, and The Ugly

By Alison C. Berg, PhD, RDN, LD

Google “paleo diet” and you will have no shortage of results or interpretations on the diet’s guidelines. The term “paleo diet” typically refers to a diet where the individual should only consume what would have been available in Paleolithic times: fish, meat, vegetables, and fruit, but no dairy, grain products, or legumes. The idea behind the diet is that if we eat like our ancestors, we will be lean like our ancestors, and avoid some of the more common modern day health problems like obesity, cancer, and heart disease.

As a dietitian, I will tell you most people in America could probably benefit from consuming more vegetables and fruits, and maybe a few less grains. About three out of every four Americans, ages 2 and older do not get the recommended amounts of fruits and vegetables. Over half of the population eats too many grains (Dietary Guidelines for Americans, 2015). So if the paleo diet helps you eat more fruits and vegetables, that’s probably a good thing. Higher intakes of fruits and vegetables have been associated with reduced risk for many chronic diseases, including high blood pressure and most cancers. That’s the good.

Now for the bad. Many people already eat too many protein foods, like the meat that the paleo diet emphasizes. Most adults need about 5 to 6 ounces of protein foods per day (Dietary Guidelines for Americans, 2015). Many of these protein foods are sources of saturated fat, and higher saturated fat intake is associated with increased risk for heart disease. So if the paleo diet has you eating more saturated fat, then your heart could be in trouble.

Furthermore, about three out of every four Americans don’t consume the recommended amounts of dairy. While dairy gets a bad rap, low fat and fat free dairy products are nutritional powerhouses. Dairy provides calcium, potassium, and vitamin D, which are all nutrients most Americans don’t consume enough of; these nutrients are associated with reduced risk for several chronic diseases. Calcium and vitamin D are essential for bone health, and calcium from dairy foods is easier for the body to use than the calcium found in plant foods. So as a dietitian, I get a little nervous when people want to cut out dairy completely, especially when that person is an adolescent female or a pregnant woman who needs all the calcium she can get for bone health.

So that’s the bad. What about the ugly? For most, this diet is likely not sustainable long term. Many of the foods in the paleo diet require refrigeration and the type of preparation that requires significantly more time. In my experience, “not enough time” is the number one reason people cite for not eating healthy. I worry that well-meaning paleo dieters will become discouraged over another failed diet and stop fighting the good fight to simply eat healthier.

Most importantly, we don’t know if people in the Paleolithic era would have had less heart disease, cancer, or diabetes, as most of them didn’t live long enough to find out! For example, in men, the risk for heart disease starts increasing at age 45 and women at age 55. Most Paleolithic people didn’t make it to 45, let alone 55!

What we do know is this: we need to eat more fruits and vegetables and fewer refined grains; get plenty of exercise, and if this diet helps you do that, then more power to you! Just make sure you don’t replace your pizza with prime rib, and think that’s going to solve everything. And remember, when you move more you live more!