Why I Think the Paleo Diet Is Silly

Lately, many nutrition gurus have been promoting what they call a “paleo” diet. The word “paleo” comes from Paleolithic, which literally means “early stone age.” They think that human beings ought to be eating a diet like the diet that people ate during the early stone age. Personally, I think that the arguments in favor of the paleo diet are silly, for several reasons. I think that the appeal of the paleo diet is based on adolescent male fantasies of being an unwashed, unshaven big game hunter who gets to spend time with a hot-looking maiden in a fur or leather bikini. Real men don’t eat quiche. They eat brontoburgers:

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Low-Fat, High-Carb Diets Reverse Insulin Resistance

Dr. George Lundberg, the former editor-in-chief of JAMA, graciously invited me to coauthor this editorial on how starchy, low-fat diets reverse insulin resistance!

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Humans Are Starch Eaters

Here’s an interesting talk by Nathaniel Dominy, PhD, an Associate Professor of Anthropology at Dartmouth University. He explains the central role of diet in the amazing worldwide success of the human species. If you can’t find enough to eat, you can’t do any of the other things that you would need to do to help you and your children survive.

He makes several important points. One is that human beings are behaviorally “plastic.” He uses the term “plastic” in the scientific sense, meaning that something can take any shape. Our behavior is “plastic” because it can easily be reshaped. As he pointed out, human beings can adapt to many different climates because we have learned to make and wear clothes. We can also learn to eat lots of different foods.

One type of food that is available everywhere except the Artic is starchy foods. All of the energy in our diet comes from sunlight, which green plants use to make glucose out of carbon dioxide and water. Plants then store a lot of this glucose in the form of starch, often in their roots or tubers and in their seeds. Unfortunately, starch is hard to digest. To digest it, we use amylase, an enzyme that converts the starch back to glucose.

Dominy suspects that our ancestors’ ability to recognize and use tuber-forming plants opened up a food source unknown to other primates. “It’s kind of a gold mine. All you have to do is dig it up.

Dominy points out that, when compared with other primates, human beings have extra copies of the gene for the starch-digesting enzyme amylase. As a result, we have a lot more amylase in our saliva than gorillas or chimpanzees do. People from societies that depend heavily on starchy diets have several more extra copies of the amylase gene and therefore produce a lot more amylase in their saliva. In other words, they have become genetically more efficient at digesting starches. This kind of change can be seen in genetically related populations that have been adapting to different diets for only a few thousand years.

Although humans can and do eat practically anything (we are behaviorally plastic), that doesn’t mean that we are well adapted to a meat-based diet. As he puts it, “Anatomically, we’re not adapted to meat at all…. We simply don’t have the adaptations that you would need to chew meat efficiently. Anyone can look at the teeth of their dog or cat and see what your teeth should look like if you’re going to eat meat. Our teeth don’t match.” Dominy concludes, “The fundamental component of the human diet is a mix of plant foods, with a large amount of starch coming from tubers and seeds.”

In this context, I’d point out that the adaptations to a meaty diet go far beyond the shape of the teeth. Even though dogs often eat a fatty, meaty diet, they generally don’t get high cholesterol or atherosclerosis unless they also have a thyroid disorder that upsets their cholesterol metabolism. In contrast, human beings that eat a fatty, meaty diet are much more susceptible than dogs are to high cholesterol and atherosclerosis. That explains why atherosclerosis is the leading cause of death in the United States but practically nonexistent in societies where people eat a low-fat, plant-based diet.

Why I Don’t Worry About Sugar

Most of the people I talk to about nutrition are convinced that carbohydrates are their enemy. They think that “sugar spikes” cause diabetes. (They have it backwards. Sugar spikes are the result, not the cause of diabetes!) People seem to be particularly worried about the effects of a sugar called fructose. Personally, I’m not worried about carbohydrates, even fructose, as long as it’s found in an unrefined plant source. I even think that adding a spoonful of sugar or perhaps some maple syrup every now and then could help a lot of people stick to a healthy low-fat, plant-based diet.

Genetically, human beings are almost identical to chimpanzees. Our DNA is almost exactly the same as theirs, which means that our body chemistry is also almost exactly the same as theirs. Since chimpanzees, like many other apes, are mainly fruit-eaters (frugivores), it stands to reason that they probably thrive on a diet that contains a lot of fructose, which is a sugar that is common in fruit. However, the fructose that wild chimpanzees eat is diluted with water and fiber and packaged along with plenty of other nutrients, along with antioxidants and other good things.

Yes, you can make yourself sick by eating too much sugar. However, it would be difficult for most people to get that much sugar from eating fruit! One study found that eating way too much added sugar (at least 25% of total calories!) is associated with only a relatively small increase in the amount of fat (triglycerides) in the blood and a small decrease in the level of HDL (“good”) cholesterol. Of course, if you are having a problem with triglycerides, you should probably cut way back on your consumption of table sugar and high-fructose corn syrup.

Sugar does rot your teeth, at least if you don’t brush carefully after meals. As a result, chimpanzees are prone to dental caries (cavities), just as humans are. However, wild chimpanzees don’t seem to be fat and diabetic and they don’t get heart disease. So why should I imagine that I would get fat and diabetic and suffer from heart disease if I ate a lot of fruit?

Eating lots of sugar does not cause diabetes. Instead, cow’s milk seems to be the culprit in causing type 1 diabetes. A diet that is high in fats and animal protein seems to be the underlying cause in type 2 diabetes.

Eating too many calories from any kind of diet tends to make people gain weight. However, you gain a lot more weight from extra calories from a fatty diet than from extra calories from a high-carbohydrate, low-fat diet. Converting sugar to fat wastes calories. That’s why it’s hard to fatten on carbs but easy to fatten on fats.

Of course, there are a few people with genetic disorders that make it hard for them to tolerate fructose. One of them is hereditary fructose intolerance. Another is fructose malabsorption.

Hereditary fructose intolerance is a potentially fatal genetic disorder that occurs in about 1 out of 20,000 people in European countries. The disorder results from the lack of an enzyme called aldolase B. In people with this disorder, eating anything containing fructose, including sucrose (table sugar), sets off a series of complicated metabolic problems that can ultimately cause liver damage. The only solution is for these people to avoid any foods that contain sucrose or fructose.

Fructose malabsorption is an unrelated problem that is far more common but much less serious than hereditary fructose intolerance. Fructose malabsorption results from the absence of fructose transporters in the cells that line the small intestine. Without fructose transporters, the person cannot absorb fructose from his or her food. Even people who have some fructose transporters might be able to absorb only a limited amount of fructose. The remaining fructose will then remain inside the intestines, where it will be fermented by bacteria. The result is syndrome that looks a lot like lactose intolerance: gas and diarrhea. Fructose malabsorption is a common but often undetected cause of recurrent abdominal pain in children.

Fortunately, I don’t have hereditary fructose intolerance or fructose malabsorption. This means that I can eat as much fruit as I like!


Note: For a clear explanation of how the body handles sugar, see my book Thin Diabetes, Fat Diabetes: Prevent Type 1, Cure Type 2.

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