The Paleolithic Prescription ~ 60:20:20 Template

Over the past few years, I've accumulated quite the collection of older books, ranging from texts to mass-media diet books.   Thank you Amazon which is my source for 90% of these finds.  I'm not sure why I hadn't gotten it before, I did purchase The Stone-Age Health Programme around a year ago, but for some reason I only just now got a copy of The Paleolithic Prescription. My Stone-Age has gone temporarily missing, but these appear to be the same book, or contain similar tables and such, and I'm pretty sure Stone-Age is/was a British version of Prescription.   Here's a cellphone snap of Table XVII, a day's worth of "Paleolithic" Food from the other book that I had tweeted out last March (it is identical in the two books).  Here's a direct link to the image.  It's blurry, I didn't have much luck quickly getting a better image from this book, so it will just have to do.  You'll have to zoom in with your browser, but you'll be able to make out the following:
  • 65% Veggies, 35% Animal
  • Carb 55% , Protein 26% , Fat 19%
  • An insidiously fattening 400 grams of carb!
  • PUFA:SaFA ratio 1.35
  • Whole wheat bread, oatmeal, oat bran and wheat bran
  • Lean meat
  • Orange juice
  • Skim milk, low fat cottage cheese
  • Corn oil margarine

I admit to being rather shocked by this myself.  So I did a little more skimming of this book than the other, and in the last chapter, you find some guidelines and take-aways from the material presented on the first 264 pages.  This chapter is entitled The Paleolithic Prescription: Old Ways, New Prospects.  You actually have to wait another 10 pages of explanations and convincing for the advice under the heading Nutrition:

Our nutritional protocol attempts to balance the dietary patterns of our ancestors with twentieth-century food availability.
Carbohydrate should provide about 60 percent of an average day's calories; sugar and refined flours should be minimized while fruits, vegetables and whole grains -- sources of complex carbohydrates -- should be emphasized. 

Protein should constitute about 20 percent of average daily calories and should come from low-fat sources.

Fat should constitute the remaining 20 percent of each day's calories.  More should be polyunsaturated than saturated; avoid butter and lard as well as highly saturated coconut, palm, and palm kernel vegetable oils.

There you have it.  60:20:20.  While the book contains information on how grains are relatively new to the human experience, for the most part they were not demonized as digestive devils based on a litany of toxicants (none of the usual suspects appears in the index, nor in my skimming of the sections on wheat and corn).   Rather, whole grains should be "emphasized".  These recommendations are preceded by the following:
The following life-style recommendations are based on our current understanding of what life must have been like during the Late Paleolithic (generally between 35,000 and 20,000 years ago).  They are also balanced as closely as possible with the consensus views of mainstream scientists and physicians concerned with health promotion and disease prevention.  They have been modified still further to accommodate the realities of life as most of us experience it today.  They are intended to be practicable, not ideal and unattainable.
Agree or disagree with this approach, it was the one put forth in a mass media book by the originators of "paleo", based on their own groundbreaking 1985 paper.  The macro ratios in Prescription were clearly a concession to the consensus, but here's the summary table from their 12 year update.  But, much of the differential would swap carb out for protein where almost 200g protein would already be an ample intake.

When S.Boyd Eaton addressed the audience at AHS12, his presentation included this slide -- to the gasps of many in the audience according to the Twitter buzz.  


Long-Term Paleo: What Happens if You Follow the Ancestral Health Protocol for Thirty Years?

It was clear from both the title of the talk, and his demeanor in delivery, that this was, indeed, the prescription he had followed for himself.  

Templates ...

Re-read the paragraphs above if you need to in order to grasp the spirit of Eaton, Shostak and Konner.  They were the original keepers of the template. Perhaps the macros in practice were a bit more Zone-like than USDA-like, but they most certainly weren't in any way, shape, or form, like the modern "template" where one can add in high fat dairy, or -- gasp!! -- legumes without drawing the ire of Father Cordain and the keepers of his Paleo Diet Church.   With The Paleo Diet, Cordain turned paleo into a carbophobic, food fearing elimination diet.  Oh, he always allowed for a free meal here and there, just so long as you understood you were poisoning yourself with each pancreas and intestinal taxing bite!

No, these folks were about to transitioning away from processed foods and an increasingly sedentary lifestyle, back to a simpler approach based on real whole foods and greater activity.  They recognized the latter as often needing to be purposeful, hence called it exercise.  There was no 30 day challenge nonsense.   No 21 day detox.  No used car salesman crap.   No mention of leaky gut.  No need to eliminate pet toxicants from the diet so as to "heal" something real or imagined, or that you never knew you had.   There was absolutely no mention of the need to deliberately exercise in order to "allow" yourself to eat a potato, and, of course the ridiculous notion of fattening fruit (because it turns to fat, so eat your butter!) was nowhere to be found in this book.

They mention insulin and diabetes, and although they put forth an "exhausted pancreas" model (in the genetically susceptible), there is no obsession over carbohydrate causing this need for insulin.  Rather obesity/excess weight resulting in increased insulin secretion is put forth as the culprit.  There actually is mention of caloric intake and expenditure.  

It really makes one shake their head with wonderment over where in the world Cordain picked up his ideas about diet (and exercise).  While ship jumpers blame paleo branded goodies for the downfall of their vaunted movement, perhaps the roots lie far deeper.  The spirit of the Paleolithic Prescription was not one of fear mongering over toxins in real foods, nor was it about demonizing particular foods to the point of calling them "murder" or not-human-food at all.  I can think of no better activity to deprogram from today's paleo brainwashing than to read this book either before or after the ridiculous Hartwig book It Starts With Food.  This is what is wrong with paleo.  Perhaps even less so, ironically, than the paleo cookies and cream.

Lastly, the exercise portions of the book call for an unsurprisingly balanced approach of being more active in general, aerobic exercise and strength exercise.  Missing from the book is a tone of any sort of exercise activity being the "wrong kind", or that somehow wearing Vibrams while constructing cheerleader pyramids and giving each other piggyback rides, or perhaps crawling through Central Park, makes someone an enlightened playful Grok.   


Hi, Evelyn.

"The Paleolithic Prescription" was written in 1988. Eaton and Konner updated their concept of the "estimated ancestral diet" diet in an article published in 2010. Some tidbits:

- Carbohydrates, % daily energy 35-40

- Protein, % daily energy 25-30

- Fat, % daily energy 20-35

- Added sugar, % daily energy 2

- Fiber, g/day >70

- EPA and DHA*, g/day 0.7-6

- Cholesterol, mg/day 500+

- Sodium, mg/day under 1,000

- Potassium, mg/day 7,000

I saw the video of Eaton's AHS2012 presentation a while back. If memory serves, he thought legumes were acceptable, too.


Reference: Konner, Melvin and Eaton, S. Boyd. Paleolithic Nutrition: Twenty-Five Years Later. Nutrition in Clinical Practice, 25 (2010): 594-602. doi: 10.1177/0884533610385702
charles grashow said…
Everyone knows that LCHF diets work. the N=1 experiments prove that.

Here's one that proves the opposite.

SO - as a result of her stupid husband's stupid diet Christine has gotten Hashimoto's AND kidney stones!!
Lighthouse Keeper said…
Whilst we are on the subject of Paleo, one truly mourns the passing of the Ancestral Health Symposium which has breathed it's last breath.
River Rance said…
Why is she smiling? There is no cure for Hashimoto's thyroiditis...kidney stones are painful....if she was a child...then Jimmy Moore would be guilty of
Munchausen syndrome by proxy, which is considered child abuse and a crime in most states...but since they are adults she no doubt has Stockholm Syndrome. I can only imagine what must be lurking in his body. It's probably not going to turn out good for either...his behavior has always perplexed me, and he certainly has had his share of enabling from other hucksters like himself
carbsane said…
Thanks Steve, Yeah, this post repeats some of what I posted a while back, but this post was just to highlight what was in the original book.

Some of the macros may have shifted a bit, but Eaton most certainly has not switched to the bacon and butter, Big Fat Surprise (Lie) side of things. The "paleo diet" clinical trials have been similar. In most cases lower in carb, but not low carb, and the difference more in protein than fat. The fat content of paleo in clinical trials tops out at 40% and sat fat of 11% is the highest I've seen -- and most if not all of these were in caloric deficit = absolute reduction.
carbsane said…
You're right RR. There is definitely a Stockholm Syndrome thing going on, and were she a minor he could definitely be charged. Her health has done nothing but decline since she has adopted his diet more and more fervently. Sad none of her friends or family see it. :(
Emmie said…
I am not defending the "Moore nutty diet," but to be accurate, there is virtually no connection between Hashi's and diet. Hashimoto's is an auto-immune disorder that affects mainly females and has a strong genetic connection. I have Hashi's, and according to my excellent endo, what or how one eats does not incline one to this disease.

I've also known people who get kidney stones who eat a variety of diets, including SAD. There seems to be a specific propensity to kidney stones so that someone eating and identical diet would NOT develop the stones.

Everything in life is not related to diet. In fact, most physicians I know attribute most problems to genetics.
Lighthouse Keeper said…
It makes one wonder what is going on here, Hashimoto's seems to be almost run of the mill conversation in the low carb/paleosphere even though prevalence in the population is much less than one percent. Most "men in the street" have probably never heard of it .
Lighthouse Keeper said…
This is low carb absurdity writ large, kidney stones - risk factors include high consumption of animal protein.
blipton said…
I'd be interested to see your take on the book 'The Compass of Pleasure'. There's a chapter in particular ('Feed Me') that goes into the mechanics of how satiety, insulin, leptin all interact to determine weight gain/loss.

Also do you have plans of writing a book? It'd be nice to see a book that offers a different scientific viewpoint that of Taubes' book 'Why We get Fat', or Naughton's documentary 'Fat Head'. It'd be great food for thought for all those people who follow Keto diets!
charles grashow said…

An interview with Jimmy and Christine Moore on the 2013 Low-Carb Cruise
Emmie said…
Perhaps only people who regularly post online AND are concerned with their health comment on their thyroid issues, but I have many friends who have Hashi's and only talk about it with close friends. I just happened to go to a new dentist last week, and when the hygienist looked at my basic paperwork (that asked about medical issues), she said, "I not only have Hashi's too, I take exactly the same Rx that you do." It's far more common than 'just' in the lowcar/paleosphere.
Lighthouse Keeper said…
Well it is said it may be under diagnosed but most medical authority statistics put medically diagnosed sufferers at 0.3 to 1.5 per thousand, so that begs the question as to who else is diagnosing those undiagnosed by the medical profession.
Kitty said…
Wow. He wanted to be a muscular 210 lbs and see his abs. Now he can't get below 300 lbs because of "metabolic dysfunction" and is thrilled that he's so healthy.
charles grashow said…
To all of the people in the LCHF community who boast about their high HDL-C levels
Progression of Carotid Atherosclerosis Associated With Cholesterol Overloaded HDL-P | ACC

Led by Yue Qi, MD, PhD, the study examined the ratio of HDL-C to HDL-P in participants taken from the Chinese Multi-provincial Cohort Study-Beijing Project. At baseline, there were 930 participants, ages 51 to 67, with complete data from two previous examinations who did not already have cardiovascular disease. Researchers found that the prevalence of carotid plaque was 20 percent at baseline, with the mean HDL-C level and HDL-P number at 1.40 mmol/l and 30.3 µmol/l, respectively.

The results of the study showed that “very high levels of cholesterol-overloaded HDL-P are independently associated with the increased risk of carotid atherosclerosis.” After the five year follow-up period, 53 percent of participants developed new-onset plaque, while 49 percent of participants with no baseline plaque had incidence of new-onset plaque. Further, researchers found that participants who had both the highest HDL-C and the lowest HDL-P numbers were at higher risk for plaque progression than those with both the highest HDL-C and HDL-P numbers.

The authors of the study state that the results “suggest that HDL-C indicates the cargo of HDL particles, and may... reflect the potential for reverse cholesterol transport if the undesirable effects of cholesterol-overloaded HDL-P can be removed.” They conclude that cholesterol-overloaded HDL-P may be a strong indicator of carotid atherosclerosis risk, making an individual with a high HDL-P number more likely to develop atherosclerosis.
Carotid Atherosclerosis Predicted by Cholesterol-Overloaded HDL Particles
Cholesterol-Overloaded HDL Particles Are Independently Associated With Progression of Carotid Atherosclerosis in a Cardiovascular Disease-Free Population: A Community-Based Cohort Study.
charles grashow said…
Well as he's said he was a large baby so his genetics are the cause for his inability to lose weight. Has nothing to do with ANYTHING else - he's a prisoner of his genetics and NOTHING can be done.
Scott Peterson said…
60:20:20? That's....OMG...people can do it!!! It won't cost us $200 every time we go to a Whole Foods market.

Wow, what a relief. I can be Paleo and stay on my budget!
Man said…
If you want to eat "paleo", just eat the whole natural foods you can find (hunt / gather), regardless of their macro partition, avoid constant binging / gluttony and remember that you were given a body that is meant to move some. Why is it so hard for many people to understand that ?
carbsane said…
This seemed to be the spirit of this book as even though they gave macro ratios, it wasn't really stressed. It was also more overall lifestyle than just diet particulars.
carbsane said…

This is what ticks me off. Has "The Myers Way" fixed Christine? Oh of course not. The "Paleo Mom", , who has written a book on AI and follows AI protocol for her other myriad AI she claims it treats, just now thought to get tested for Hashi antibodies? Not to mention apparently the AI helped for squat then ... right?

That said, I really do wonder about the seemingly high rates of Hashis in the low carb world. Also "subclinical" thyroid that ends up getting "properly diagnosed" and "treated". When I was on Jimmy's forum, reports of needing to increase thyroid meds were not infrequent. Is it possible that the non-pathological downregulation of thyroid by LC can unmask pathological issues? I don't know. I'm not saying it does. I just find it curious.
Thomas said…
He's a prisoner of his own psychopathology. Which may indeed be genetic. :)
carbsane said…
Sorry my link showing Myers' book was to Jimmy's FB page announcing his review of her book:
carbsane said…
I have some ebooks in the works, and need to get my first one back out there, but trying to balance time between "real life" and this has been more than challenging this past year. Maybe this year ;-)

I'll see if I can get a copy of that book!
Karin said…
- Potassium, mg/day 7,000

Really?? I've actually been trying to focus lately on getting enough potassium every day. I have a really hard time doing this without eating a boatload of calories. Basically, the only way I can get my daily potassium up to 4000 mg/day and keep my calories under 2000 is by including potatoes in my diet every day. Maybe I could do it with bananas if I liked them more. So, I went to fitday to see if I could figure out how to make the potassium add up to 7,000 mg, and keep the calories under 2000. I ended up using 2 pounds of potatoes in order to do it. That adds up to about 800 calories (without any added fat), and that gives some room for proteins, fruits and veggies, maybe a little dressing, etc. I couldn't get all the RDAs to come up to 100%, but I got close. A person would have to do this Every Day in order to get 7,000 mg/day of potassium. There are probably other ways, but this would not be as easy as it sounds. I encourage people to plug their typical diet into fitday (or similar), and see what the potassium adds up to. It's probably lower than you think.
Wuchtamsel said…
Well I guess that's just a marker for the degree of hypochondria and sissyness in this "subculture". Look at other forums of obscure health beliefs and you'll find they are full of (in many cases self-"diagnosed") Hashimoto, alongside of many invented "diseases" like "adrenal fatigue", "overmethylation", "Multiple Chemical Sensitivity" and so on.
Hashimoto is a VERY common disorder and these LC-guys just like to carry it around like a monstrance. And they of yourse believe that EVERY malaise has its root cause within this one disorder. Hashimoto is, while not "curable" in the true sense of the word, a pretty ease to control problem and not such a big deal. I have it myself since childhood.
carbsane said…
Thanks for sharing this ...

I have a long standing question with how a lot of their nutritional estimates were arrived at. For example, the O6:O3 ratio of 1:1, or how low fat and low sat fat (which isn't cholesterol but tends to go hand in hand with animal fats, and especially saturated animal fats) could feasibly be higher in cholesterol than modern SAD. Also fiber and vitamin C ... where is all of this coming from?
Karin said…
Yes, I guess that was my question too. He seems to have data to back up the macros, but the source for everything else is much less clear.
Lighthouse Keeper said…
There is a certain gestalt at work whereby certain diseases or disorders are pushed to the fore as a "poster child" for a dietary regime that purports to have unique powers to control or cure it.
beallen0417 said…
I think the following study would suggest otherwise. Neu5GC is a major component of low carb diets and it has been linked to Hashimoto's.
Emmie said…
I totally agree about the prevalence of 'conversation' about thyroid issues and the ubiquitous "adrenal fatigue' among the low-carb nuts is a marker for their overall hypochondria and basic idiocy.

The Wilcox/O'Hearn blog Ketogentic Diet for Health currently has an analysis of why the T3 thyroid hormone is lower for someone eating low carb--and it's perfectly normal. However, the low carbers who now believe that MORE fat is essential to life and complain that they 'can't' lose, immediately blame the thyroid and hassle doctors into a diagnosis based on their 'low T3.' They also claim that T3 must be at the 'high end' of the lab range to be 'normal.' This is all internet nonsense.

I have Hashi's, and my T3 is regularly below the half-way mark of the lab range--and that's perfectly normal for me. That's why the labs have 'ranges'--to include variations among individuals.

But, of course, it must be thyroid if I'm not losing weight. It couldn't possibly be all that heavy cream and coconut oil and cream cheese that I'm eating because we all know that calories don't count and FAT IS GOOD.

Yes, the prevalence of thyroid 'issues' among low carbers is basically due to their refusal to believe that they're not losing because they're eating too damn much. It has to be the thyroid.
Emmie said…
According to any measure, I never eat enough 'potassium' to get a minimum, yet I have bloodwork every 4 months (my thyroid check up), and my potassium levels are always ideal.

I think there's too much focus on measuring thanks to all those internet sites that tell you how much you need, etc. People are becoming unnecessarily obsessive, IMO.

For example, my siblings are all Type 2 diabetics, and I feared the disease more for the need to do daily blood checks than for anything else. Now I read on the internet that people who are NOT diabetic are checking their blood glucose regularly--yet they have no idea what the numbers mean (that's why they post--to ask). This boggles my mind. If you have concerns, the best thing is to get an A1C every six months or so--NOT prick your finger 3x a day!
Emmie said…
"Major component of low-carb diets"? I don't see that in this article.
In fact, correlation does not equal causation--this article is speculative at best.

My own Hashi's was diagnosed while I was eating a rather high-carb diet (standard American), and I have friends with Hashi's who have never low-carbed at all.
Karin said…
I agree, but I did have a low potassium on my blood work a while ago. However, the problem was probably that I was drinking too much water, and maybe not that there was something wrong with my diet. I probably was being a little obsessive about the potassium at one point, and I've backed off on that. I rarely hit my 4000mg/day target anymore (I like potatoes better than bananas but I was getting a little sick of them), and the potassium on my last blood work was normal. I keep seeing these really high recommendations everywhere, and since I have trouble even hitting 4000mg/day, the 7000 recommendation really seemed insane, and I just had to comment.
Karin said…
I suppose I could do that. I did buy some No Salt, but I read a few horror stories about people overdosing on it, and decided not to use it.
Thomas said…
"There is definitely a Stockholm Syndrome thing going on..." Now that you mention it, that's EXACTLY what that smile seems to be suggesting. That or some sort of thought suppression.
beallen0417 said…
Any mammalian meat (a major component of the SAD and low-carb diets) as well as any dairy product (a major component of both again) will contain lots of Neu5GC. Read Dr. Varki's work to get up to speed on this.
Emmie said…
Both are common to the SAD diet, so it's not specific to low carb. In fact, I eat low carb and NO dairy and very little meat (prefer fish).

Moreover, the article you cite is about correlation--NOT causation.
Gordon said…
"... Also fiber and vitamin C ... where is all of this coming from?"

Here's a good example of far you can push confirmation bias ...
LWC said…
Charles, thank you for posting this research. I'm not a low carber, but my HDL is off the charts high (>100 the last time it was measured). My total cholesterol is moderate (hovering near, but touching my insurance company's "alert" zone). My LDL is low, so my doctor doesn't fuss, but I've been wondering if there is such a thing as "too high" HDL. Whenever I would research "elevated HDL" all I'd get were papers on why higher HDL is better.

Just wanted to say thank you again for your contributions here.
carbsane said…
I second that thank you!
billy the k said…
"...the best thing is to get an A1c every six months or so—NOT prick your finger 3x a day!"
Pre and Post-meal BG testing, alas, will probably continue to be a necessity for folks with
blood glucose concerns:

Chris Kresser posted the following re the Hemoglobin A1c test:

"The theory behind the A1c test is that our red blood cells live an average of three months, so if we measure the amount of sugar stuck to these cells it will give us an idea of how much sugar has been in the blood over the previous three months...

While this sounds good in theory, the reality is not so black and white. The main problem is that there is actually a wide variation in how long red blood cells survive in different people. [Kresser cites a study in Diabetes Care Journal]...shows that red blood cells live longer than average at normal blood sugars. Researchers found that the lifetime of hemoglobin cells of diabetics turned over in as few as 81 days, while they lived as long as 146 days in non-diabetics.

This proves that the assumption that everyone’s red blood cells live for three months is false, and that hemoglobin A1c can’t be relied upon as a blood sugar marker. In a person with normal blood sugar, hemoglobin will be around for a lot longer, which means it will accumulate more sugar. This will drive up the A1c test result – but it doesn’t mean that person had too much sugar in their blood. It just means their hemoglobin lived longer and thus accumulated more sugar. The result is that people with normal blood sugar often test with unexpectedly high A1c levels..."
billy the k said…
Regular visitors to the Carbsane website certainly know that Kresser isn't an MD, but the peer reviewed studies that do manage to get published in Diabetes Care shouldn't be as easily dismissed, which is to say that while the HgA1c test is not as reliable as is commonly assumed, it is of course still worthwhile. True enough, fasting BG can be [misleadingly] all over the map. But pre-meal and 45 minute post-meal and 2 hour post-meal BG values still remain the only way we can see the effects that a particular meal has on our blood sugar. This is not a silly, useless test. Even though here as well one must of course use one's brain to avoid incorrect interpretations of the numbers revealed on one's meter.

The point you made above is really the key factor in these BG finger-prick tests or HgA1c tests—whether [or not] the people doing them have a clue about what they're doing. And that includes actual physicians.
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