Paleo™ ~ Still a Fad Diet in 2014, and Destined for More of the Same

Whoa boy! Did you hear? US News & World Report listed the Paleo Diet dead last in their "Best Diets of 2014" round up ... AGAIN! I warn you, dear readers, that I'm in a mood, and my snark and sarc levels are quite high as I write this.

Now, I give exactly ZERO credence to these sorts of lists, but I find it pretty darned hilarious that even the vegans and Atkins bested Paleo.  Heck, Dukan!  But there it is ... the nemesis of paleobros and brahs everywhere (especially those who've ever done a WOD) ...da da.h DAAAH ... (cue movie announcer) The ZONE.

Nothing makes the loin clothes bind and chafe more than Zone besting Paleo, even if it's some bunch of loser know-nothing "experts" making the proclamation.   There's nothing like getting dissed, yet again, in the mainstream press to bring out an official Loren Cordain rebuttal followed by a blog post from his petulant "former student", and thus far, 2014 has not disappointed.  First up Cordain goes through a statistical counting rule exercise of all the experiments one would have to do to test each diet head-to-head with each other diet.  I guess he didn't have much to add from the previous rebuttal, so why didn't he just recycle that one?

Whenever something like this comes out, there are generally three kneejerk responses from the paleo community:
  • They misrepresented the paleo diet
  • They ignored all the studies showing that it works
  • Their nutritional science is bad
That middle bullet point usually decried after complaining how they ignore all the thousands of anecdotal testimonials, making both the first and third complaints wildly hypocritical.

First things first, here's the USNWR page specific to the Paleo Diet.  It seems that they are working off of the following macro proportions:  Protein = 38%, Carb = 23%, Fat = 39% though I'm not sure which paleo diet these come from.  Certainly not the Eaton & Konner consensus "smoothie".   So perhaps one of the various paleo clinical trials, that the evaluators did look at.  Here we get a total fat consensus of sorts that is sort of inline with USNWR's 39%, but only one eeks out over the recommended 10% saturated fat.  But protein is consistently lower and carbohydrate is pretty consistently higher.  

is THIS your paleo diet?
We are, once again, back to square one trying to get some sort of definition of the paleo diet.  WHAT IS IT?????   It is hilarious that WAPF's Sally Fallon Morell complains that the paleo diet is too low in fat -- to which the various and sundry paleos protest -- but then when the mainstream complains it is too high in fat ... noooooooooooooooooooooo!  It is not!   

Ahhhh!  Now I see where USNWR gets their ratios!  From The Paleo Diet author himself, as highlighted on page 218 of Robb Wolf's book.  Let me repeat.  This is THE sample diet in The Paleo Solution:  The Original Human Diet   by Robb Wolf, 2010,  that he copied with attribution from the author of trademarked *The* capital-P paleo diet.  

Alrighty then!  So it seems that USNWR basically did a C&P from their eval of the paleo diet from at least two and a half years ago.  The one Cordain rebutted.
It is obvious that whoever wrote this piece did not do their homework and has not read the peer review scientific papers which have examined contemporary diets based upon the Paleolithic food groups which shaped the genomes of our ancestors. Accordingly the conclusions are erroneous and misleading. I feel strongly that it is necessary to point out these errors and make this information known to a much wider audience than those reached by the readers of the U.S. News and World Report.
He lists the studies: 

  1. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.
  2. Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35
  3. Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85
  4. Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson Lindeberg S: A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond) 2006, 3:39.
  5. Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.
  6. O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.
  7. Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685. 
Let's match those up to my table other than the obvious Frassetto and Osterdahl. Lindeberg is #5, but also #3 which was simply a different write-up from the same trial comparing paleo to a Mediterranean diet in ischemic diabetics. Thus, Jonsson is #2. Ryberg is missing from Cordain's 2011 list because it was a 2013 publication. I've addressed these: Frassetto, Lindeberg & Jonsson, Ryberg, Osterdahl

You'll note that #4 is missing from my list.  This is because, last I checked, pig trials don't qualify as human trials.  Also #6 is not on my list.  This is because this wasn't a clinical trial.   It was more of a documented field trip to see what occurs if you take some unhealthy urban Aboriginals and have them hunt and gather for food for several weeks.  Interesting for sure, and blogged on  here  but paleo is not about hunting and gathering, and no, fighting for the last jar of coconut butter at the specialty store doesn't count.

You can go read Cordain's full rebuttal, but he basically takes issue with USNWR using terms like "unknown" and referring to studies as "tiny" and pointing out that the studies are short.   Ummm ... they are!  And yes, the long term benefits are indeed unknown despite the claims being made.

Now, this is not to say that all or even most of the other diets have been studied in any greater detail, but the sum total of paleo to date 2011 was 5 human trials ranging from 9 to 15 subjects testing the paleo diet, for durations as short as 10 days and up to 3 months.  Further, only two of those were controlled, but neither controlled for caloric intake.  But paleo doesn't count calories you say?  Well that's all fine and dandy, but in those controlled trials, which just so happened to be the two, and only two, that lasted 3 months the control groups ate about 300 and 450 calories more than the paleos.  To say *it works* and it can cure a zillion disorders and diseases and has no drawbacks, even if what the *IT* is could be defined and standardized, is truly dishonest.  When you can't even settle on what *IT* is, even among the "pure paleo" diets implemented in this handful of studies, you're in deep trouble in terms of scientific grounds.  I'll return to this in a bit, because now let's look at the Paleo Baby Jesus weighing in with his particular brand of outrage over this repeat diss.
New Year, New News Same Old Shit
So, my twitter and FB feeds have been more backed up than an Elvis impersonator on a two week heroin binge. The topic? US News and World Reports 2014 “Best Diets” ranking, which places the crusty old Paleo Diet a dead, fossilized…corpralite-esque…LAST. Now, the PD was not just last, it was behind such hard scientific contenders as the Slim Fast and Medifast diets! (Those are diets built around shakes folks…)
Well, he did mention shakes ...  

He also writes:  "The aforementioned rebuttals are quite technical and detailed, I’m not going to rehash that material, " ... Has Robb ever really "hashed" those studies?  I mean really looked at them?  It would appear not, because had he, he would not be so wont to cite them left and right ... well not if he was intellectually honest about the diet he promotes anyway.  He goes on to cite Dr. Mat Lalonde's nutrient density work complete with video from AHS12, he didn't analyze the nutrient content of ANY of the paleo diets, and (~19 min) come to find human breast milk scores very low ... uh oh!    The sample diet is in your book Robb, have you ever put it in a program?  Skull sweat needed ...

Next up, Robb belittles people who think paleo is "too hard" by presuming it is a necessary step towards better health:
Some people make diet and lifestyle changes easily, others prefer to smoke through a trach-tube and scare little kids with their electronically synthesized voice vs changing behavior.
Yeah, as if there are only two ways to eat, mythical paleo or total crap.  You get much the same brand of condescending lovely in his book.  Ironically, he has developed a line of supplements to help people transition to paleo ... because as everyone knows, healthy diets are notorious for making you feel like total Robb before you feel better.  Put the Paleologix copy side by side sometime to the diet propaganda put out by its developers.  Sigh.

Ahh but Google Trends.  I'm sorry but has anyone seen anything about Zone in eons?  That paleo bests Zone is so Crossfit (and the competitive CFers don't do paleo).   I wasn't all that familiar with the paleo peeps a couple of years ago, but I followed LC goings on quite closely.  The "any day now this thing is going mainstream" came and went in low carb, and you keep hearing it in paleo circles.  Sorry, I couldn't help myself with the Smally meme, I keep getting this guy in my mind whenever these back patters go into rally the troops mode.  (Oh c'mon, it's harmless fun).

Off to Google Trends we go ... You can always click to enlarge.  I thought I'd add in a fad diet like Dukan to Zone and paleo just to see what happens.  On the left are the search terms, and we see that in January paleo has managed to spike up past Dukan's peak popularity.  However, when you put terms in, you are given choices, and while paleo has no such choices pop up to select "diet"or "topic", Zone and Dukan do.  It's just interesting is all, that's below right.  The red there is "Dukan Diet" as topic.  

One needs to look at some other things to put this massive popularity of the paleo diet in perspective.  Below left is what happens when you throw Atkins into the mix coming down the tail of it's popularity in 2004 it kinda puts the diet noise in perspective.  Just for fun I did a head to head for carbsane and ancestral health.  Not too shabby, and those peaks in the red ancestral health there are August.  That's some pretty cool stuff!  :-)

I even hold my own against Whole9, though I get squashed by Whole30 ... I'm going to be losing sleep over that ... LOL (actually the fact that I register at all is pretty cool ;-).).   Overall paleo seems to still be trending upwards, but given how Google doesn't distinguish between positive and negative headlines and stories, on balance, I'd say the paleo peeps are probably more than a little concerned in this regard.  But enough of the truly meaningless stuff unless you're in the marketing biz or trying to convince your cult that all's well in the world.  

So let's get back to Robb's delightful take on USNWR and the paleo diet. He writes:
3-There is no science supporting the Paleo Diet.
This one absolutely crushes me…is it too much to ask that folks go to PubMed and search for Paleo Diet? I guess I should look at this not as annoying, but as job security. Well, the rebuttals are a good resource for peer reviewed literature around this topic but here is a snippet from an email I received from Prof. Cordain:
There have been 8 RCT of The Paleo Diet. The endpoints including CV risk factors, satiety, weight loss indices show Paleo to be superior to diabetic diets, the Mediterranean Diet and to be more trace nutrient dense than the USDA food pyramid/now the Food Plate. References are as follows:
This is the same list as above, adding:

8. Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, Hauksson J, Olsson T. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013 Jul;274(1):67-76

I would think that Robb learned a thing or two about over-reaching with the paleo science schtick, or at least he might have learned, finally, what RCT stands for, and how there are more than two types of studies out there.  If one were to take Robb at his written word, one would think there are only two:  randomized controlled trial or observational study.  Cordain (and Wolf and all the rest of them) need to recognize the relative paucity of research on *any* paleo diet to begin with.  This isn't a list of 8 RCT's, it's not even a list of 8 clinical trials in human beings.  Here's the more appropriate list:

  1. Lindeberg
  2. Frassetto
  3. Jonsson
  4. Ryberg
  5. Osterdahl

This is a Twitter exchange between Robb and myself from almost a year ago.  

Is it just me, or has Robb been promising more and more studies for years now and we never seem to get them?  In his "don't poo poo the science" rant, Robb goes on:
So, we provide material like this to the detractors and get a response ” That’s not much research, we can draw NO conclusions from this.” Um, ok. So, we just keep doing what is not working? Another common dissent in this story is much of what we talk about in Paleo Land is anecdotal. Yes, most clinical findings, are observational. Most if damn near all scientific findings START observationally, cause someone to say something to the effect “hm…what the heck is going on here? I wonder if this is what’s happening?” Observation–>hypothesis–>testing–>accept/reject/refine. The Evidence Based Medicine crowd somehow forgets this process…but in an entirely selective and self serving way. When I finally get this cert done I have at least six LOOOONG posts I will do expanding on this. For now we have what has been done, and we have a number of things in the pipeline:

Firstly, someone please explain to Robb that lack of control in an experiment still makes it an experiment, not an observational study.   Let's use cholesterol as an example.
  1. Observational Study:  Measure levels at baseline, measure levels at 5 years, see if there is any correlation.  (e.g. do high or low levels withing normal range at baseline predict future levels outside of normal range?)
  2. Uncontrolled Experiment:  Measure levels at baseline, prescribe a diet and exercise regime, measure levels at 5 years, see how they change.  This is an experiment because a "treatment" is applied.  However if levels change we cannot definitively attribute them to the treatment as there was no control.  "Further studies needed" after a pilot like this.
  3. Randomized Controlled Trial:  Recruit subjects and measure baseline levels.  Randomly assign them to either (1) or (2) above, and measure levels at 5 years.  (1) serves as a control group for (2).  Now if the groups differ, the effect can likely be attributed to the treatment.
How is the EBM crowd somehow forgetting the scientific process?  How are they being self serving?  I can't wait for the half dozen or more LOOOOOOOOONG (too many O's) posts to come expanding on this!  But check out the single study in the pike Robb links to:
We intend to include 15 adult patients with a medical diagnosis of type 2 diabetes mellitus with or without medication and with an increased waist circumference (≥ 80 cm for women and ≥ 94 cm for men) in a random-order cross-over diet intervention study during two periods of four-weeks separated by a six-week washout period. Patients will be instructed to eat two healthy diets according to official dietary guidelines with respect to macro/micronutrient composition and fiber content, but differing in the type of food included, with one diet being without cereal grains and dairy products.
Ummm ... he's getting his papers mixed up, but how is this going to "plug some of the holes in Prof. Lindeberg’s original Paleo Diet in humans study"????  Both Lindeberg/Jonsson (#5/3) and Jonsson (#2) involved 12 week trials.  Lindeberg a head to head with two groups of 15 and 14 following paleo or Mediterranean diet for 3 months, Jonsson involving 13 subjects following each diet for 3 months in randomized cross-over fashion.  It may plug a few holes but it will open more if there are any results to be had.  They will fix calories so the subjects remain weight stable throughout.  I hope they plan on using true whole grain cereals ("real food").  But how is this really groundbreaking?  Do the paleos REALLY intend to take on the clinical data/literature of the Atkins diet and other lower carb approaches that incorporate dairy?  After all, that's what primal is .....
But, what, pray tell, are the other 8 large studies Robb hinted at last year?  We learn that Cordain is doing "a comprehensive study looking at the efficacy of the PD for various autoimmune conditions for which the preliminary data is very exciting.  But, it’s a retrospective survey! Bad Scientists! No RCT!!"   This is just childish really, because nobody that is serious feels this way about retrospective studies per se.  They have their pros and cons.  What *I* want to know, is where this data is coming from?  Has there even been a pilot study done on a single autoimmune disease?  Verifiable case studies even?  How can one do some sort of comprehensive retrospective study without this?  Sounds like at best we'll get a repeat of Tim Noakes SAMJ article??

What next, Reno law enforcement?  Are they doing much better than the NBA with this stuff?  We already know, thanks to Robb's own admissions, that the diet employed by Specialty Health is not a strict paleo one, or it wasn't and Robb was trying to steer it Lindeberg-ish, etc.  

Here is the bigger problem that the paleo community has with the science and the clinical trials:  They are not implementing the diets that the community as a whole follows.    It is intellectually dishonest for ANYONE to promote a high saturated fat diet based on the body of clinical evidence.  Period.  Further, the recommendations to limit fruit are in opposition to the trial diets entirely.  So you cannot have your almond flour paleo cake and eat it too here.  You can't say:
  1. Lipid hypothesis is wrong thus low fat diets are wrong and limiting saturated fats are wrong
  2. Look at these health bennies of our paleo diet that prove this 
When the paleo diet is, almost always lower in saturated fat and comparable or even lower sometimes in overall fat content vs. many "low fat" diets in clinical trials.  Remember this one?   That was a study comparing LFHC vs. LCHF diets for diabetes with the goals being LF = 30 and HF = 50%, but the LF dieters barely budged from baseline.  Paleo pretty much IS a low fat diet ... at least the majority of the ones implemented in clinical trials.   ALL clinical trials would meet USDA recs in practice (e.g. 11% in Ryberg is close enough!) 

Furthermore, in all but one trial, paleo has been a calorie reduced diet.  Perhaps unintentionally, but that's why people lose weight.  Those that lose weight rapidly on paleo have simply reduced intake rather significantly.  

And yet, Chris Kresser, who is Robb's business partner in paleo supplements for struggling very-low carbers, has written that fat is ideally between 40 and 70% of one's energy.   Lindeberg-style paleo?  Well that's just boring and unsustainable!  Catch Chris on Fox News and pass the chocolate over here .. thanks!!

The problem paleo has is multifactorial.
  1. They can't form any sort of consensus on what the diet is
  2. What consensus there is differs considerably from the diets used in the limited clinical trials
  3. Lack of scientific basis
  4. Lack of articulate advocacy for the diet
  5. Snobbery against those for whom paleo doesn't work (so they are not paleo)
You aren't going to win fans and gain legitimacy when you use terms like nob-polishing and dick-slapping in your articles.  I have even had fans of Robb's say to me that they wish the guy would "grow up" already.  It is sad that someone with the vernacular of a frat boy is the lead voice "schooling" those EBM folks.  Especially, when for the last two years at least he's been touting his work with law enforcement that is saving Reno millions, nay, billions ... with miraculous results.  Do you know where those $$ figures come from?  Risk assessment.  And realize that Specialty Health is "treating to the lipids" and targeting those with high trigs and high LDL-P to reduce them through diet AND statins or other drugs (e.g. metformin).  So either he's saying that what SH is doing is wrong-headed, or he's happy to go along with it.   Evidence Based Medicine in action.  

In the end #5 is the most off putting.  This notion that if you don't buy in you must not care about your health.  This is the biggest turn-off of pretty much most of that community.  I don't buy into the nonsense that grains are universally bad for even a sizeable minority of people.   It's interesting that Robb is bothered so by being asked what his version of paleo is.  This was the case yet again on Facebook.  If you're going to say "see, it works", it would be helpful to define *it* in some semblance of a cohesive fashion.  At least one thing had held up until now:  GRAINS = BAD (well a small crack was made S.Boyd Eaton's presentation at AHS12, but ignoring it seems to have fixed that blip).  Oh, and white rice.  That's not really a grain like the others.  Oh and it's not processed ... oh wait it is.  But still.  It's rice and it doesn't have evil lectins and whatnot. 

No, counter to Robb's claims, this person is not me and more than one person can see the utter chaos that is "paleo" aside from "successful marketing label" at the moment.  Because you see, "bad oatmeal eater" ... I hope that was in jest, because Robb's ring leader "The Paleo Dietitian" Amy Kubal had a confession for her readers the other day.  No, not that (yes, I'll address that shortly).  No in a post about getting off the paleo yo yo go round, Amy divulged the following:
Confession time – My name is Amy, and I eat oatmeal every day for breakfast. (Disclaimer: I am by no means advocating this for everyone.) I have found that my digestion, my energy, my level of satisfaction and my mental and emotional health have all improved since I’ve found a happy balance of foods (paleo or otherwise) that my body tolerates. This flexibility isn’t going to look the same for everyone and I am by no means saying that you all need to start eating oatmeal or anything else that might make you less healthy or conflict with your goals. What I am saying is that there is no one PERFECT diet for everyone and if what you’re eating is making your body OR your mind sick, then it’s definitely not the best choice for you.
So ... Oatmeal daily is on the template?  Come on.  Improved digestion you say?  Perhaps those evil grains aren't so evil after all.

screenshot from

So which is it?  Is THE paleo diet THE healthiest way you can eat?  Is it really the ONLY nutritional approach that works?   Those are heady claims, as are the references to all the research that purportedly backs them up.

This much we know:  The diets in the clinical trials involve:

  • little to no added fat
  • lean meats
  • NO dairy
  • NO grains
  • NO chocolate
  • fruit 
Whereas the "evolved" paleo diets
  • tons of coconut oil, ghee and/or butter
  • fatty meats
  • some dairy
  • oatmeal
  • chocolate
  • limit fruit -- too fattening
It is flat out DISHONEST to use the limited science such as it is, to support anything-goes-just-don't-call-it-moderation paleo.   

Rather than panning USNWR and writing long articles bashing critics, the paleo powers that be might do better to expend resources on a cohesive, substantiated, central message.  You know Robb -- that "articles of confederacy" or whatever you called them back when YOU emailed me?   Failure to do so will only make it harder, and there will be more Paleo = BS pieces to come.  Like this one:

Paleo Diet - Just Another Fad Diet Dressed Up in Junk Science Clothes

Because it is.  The best you can hope for is that it is as enduring a fad as Atkins.  And the best everyone else can hope for is that it just goes away so we can go back to eating real foods, sleeping and moving without being recruited into the cult movement by default.

Update:  I forgot to add, that after I wrote this I noticed that USNWR posted links to Cordain's rebuttal (on RW's site) and their response.   Seems Robb and Cordain need to read before rebutting.

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
—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.


charles grashow said…
"It seems that they are working off of the following macro proportions:
Protein = 38%, Carb = 23%, Fat = 39% though I'm not sure which paleo
diet these come from."

Probably from this paper by Cordain

"The macronutrient content of the experimental diet (38 % protein, 39 %
fat, 23 % carbohydrate by energy) varied considerably from current
western values."
charles grashow said…
Taz said…
All these temporary fad diets are just a waste of time and energy. It's much more efficient (and healthier) to just implement sustainable long-term habits.
carbsane said…
Thanks for the bare link Charles. I did hyperlink to that paper. 3/4ths of a pound of salmon for breakfast!
Elizabeth Reid said…
I secretly think paleo causes harmful, disordered eating patterns in WAY more people than it actually helps. There are anecdotal successes, but that's because people like me generally don't advertise our terrible, personal experiences. I lost 20 pounds "educating" myself on the evils of grains and carbs, gained back 35 pounds when paleo became completely impractical in real life, blamed myself for not "doing it right," and then went to spend 18 months nursing an already disordered way of eating from a lifetime of dieting. I was terrified that I would get Alzheimer's and arthritis if I ate bread.

No diet should put the type of arbitrary moral implications on food that paleo does--if you eat this, you are "bad," you are "wrong," you will get sick. That fucks people up in the head.
Screennamerequired said…
38% protein is ridiculously high. I think 20% is overkill on a weight maintenance diet for most people. I don't need to eat double the protein I require just to have most of it turned into carbs. I'll eat the healthy carbs directly.

"Next up, Robb belittles people who think paleo is "too hard" by presuming it is a necessary step towards better health"

I see people criticized a lot for not wanting to give up certain foods (the stupid part of that is that most of the time people being told to give up foods that are actually healthy). Yet not many want to give up dairy and chocolate.

It's obviously too hard or just not realistic long term. Where are all the lean meat eating, butter shunning paleo's? Even Paleo Jesus himself doesn't follow the "Original human diet".

If I could design a study it would be include mostly healthy moderately active people eating at weight maintaince. It would be using the actual paleo diet that people follow (ghee, bacon, coconut oil, fatty meats, chocolate, vegetables and a limited potatoes, fruit and whey shakes "post workout"). It would go up against a diet high in beans, lentils, nuts, whole grain bread, oats, and fairly small amounts of meat and dairy. Instead of the dreadful "Low fat" diets that usually go up against low carb diets in weight loss studies to make them look good. Maybe I should make my pitch to NUSI
Sanjeev Sharma said…
did everyone get the same page i did, with Lyle's comment at the top?
carbsane said…
Lyle's comment is CLASSIC!!!!!

Never tactful, but classic :-) It's here:
carbsane said…
Yeah, NBA goes paleo ... must modify with carbs to perform.
Robb goes paleo ... must invent NorCal Margarita
Jimmy goes paleo ... well that didn't even last a week
Amy Kubal goes paleo ... must eat oatmeal to recover (hopefully) from anorexic relapse.
Chris Kresser goes paleo ... eats goat cheese and chocolate to prevent boredom
Diane Sanfilippo goes paleo ... ghee and fermented dairy become "practical"
Mark Sisson goes paleo ... immediately adds dairy so he can keep selling protein shakes

list goes on ...

Apparently none of the above cares about their health either. Otherwise they wouldn't be eating butter and bacon.
carbsane said…
You are not alone Elizabeth. I've been hearing this story near daily since I started speaking out about ED in the paleo community. It would be better, however, if there was any consistency in their restrictive message. The problem there is that such an austere diet likely doesn't ensnare as many to begin with. Pretty sick bunch when you think about it.
LWC said…
Sean Croxton has fallen off the Paleo bandwagon too, though for him that's all it was. I never got the sense that he was a true believer, rather he was a guy looking for a trendy topic for a webinar or "summit." But then there's Paleoista, who's as fierce and dogmatic as ever.
ExEffectsGuy said…
I wouldn't be surprised is "Jimmy" goes Vegan in the next few years. or maybe a breatharian?
carbsane said…
You've got Croxton's number. Whatever gets people to sign up for his next summit is it. He wrote this last April:

If I had to guess, I would say that for every one person who has tasted success with paleo (it tastes like bacon, by the way), there are at least ten who have failed.

Who cares about the 10 I suppose.
carbsane said…
Nah .... he's too entrenched in his brand to publicly change. Surgery seems more likely. It's worked for a few low carbers when LC ultimately failed.
ExEffectsGuy said…
Well I don't know about that. An extreme example of "cults" would be Jim Jones and the ko laid drinking or Branch Dividians. I wouldn't be surprised if some diet geniuses have secretly had lapband surgery. With HIPPA, who would know?
ExEffectsGuy said…
You're right! You know a "way of life" eating cult has gone over the edge when the "community" has discussions over several days discussing Paleo toothpaste. I'm not kidding. I've seen them!
carbsane said…
There is too much guilting going on. I'm sure it was difficult for Amy to admit to eating oatmeal and yet tequila? That was her "joke" cure for all that ails you for a while (Twitter). When I spent some time at Paleo Hacks there was all this no soap no shampoo stuff. I know some seem to do well with that, but I kinda like my shampoo and conditioner and I don't really spend any sort of exorbitant amount on any of this stuff anyway.

There was a SERIOUS post on FB the other day by a mother whose kids got cavities and her family is now starving because they are trying to cut all cavity causing foods. This is pretty sick if you ask me. Paleo toothpaste. Just don't accidentally grab the paleo pit paste I suppose ;-)
carbsane said…
Oh, and by the way, my name is Evelyn and this is what I ate for breakfast this morning.
charles grashow said…
When his new book comes out do you think he will have updated blood work??

OH - BTW - as to his zero CAC score
Frequency and extent of coronary atherosclerotic plaques in patients
with a coronary artery calcium score of zero: assessment with CT

Coronary computed tomography (CT) angiography was performed in 288 cases with a CAC score of zero. The plaques that were detected using coronary CT angiography were categorized into two groups: nonsignificant (<50%) and significant (≥50%). Based on the coronary CT angiography results, the patients who had plaque and those who did not have plaque were compared in terms of the demographic characteristics and the presence of
cardiovascular risk factors.

Noncalcified plaques were detected in 50 cases (17.4%) on CT angiography, of which six cases (2.1%) had significant stenosis. The plaques were localized most frequently (38.2%) in the proximal left anterior descending artery. When all the plaques considered 50% of the plaques were localized in the proximal segments, 42.7% were in the mid-segments, and 7.3% were in
the distal segments. Hypertension was a significant risk factor for
coronary artery disease in both genders, and smoking was a significant risk factor in females. Additionally, diabetes mellitus was a borderline significant risk factor in both genders.

In patients with a CAC score of zero, the frequency of noncalcified
plaques is too high to be ignored. The distribution of these plaques in the coronary artery is similar to calcified plaque localizations. Patients who have a CAC score of zero and cardiovascular risk factors need to be evaluated with additional tests for the detection of noncalcified plaques.
ExEffectsGuy said…
Absolutely! I try to never blame the folks who are on these diets, having been on a lot of them myself over the years, but I actively dislike the geniuses promoting them whether it's Pritikin, Atkins, the China Study folks, or the Grain Brain geniuses. I am ashamed myself to admit AGONIZING over eating eating a single cookie! It was crazy and thinking about that agony I started to realize how full of s***t these nitwits are. Sorry but America's favorite TV doctors are just as idiotic in my eyes. Their ideas are all based on the theory that they know something you don't know and often you can't comprehend. Ughhhhh......there I go spouting again. I have to remind myself the I don't know nuthin' either, but I know enough. that even possible? :(
Jaie Jac said…
You'll never see your study actually done by people pushing Low carb/paleo. Why? It would make paleo look like absolute crap.
ZM said…
"Who cares about the 10 I suppose."

Few people benefit, who cares about the majority. Much like statins I guess :)
carbsane said…
What does this have to do with statins? I don't get your point.

But if you want to draw an analogy, statins come with a long list of possible side effects, etc. Contrary to popular belief, they are not prescribed indiscriminately based on no evidence whatsoever, as a cure all with no possible drawbacks. I see no similarities.
ZM said…
The majority of people taking statins do not benefit. If Croxton's statement is correct then statins and the Paleo diet share something in common.
charles grashow said…
"The majority of people taking statins do not benefit."

Proof for the statement would be nice.
Gina said…
"Some people make diet and lifestyle changes easily, others prefer to smoke through a trach-tube and scare little kids with their electronically synthesized voice vs changing behavior."

That statement set off all the douchebag alarms in my house. If you find his diet unreasonably limited/inconvenient/expensive, etc, you are a monster who deserves death and disfigurement. Got it. Do people actually find this kind of batshit rhetoric motivating? I'm going to have a hummus and tomato sandwich on whole wheat with a side of Baked Lays to clear my head.
ZM said…
"Proof for the statement would be nice."

Why do you need proof of the substantial residual risk seen in every statin trial?
ZM said…
"Proof for the statement would be nice."

It's not controversial Charles. Do you really want proof of the substantial residual risk seen in every statin trial?
ZM said…
The risk reductions see in statin trials are not large. Superko published a decent article on this -
charles grashow said…
Yes and please define "substantial residual risk in EVERY statin trial?
charles grashow said…

Only 71 - guess carbohydrates CAN kill after all.
ZM said…
Meaning that the majority of events still occur despite statin treatment -

"We´re in a very exciting era in cardiovascular medicine where we have rigorous, randomized, placebo-controlled clinical trials that
demonstrate that achieving therapeutic goals only reduces risks for a minority of patients. We´re very proud of the minority that we are able to help, but the majority still go on to experience events."
charles grashow said…
Are you really talking about substantial residual risk of future CVD?

Sanjeev Sharma said…
> Never tactful
David Hume on belief: believe in portion to the evidence.
HL Mencken: comfort the afflicted, afflict the comfortable
Lyle: afflict the bullshitters in portion to the bullshit
Sanjeev Sharma said…
food reward Friday bait ...
carbsane said…
That is not risk. Risk is demonstrated negative effects of statin therapy.
carbsane said…
Hehehe .... I'm a bit biased at the moment as Lyle has been a bit interesting, shall we say, with yours truly on FB. As in STFU Evelyn interesting ;-) Still think he's scientifically aces though.
Screennamerequired said…
"You'll never see your study actually done by people pushing Low carb/paleo. Why? It would make paleo look like absolute crap."

I suspect it would as well. I used to see it all the time in forums. Once it got more popular and more healthy people started adopting it you'd see all sorts of problems popping up that didn't exist on their previous diet. Using the diet as a weight loss intervention for the overweight and metabolically compromised is one thing, recommending healthy people (even kids) that already eat a good diet to transition to it is completely different.
Screennamerequired said…
Yeah. You have to love the "Modified paleo", sometimes referred to as a "paleo template" or "80/20 paleo".

Come to think of it I do probably follow a modified paleo diet, while as the same time adhering to a DASH diet template while also being closely aligned to a 80/20 Zone diet.
Bris Vegas said…
The ACTUAL criticism of the Paleo Diet was that it lacked "important nutrients" allegedly contained in grains and dairy. This is completely nonsensical because Cordain's version of the Paleo diet is very high in dietary fibre and calcium (from green vegetables). In most other regards the paleo diet scored highly in this survey

PROFESSOR Loren Cordain is a full Professor at a respectable university. He has co-authored dozens of nutrition papers with many of the most eminent academic nutrition researchers on the planet including David Jenkins and Jenny Brand-Miller. To suggest that Cordain is some sort of fraud or fringe dwelling fruit loop is totally dishonest.
Bris Vegas said…
The official Australian medical guidelines say that patients should NOT be tested for CAC. because it has no clinical validity.
Lighthouse Keeper said…
Yes, modified paleo brings to mind an inverted version of the oft used Shakespeare misquote " A rose by any other name is still a rose". Odds are that the next modification will be the limited inclusion of legumes as part of the new resistant starch trend. Oats might be creeping in for the same reason.
Sanjeev Sharma said…
non specific lashing out is hard to take. Sometimes he's like a snowball set loose at the top of a hill ... I just have to wonder where he gets the time & energy to keep it up.

I got specific spanking though - a long time ago now & I'm glad for it - it's what finally moved me off Atkins.
charles grashow said…
They also say

"A brilliant example of unraveling a molecular disease led to the
discovery of the statins, and indeed the statins have had a major impact on cardiovascular disease, very effective medicines in broad categories of individuals and primary care in primary prevention of high-risk individuals and secondary prevention. Very consistent body of data."
Sanjeev Sharma said…
yeah, Jimmy had opportunities when Taubes abandoned him with
1 letting rice & Asians off the hook
2 blaming sugar instead of the blanket "carbs" he had been demonizing for so long
3 the ridiculous "move the goal posts" manouevre of "low fat but very low calorie diets only work because they are low insulin"

JM really comes off as a true believer. I do still suspect that the same drive that led him to try to co-opt paleo will someday make him abandon canon Taubesianism (which, again, Taubes has already done)
ZM said…
Hmm...statins are "very effective medicines" but at the same time only benefit a minority. Seems that "very effective" has lost its meaning.

I've already established my original assertion that statins only benefit a minority which you challenged me on. I don't want to get into an off-topic debate about statins which was never my intention.
carbsane said…
Sorry, read too fast. What is the residual risk with low carb diets? We set a bar too high when we expect risk to disappear from a single treatment ... any single treatment ... including diet. Paleo hasn't even begun to be studied in this context!

Incidentally, Carbohydrates Can Kill author Dr. Robert Su passed away "unexpectedly" last month at age 71.
carbsane said…
This is something everyone considering statins ought to be aware of. I am in total agreement on this.
carbsane said…
He's mostly mad at me for "giving publicity" to these people. As if saying nothing will be more effective?
carbsane said…
Contrary to popular opinion, refined carbs have never been sanctioned and have been blamed for as long as I can remember. Therefore a core of low carbers will probably always be able to make a living. NuSI has a few years of "red meat" in the pike.

It's not for me to give career advice, but Jimmy has done well for himself as an internet entrepreneur. Doesn't hold a candle to some, but he's supporting his family at a higher socioeconomic level than before. It's too bad he doesn't "cash in" while the going is good and get into something with more job security. The writing is on the wall with the lineup for this year's LC cruise. How many times can FatHead give the same spiel?
ZM said…
I agree. All we have on these diets are trials on surrogate markers which in my view are meaningless.
charles grashow said…
Does wheat make us fat and sick?

In fact, foods containing whole-wheat, which have been prepared in customary ways (such as baked or extruded), and eaten in recommended amounts, have been associated with significant reductions in risks for type 2 diabetes, heart disease, and a more favourable long term weight management. Nevertheless, individuals that have a genetic predisposition for developing celiac disease, or who are sensitive or allergic to
wheat proteins, will benefit from avoiding wheat and other cereals that contain proteins related to gluten, including primitive wheat species (einkorn, emmer, spelt) and varieties, rye and barley…Based on the available evidence, we conclude that whole-wheat consumption cannot be linked to increased prevalence of obesity in the general population.

The authors find little evidence in support of popular myths:

Proliferation of wheat products parallels obesity and is causally related. No, it does not.

Wheat starch differs from starches in other foods in especially undesirable ways. No, it does not.

Whole wheat bread has a higher glycemic index than sugar. No, it does not.

Wheat contains opioids that make people addictive. No, they do not.
charles grashow said…
Optimal Low-Density Lipoprotein Is 50 to 70 mg/dl
Lower Is Better and Physiologically Normal

Thus, although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted.
charles grashow said…
t s said…
but is he a brain surgeon?
ExEffectsGuy said…
I don't think he's a quack. In fact, I don't think of him ata all. If you write a few or several books in the span of a few years, what are you learning that's so different so quickly? What do you have to tell people EVERYDAY that's so different than what you said a over the past few months? If you're analyzing and t aggregating, fine, but if your touting, selling, linking to advertisers and going on guru podcasts in different versions of a mutual admiration society discussion, you become suspect at best. Why doesn't the Univesity own or back this stuff? When I listen to doctors from Harvard Medical, they may indeed have a book, but it's a Harvard backed book, and all the same info is on their website. Mayo Clinic used to be like this but recently have decided they have to capitalize and monetize their name recognition. Sorry to ramble. My "Learn to Stop Droning On" lessons haven't started yet!
ExEffectsGuy said…
I have had a couple of doctors in the past who told me statins were a miracle and ought to be in the drinking water. In fact, some cities proposed this in the past few years, though more thoughtful folks have gotten rid of that idea so far. My current doctor says statins have some effectiveness who have had cardiac events or are at very high cardiac risk. Even then they require very close monitoring he says. The recently proposed new scoring for cardiac risk and statin assessment was met with quite a bit of pushback from many many doctors who didn't like the idea of medical discretion being discarded for a global scoring system. Just sayin'.....
Screennamerequired said…
That paper is one of the many reasons why Cordain has come across as a fruitcake. He sort of changed his stance on saturated fats and high LDL recently because he know's his target audience. He was getting left behind and dismissed in the internet paleo world because of his rational stance on saturated fats. So he softened his tone to pander to his audience. It's a tough balancing act trying to cater to these people while at the same time trying to gain some legitimate mainstream acceptance. Do you think Specialty Health would support a diet that has half the participants in it having their LDL shoot up?
ExEffectsGuy said…
As far as the low carb cruise, can we REALLY ever get tired of hearing about the plot to kill us all to sell breakfast cereal and statins?? NO!
charles grashow said…
'Do you think Specialty Health would support a diet that has half the participants in it having their LDL shoot up?"

Robb Wolf and the doctors were treating the police officers to get their LDL-P <1000 and their LDL-C <100 by using statins and metformin, etc. so the answer is no
carbsane said…
carbsane said…
I posted some thoughts on Facebook (link at right, public page) about this. When someone like this dies, it's really a disservice to all for them to not disclose the cause. No matter what. Because these people put themselves in the public eye with their "revolutionary" ideas. Not just that they openly encourage others to follow their lead with promises of better health and longer life. But apparently, they don't see it that way. Oh well. If you dare speculate or ask, you get called a vulture.
carbsane said…
Exactly! This attitude pervades the paleo community. What is amazing is how many roads lead back or through Robb. He's not exactly motivational or inspirational. Here's from his book (p. 235-6):

What if all these biomarkers are just, well, close to being good? Well, how much do you enjoy living? If the biomarkers do not fall into place, you might have some genetic variability that makes your numbers a bit odd, and that may or may not mean a damn thing for your CVD risks. But this is rare. More often, these borderline numbers are proof you are a Cheater Mccheaterkins.

Lack of compliance means lack of results, so be honest with yourself in this regard. It’s just your life.

That's an interesting chapter folks. Especially given his involvement with the statin-employing, lipid hypothesis compliant, EBM driven Specialty Health program.
Sanjeev Sharma said…
>He goes on to cite Dr. Mat Lalonde's nutrient density work complete with
video from AHS12, he didn't analyze the nutrient content of ANY of the paleo diets, and (~19 min) come to find human breast milk scores very low ... uh oh! T

at 41:08 Dr. Lalonde presents his conclusions, #1 : diet centered around meat, vegetables ... all essential nutrients in adequate quantities.

did anyone notice anything in the presentation about ensuring "adequate quantities" ... ensuring no single nutrient or set of nutrients would be deficient in the proposed diet? I didn't see any work addressing this one point.

I suspect the spices and vegetables COULD cover the minerals that miss axe-grinding cherry picker extraordinaire pushes but I didn't see that work presented. I take it Evelyn didn't see it either, from this in the above article:

> he didn't analyze the nutrient content of ANY of the paleo diets,

Also, yes, I had not realized some in the Vegan/plant-based camp were constructing these biased indices ... putting polyphenols above amino acids & minerals & vitamins.
charles grashow said…

"Palmitic acid is atherogenic. And there’s not an experiment in humans or animals or tissue to show that it doesn’t down regulate the LDL receptor. This is a point that is never addressed in Gary Taubes’s book or Eric Westman’s articles, or Ron Krauss. You need to address the down regulation of the LDL receptor. That controls the flux of oxidized LDL in and out of the intima."

"The LDL receptor studies lend experimental support to the epidemiologists’ suggestion that the levels of plasma cholesterol usually seen’ in Western industrialized societies are inappropriately high (9). This support derives from knowledge of the affinity of the LDL receptor for LDL. The receptor binds LDL
optimally when the lipoprotein is present at a cholesterol concentration of 2.5 mg/dl (28). In view of the 10 to 1 gradient between concentrations of LDL in plasma and interstitial fluid, a level of LDL-cholesterol in plasma of 25 mg/dl would be sufficient to nourish body cells with cholesterol (118). This is roughly one-fifth of the level usually seen in Western societies
(Fig. 16 and ref.119). Several lines of evidence suggest that plasma levels of LDL-cholesterol in the range of 25-60 mg/dl (total plasma cholesterol of 110 to 150 mg/dl) might indeed be physiologic for human beings. First, in other mammalian species that do not develop atherosclerosis, the plasma LDL-cholesterol level is generally less than 80 mg/dl (Fig. 16 and ref. 120). In these animals the affinity of the LDL receptor for their own LDL is roughly the same as the affinity of the human LDL receptor for human LDL, implying that these species are designed by evolution to have similar plasma LDL levels (9,119). Second, the LDL level in newborn humans is approximately 30 mg/dl (121), well within the range that seems to be appropriate for receptor
binding (Fig. 16). Third, when humans are raised on a low fat diet, the plasma LDL-cholesterol tends to stay in the range of 50 to 80 mg/dl. It only reaches levels above 100 mg/dl in individuals who consume a diet rich in saturated animal fats and cholesterol that is customarily ingested in Western societies (116)

Once LDL receptors become saturated, the removal rate of LDL is proportional to the number of receptors. Whenever the number of receptors is reduced, plasma LDL levels must rise.
Sanjeev Sharma said…
I don't know what he intends so I sometimes see this but I'm the wrong person to pass judgement on it ... I regularly commit this kind of foul - sometimes I just love the use of English too much and hit "post" before I realize I've written something TOO pointed.

Even my business writing used to be this way- trying to go for the effect & stand out in the reader's memory. One of the software manuals I wrote way back was criticized by managers as "too forceful" (the users loved it BTW).
Trina said… Trina I peed on Paleo. To quote Ren and Stimpy: "It is mine!! All mine!!"
January 12 at 3:48pm

Sure he was joking but ?! Lol ...
Neddam said…
C'mon now, it is very ghoulish to analyse the cause of death of anyone who promotes healthier living in whatever way. Like an anecdote proves anything either way. Just because other people lower it to ad hominem mud-slinging does not mean that we have to.
justjuliebean said…
This is how I eat. Lots of veg, beans, fruit. Small amounts of whole grains, dairy, egg, nuts, bacon, meat. (I dislike meat other than bacon, but if I go totally veg, it's too much bread/cheese). I get all the health benefits that the paleotards keep going on about. In my mid-forties, nothing hurts, high energy, no health issues, no digestive issues, lots of endurance. I hate the idea that you either eat low-carb-high-fat, or you eat poptarts and sandwiches and overprocessed crap. Very disingenuous.
Screennamerequired said…
New plant positive videos are up tommorow.
Neddam said…
He owes no one anything, he's dead. Do his loved ones owe us something?
carbsane said…
Honesty? I think so. His book made it into the obituaries after all. Carbohydrates Can Kill. So I'd say so. Yes, you make a living telling people to avoid something that causes all manner of disease, yep. Honesty. Let people decide for themselves with ALL of the information.
Avishek Saha said…
Wow long post. I think that's the whole point as well: there is no perfect diet. In fact finding the perfect diet is what runs people into disordered eating habits and is something that's been correlated with it by psychologists for decades now.

The evolved paleo diet is arguably low in fat and animal products as well, as the new Hadza study suggested. Whether these types of contradictions went into the USNWR or not I don't know, but I do know that the USNWR is very unreliable, so I wouldn't use that as more evidence to bash the paleo diet.

I'm not on a paleo diet but I'd have to agree that the report seemed to be against the paleo diet because of the high amts of saturated fat and cholesterol, which we all know isn't that bad for us. What specific paleo diet they were referring to I don't know, because that hasn't been defined... and shouldn't be! My paleo diet involves eating rice mutton, milk, and curry. Works for me
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