Paleo diet guide: Benefits, risks and expert opinion

Paleo diet
Paleo diet

The Paleo diet is one of the most popular diets in the world. Also known as the Caveman or Stone Age diet, it is based on the food consumed by our forebears in the Paleolithic period, which dates from 2.5 million to 10,000 years ago.

“A simple guideline for the Paleo diet is, if it looks like it was made in a factory, avoid it,” says Natalie Burrows, a registered nutritional therapist .

Recommended foods to eat include lean meats, fish, fruits, vegetables, nuts and seeds — foods that in the past could be obtained by hunting and gathering. Apart from appealing to people wanting to lose weight, it’s particularly popular with Gen Z and fitness buffs. “Gym-goers tend to be drawn to the Paleo diet due to the high amounts of muscle-building protein,” says Bini Sureshbabu, a registered dietitian at the Cleveland Clinic.

With more than 25,000 average monthly searches for it in 2023, increasing numbers have turned to it in the UK. But is it really good for your health?

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Health benefits of the Paleo diet

A 2019 study found that the Paleolithic diet may assist in controlling weight and waistlines and in the management of chronic diseases. Other studies have suggested that the Paleo diet may provide some benefits in the prevention of metabolic syndrome, Type 2 diabetes, cardiovascular diseases and cancer.

“If you’re looking to eat healthier and lose weight, the Paleo diet might be advantageous. It does encourage more fruit and vegetables, nuts and seeds and foods that we currently don’t eat enough of,” says Tracy Parker, a registered dietitian for the British Heart Foundation. However, she adds, “There’s not enough research to support the premise of the diet preventing chronic disease.”

“Focusing on whole foods is not a bad thing and nor is the removal of processed sugary foods. From a health perspective, many people would feel better adopting these principles,” Burrows explains.

Our busy lifestyles mean that more of the foods we choose are processed – and cutting these out is a positive thing for our health. “These foods have lots of added ingredients: salt, sugar, saturated fat and palm oil, the types of foods and additives that have an implication for our blood cholesterol level, blood pressure and weight, increasing our risk factor for Type 2 diabetes,” says Parker.

The Paleo diet can provide a wide range of benefits for people with diabetes, including weight loss through lower carbohydrate and sugar intake, as well as increased insulin sensitivity. Studies have suggested the Paleolithic diet is associated with lower levels of systemic inflammation. “There’s not enough research to suggest it’s anti-inflammatory, but people who have autoimmune diseases and other conditions linked to inflammation might consider trying it,” notes Sureshbabu – as long as it’s under the advice of a healthcare professional or dietitian.

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Health risks and criticisms 

“I wouldn’t call the Paleo diet ‘healthy’ because it is somewhat restrictive and as a dietitian, I recommend being able to have a little bit of everything,” Sureshbabu says. Eliminating food groups can create a risk of developing eating disorders.

Our Paleolithic ancestors basically ate whatever was in their surroundings and in eliminating foods that had been introduced through farming over the years – dairy products, beans, grains and cereals – you’re cutting out foods that have many health benefits.

“The main health risk I would associate with a Paleo diet is nutrient deficiency,” Sureshbabu continues. “If you’re eliminating food groups like grains, dairy and legumes, these provide essential nutrients, like vitamin D, fibre, calcium and minerals.” Wholegrains are packed with fibre, B vitamins and folic acid, antioxidants and micronutrients, so they reduce the risk of cancers, heart disease, stroke and Type 2 diabetes as well as being important fuel for brain and muscle function. And cutting out dairy can compromise bone health. “This means you’re at increased risk of osteoporosis or bone fractures,” says Parker.

Furthermore, the diet relies heavily on high-quality organic foods and fresh fruits and vegetables, which can make it expensive to follow. It also requires a lot of planning in order to ensure you’re getting all the right nutrients in your diet.

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The foods to eat and avoid

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What the experts say about the Paleo diet

An adapted Paleo diet is better

The wholefoods approach of the Paleo diet is a healthy one for most people, says Burrows. “However, I prefer a version where dairy and legumes can be consumed, but on a reduced basis. This makes it much easier to stick to and these foods also hold key nutrients.”

Understand your individual needs

Before adopting any diet that restricts foods, understand your needs, health status, relationship to food and what your starting point is. Suddenly increasing your consumption of anything can have a negative effect. “For example, suddenly introducing lots of fibre may cause a change in bowel motions and bloating,” says Burrows, so take your time and get guidance from a registered qualified professional.

It’s hard to sustain without flexibility

The lack of flexibility in the Paleo diet can cause challenges when socialising and eating out and make the diet hard to sustain long-term. “We live in a modern world and diets need to be flexible,” explains Burrows. “Not being able to have processed foods means cutting out even the healthy ones, like oat milk, which is a great alternative to cow’s milk,” she adds.

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Comparing diets: Paleo versus Keto versus Atkins

The Atkins, Keto and Paleo diets are all lower-carbohydrate diets. A classic Keto diet is notoriously hard to stick to, with 70-80 per cent fat from total daily calories, 5-10 per cent carbohydrate, and 10-20 per cent protein. “But there are benefits from a brain health perspective, especially with neurodegenerative diseases and epilepsy, and for these reasons, it may be worth the effort,” says Burrows.

The Atkins diet is also a predominantly fat and protein-based diet with limitations on sugar, refined grains, “diet” and “low-fat” foods, high-carb fruits, starchy vegetables and legumes. A study in 2021 found it to be good for heart health. “But saturated fat’s effect on health and heart disease continues to be a topic of debate among scientists,” says Burrows.

The main difference between Paleo and Atkins is that the latter accepts some grains and full-fat dairy is encouraged whereas on the Paleo diet these are both limited or avoided. “The Paleo diet doesn’t advocate a lot of fat whereas on the Keto or Atkins diets you’re encouraged to eat a lot more high-fat foods like bacon, cheese and fried eggs, which are not good for your health,” says Sureshbabu. The Keto and Atkins diets also include the kind of processed foods that are less likely to be nutritious – whereas the Paleo diet excludes processed foods entirely.

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Common myths about the Paleo diet

It’s the ‘steak and bacon diet’

Many will view the Paleo diet as a licence to consume large amounts of red meat, sausages, burgers and other processed meats – in fact, some refer to it as the “steak and bacon diet”. “In fact, higher intakes of red and processed meats are linked to an increased risk of cardiovascular disease and certain cancers as well,” says Parker.

Cavemen ate loads of meat

As we learn more about the Paleolithic period, we are discovering that an estimated 3 per cent of their diet came from animal-based foods and that a high proportion of their food came from plants. “For hunter-gatherers it was hard to get meat, so their diet was in fact fundamentally plant-based. It’s their whole lifestyle, including how active they were, that potentially explains why people from the Paleo times are thought to have been healthier,” Parker explains.

It can help you prolong your life

“The Paleo diet is promoted as a high-protein, low-carb way of eating that can help you live longer. But people in Paleolithic times didn’t live to an age where chronic disease typically emerges,” says Parker. “So when we talk about chronic disease, heart disease, cancer and Type 2 diabetes, we don’t know what long-term health benefits there may have been.”

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