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Paleolithic Diet

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Last Update: October 27, 2018.

Introduction

A Paleolithic diet is essentially the diet that humans ate during the Paleolithic or “Old Stone Age” era. This period, about 2.5 million years ago, is marked by anatomic and physiologic changes that were taking place in in the human body as people adaptated to climate change, learned to control of fire, and began to use stone tools. Anthropologists hold that the diet of our ancestors heavily influenced their neural expansion, increased brain size, and reduced gastrointestinal tract size.

Function

So, how did this interest in a prehistoric diet start? And what do health care professionals need to know about the ancient diet pattern's resurgence?

The last hundred years have seen a boom of industrialization, leading to the growth of a fast-paced economy. Though industrialization is essential for human advancement, it also has given rise to ultra-processed, low cost, readily available foods to sustain a growing population. A consequence of consuming these foods is a doubling or tripling in the rate of chronic diseases like obesity, diabetes, hypertension, and heart disease. Scientists and laypeople alike have started looking at solutions for these epidemics; alternatives focus not just on medications but the adoption of significant dietary and lifestyle changes. This quest for the "ideal" diet for health and longevity has brought to light several ancient cuisines, some have been thoroughly studied, like the “Mediterranean Diet.”

 The concept of Paleolithic diet started in the 1970s, and its popularity soared after the publishing of the book The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat by Loren Cordain in 2002. Since then, the public has shown a tremendous interest in this diet, also called the “cave man diet” or “Stone Age diet.” Many cookbooks have been published claiming to have Paleolithic recipes. The idea behind this diet is that if we revert back to what our prehistoric ancestors ate and reject the modern-day, processed diet, our health outcomes would change significantly. The challenge, however, with this diet is that is conflicting versions of this diet are presented to the public, creating confusion.

Thankfully, several breakthrough developments in the field of anthropology in the last few years have helped dieters and practitioners better understand the Paleolithic diet. Perhaps one of the most popular misconceptions is that our ancient ancestors were mainly carnivores when, in fact, they mostly ate a plant-based diet. The diet was very broad and was also influenced by the geographical location of the group and food availability.

Scientists and anthropologists have been able to reconstruct this diet based on the evidence gathered from archeological remains and studying the modern nomadic tribes. The prehistoric man is also known as the “hunter and gatherer “as agriculture had not started yet. In the modern world, we still have about a dozen or so tribes still following the same hunter and gatherer concept. These tribes are located in different parts of the world and in all climatic terrains. The most extensively studied tribe is the Hadza tribe from central Tanzania because the African continent is considered the hallmark of human evolution where the majority of prehistoric fossils are found. Since the Hadza group resides in the tropical forest, their diet mainly consists of plants, fruits, tubers, and game animals. One of the most popular food groups for them is honey. There also are studies available on some Nordic tribes, who sustain mainly on fish and other seafood.

Based on these findings, the Paleolithic diet most likely consisted of the following-

  • Plants - These included tubers, seeds, nuts, wild grown barley that was pounded as flour, legumes, and flowers. Since they had discovered fire and using stone tools, it is believed that they were able to process and cook these foods.
  • Animals - Because they were more readily available, lean small game animals were the main animals eaten. As per some estimates, animal products contributed to only about 3% of the whole diet. Animals were not yet domesticated so dairy products were probably not included.
  • Seafood - The diet included shellfish and other smaller fish. It was a major component of a diet in the coastal regions.
  • Insects - A variety of insects and their products, including honey, honeycombs, were eaten. They were a major fallback food. Recently, the interest in edible insects, called entmophagy, has increased. The United Nations released a list of edible insects as an alternative to meat products as the insects are said to provide similar nutrition benefits. 

Clinical Significance

It is clear that they did eat a variety of high-quality foods that were rich in nutrients and fiber. Compared to this diet, the diet we eat today provides much less variety and is loaded with artificial sugars and salt.

Since it is impossible to mimic the exact diet that our Stone Age ancestors ate, we can reasonably take some key foods and adapt them to a modern lifestyle.

There has not been enough evidence to complete as many clinical trials on a aleolithic diet as compared to some of the other diets. Nevertheless, there have been some interesting studies.

Whalen KA, et al. have done studies on the Paleolithic Diet, comparing it to the Mediterranean Diet. In one study of over 2,000 people, participants in each group consumed the list of foods that would fit into each diet pattern. The results were similar in both the groups, although the consumers of a Paleolithic diet decreased their all-cause mortality, decreased oxidative stress, and also decreased mortality from cancers, specifically colon cancers.

Another study by Blomquist C, et al. involved women who were postmenopausal and also overweight. They found that a Paleolithic diet decreased lipogenesis promoting factors, improved insulin sensitivity, and reduced circulating triglycerides.

The Paleolithic diet also has been studied as a supplement for therapeutic management in patients with inflammatory bowel disease. An interesting article by Dr. Jacob Eaton and Dr. Lara Lannotti, strong advocates and pioneers of the Paleolithic Diet, focuses on the mismatch of genomic evolution and the modern day diet. As discussed above, the diet that our ancestors ate has had a major impact on our genetic evolution. Since today's diet no longer contains the same variety and nutrition, however, there is an increase in chronic diseases caused by both “undernutrition” and “overnutrition.” Multiple other smaller-scale studies confirm similar results.

Physicians across the globe have been trying to incorporate healthy dietary and lifestyle habits into the therapeutic regimen of their patients. A Paleolithic diet is certainly a reasonable option for physicians to choose as it advocates healthy eating.

Questions

To access free multiple choice questions on this topic, click here.

References

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Kakodkar S, Mutlu EA. Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease. Gastroenterol. Clin. North Am. 2017 Dec;46(4):745-767. [PMC free article: PMC5821251] [PubMed: 29173519]
2.
Blomquist C, Chorell E, Ryberg M, Mellberg C, Worrsjö E, Makoveichuk E, Larsson C, Lindahl B, Olivecrona G, Olsson T. Decreased lipogenesis-promoting factors in adipose tissue in postmenopausal women with overweight on a Paleolithic-type diet. Eur J Nutr. 2018 Dec;57(8):2877-2886. [PMC free article: PMC6267391] [PubMed: 29075849]
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Altowaijri G, Fryman A, Yadav V. Correction to: Dietary Interventions and Multiple Sclerosis. Curr Neurol Neurosci Rep. 2017 Oct 17;17(12):93. [PubMed: 29038900]
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Anton SD, Hida A, Heekin K, Sowalsky K, Karabetian C, Mutchie H, Leeuwenburgh C, Manini TM, Barnett TE. Effects of Popular Diets without Specific Calorie Targets on Weight Loss Outcomes: Systematic Review of Findings from Clinical Trials. Nutrients. 2017 Jul 31;9(8) [PMC free article: PMC5579615] [PubMed: 28758964]
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Afifi L, Danesh MJ, Lee KM, Beroukhim K, Farahnik B, Ahn RS, Yan D, Singh RK, Nakamura M, Koo J, Liao W. Dietary Behaviors in Psoriasis: Patient-Reported Outcomes from a U.S. National Survey. Dermatol Ther (Heidelb). 2017 Jun;7(2):227-242. [PMC free article: PMC5453925] [PubMed: 28526915]
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Blomquist C, Alvehus M, Burén J, Ryberg M, Larsson C, Lindahl B, Mellberg C, Söderström I, Chorell E, Olsson T. Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity. Obesity (Silver Spring). 2017 May;25(5):892-900. [PubMed: 28440046]
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Whalen KA, Judd S, McCullough ML, Flanders WD, Hartman TJ, Bostick RM. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with All-Cause and Cause-Specific Mortality in Adults. J. Nutr. 2017 Apr;147(4):612-620. [PMC free article: PMC5368578] [PubMed: 28179490]
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Whalen KA, McCullough ML, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults. J. Nutr. 2016 Jun;146(6):1217-26. [PMC free article: PMC4877627] [PubMed: 27099230]
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Whalen KA, McCullough M, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and Mediterranean diet pattern scores and risk of incident, sporadic colorectal adenomas. Am. J. Epidemiol. 2014 Dec 01;180(11):1088-97. [PMC free article: PMC4239795] [PubMed: 25326623]
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Armelagos GJ. Brain evolution, the determinates of food choice, and the omnivore's dilemma. Crit Rev Food Sci Nutr. 2014;54(10):1330-41. [PubMed: 24564590]
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Bookshelf ID: NBK482457PMID: 29494064

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