Is the Paleolithic nutrition concept scientifically sound?
If your primary source of information about nutrition is the mainstream media, the nutritional trends of the day, and/or conventional dietary guidelines, then you may have been led to believe that the answer to that question is no. If your primary source is the scientific literature, however, then you’ve undoubtedly realised that the true answer is yes, and that much of what is written and said about the original human diet outside of the realm of genuine science is of a biased, non-scientific nature. In reality, no other dietary concept has scientific roots as deep and strong as that of the Paleolithic nutrition concept…
The fundamental science of Paleolithic nutrition
The Paleolithic nutrition concept first saw the light of day in 1985 in a peculiar scientific paper entitled “Paleolithic Nutrition: A Consideration of Its Nature and Current Implications“. The authors of the article – radiologist Boyd Eaton and anthropologist Melvin Conner – utilized a groundbreaking Darwinian approach to nutrition, unknowingly laying the groundwork for what would become a vibrant evolution-oriented health movement. They weren’t the first researchers to look to the past for clues as to what we’re designed to eat; however, nobody before them had truly nailed down a sound dietary concept based on the eating habits of our distant ancestors.
The idea they presented was simple, yet monumental. Basically, they argued that insights into what constitutes a healthy human diet may be gleaned by studying the dietary practises of hunter-gatherers and human ancestors, for the simple reason that we – like all other organisms – are a product of adaptive evolution, shaped in response to the selective pressures that have been imposed on us throughout our evolution, a subset of which pertain to the nutritional conditions under which we evolved.
In the time that has passed since these evolutionary thinkers first presented their dietary proposal to the world, a number of additional review papers on the topic have been published, some of which are listed below:
- “Stone agers in the fast lane: Chronic degenerative diseases in evolutionary perspective”
- “Paleolithic nutrition revisited: A twelve-year retrospective on itsnature and implications”
- “Paleolithic Nutrition: Twenty-Five Years Later”
- “Origins and evolution of the Western diet: health implications for the 21st century”
- “The western diet and lifestyle and diseases of civilization”
- “Lifestyle and nutritional imbalances associated with Western diseases: causes and consequences of chronic systemic low-grade inflammation in an evolutionary context”
- “Cardiovascular Disease Resulting From a Diet and Lifestyle at Odds With Our Paleolithic Genome: How to Become a 21st-Century Hunter-Gatherer”
- “A multidisciplinary reconstruction of Palaeolithic nutrition that holds promise for the prevention and treatment of diseases of civilisation“
- “How Western Diet And Lifestyle Drive The Pandemic Of Obesity And Civilization Diseases”
The 8 scientific pillars of the Paleolithic diet
At this point, the question you may be asking yourself is this: Is there any hard-hitting evidence to support the notion that most of us would be best of eating a diet similar to that of our Stone Age ancestors?
Actually, there’s plenty…
The idea that we would benefit from adjusting our diets so that they more closely resemble the type of diet we’ve eaten throughout most (>99.5%) of the time we humans have been around doesn’t only make intuitive, Darwinian sense; it’s also supported by several lines of scientific research, the most notable of which are described below.
1. Paleontological research
Among evolutionary biologists and paleontologists, it’s well known that the Agricultural Revolution unfavorable affected the health of Homo sapiens. The human population grew following the dawn of agriculture; however, that doesn’t necessarily mean that people got healthier. On the contrary, examinations of fossil remains have revealed that Neolithic humans who had taken up Agriculture didn’t grow to be as strong and tall as Paleolithic hunter-gatherers (1, 2, 3, 4). Moreover, they were more prone to develop tooth decay, malocclusion, periodontal disease, and many other diet-related health problems (1, 2, 3, 4, 5). This isn’t surprising, seeing as they ate a less diverse and starchier diet than their preagricultural antecedents.
These findings are very consistent, in the sense that pretty much whenever and wherever people have made the transition from eating a hunter-gatherer style diet to eating a more simplistic diet that is largely built up of grains and/or dairy foods, adverse health outcomes have been a part of the “transition package” (1, 2, 3, 4). The dietary shift that accompanied agriculture was not solely responsible for bringing about the decline in the human health condition that accompanied the first major epidemiological transition in human history; however, it was undoubtedly a major contributing factor.
2. Genetics research
The natural question that arises from the previous section is: Have the health comflications that accompanied the Agricultural Revolution been weeded out by evolution as a result of genetic change?
The short answer to this question is no. Over the past millennia, certain diet-related genetic adaptations have spread within some human populations and equipped people with an enhanced ability to digest and metabolize various forms of modern foods. For example, within certain populations that have a long history of eating starchy diets, natural selection has driven up the copy number of the AMY1A gene (6), a gene that codes for an enzyme that is involved in carbohydrate digestion.
With that said, we know for certain that we’re not well adapted to consume grains and dairy foods (1, 7, 8, 9). The adaption that has occurred is only partial. This statement is supported by the fact that we, just like our ancestors, are prone to develop tooth decay, bone mineral disorders, and many other health problems if we consume a lot of grains and/or dairy foods (7, 10, 11, 12, 13, 14).
Foods are composed of a great variety of different nutrients and other compounds. Perhaps needless to say, if an animal species suddenly incorporates a completely new food group into its diet, just one or a couple of smaller genetic changes are not going to fully accommodate for that dietary change.
The key thing to remember is that natural selection only “takes action” if there’s a reproductive impact to a stimulus. A lot of people can eat and digest milk and grains and not experience any acute gastrointestinal issues or major reproductive impairments. Under certain environmental conditions, they may even benefit, in a Darwinian sense, seeing as grains and dairy foods are a source of nutrients and energy that can be put into reproduction.
This is not the same as to say that it’s healthy to eat such foods though. Natural selection will be slow to respond to any potential subtle or chronic adverse health effects, especially ones that primarily appear late in life, post reproduction, as such late effects tend to have little to no impact on organismal reproductive success. This is particularly true under modern, industrialized conditions.
3. Clinical research
Some people seem to be under the impression that very few or no Randomized Clinical Trials (RCTs) have looked into the therapeutic potential of hunter-gatherer style diets. This is simply not true. Over the past decade, a number of clinical trials on Paleolithic nutrition have been published (e.g., 16, 17, 18, 19, 20), some of which were conducted by the legendary scientist Staffan Lindeberg and his research team.
These studies have corroborated the Darwinian nutritional view, showing beyond any doubt that the Paleolithic diet is a very healthy diet. Some of the studies have a fairly small sample size, however, as a whole, the clinical evidence is quite convincing. With the exception of a few poorly designed studies suffering from severe methodological shortcomings, the trials in this area all point in the same direction, in the sense that they suggest that Paleolithic-style diets are efficacious in the treatment of several metabolic and inflammation-driven disorders and tend to produce greater health improvements than “prudent” diets such as the Diabetes diet. This is exactly what one would expect to see, seeing as the Paleolithic diet has certain unique characteristics that separate it from other diets (something we’ll talk about later).
A common belief is that it’s been scientifically proven that it’s healthy to eat a lot of whole grains. This is simply not true. Several RCTs and meta-analyses have indeed shown that the consumption of whole grains is associated with various positive health outcomes (e.g., 21, 22); however, these studies have a major limitation, and that is that they don’t compare prudent grain-free diets (e.g., Paleolithic-style diets) with diets rich in whole grains; rather, they compare the health effects of whole grain consumption with the health effects of refined grain consumption or the consumption of some other unhealthy food or a flexible diet. Hence, they by no means prove that it’s healthier to eat a diet rich in whole grains than a prudent diet that doesn’t contain any grains at all.
One of the major problems that plague the field of nutrition today is that there’s too much focus on clinical research. Some authorities seem to be under the impression that everything needs to be tested in RCTs and that the only evidence that truly matters is the evidence that is derived from strictly controlled, double-blinded studies.
This view comes across as untenable. Clinical research is important, yet it’s merely the icing on the cake. This icing is not much use if we don’t have a cake.
4. Morphological research
You can learn a lot about what an animal should eat by studying the structural composition of that animal. Some animals are clearly designed to consume a plant-rich diet. Cows, for example, have a large intestinal system in which trillions of microorganisms are hard at work, turning the cellulose-rich plants they’re eating into fatty acids and other end-products. Other animals, such as lions, on the other hand, don’t have a huge fermentation chamber, but rely mostly on their own genes to break down the foods they’re eating.
Typically, animals that eat a lot of plant matter have larger guts than those that eat more animal-based diets, which is not surprising, seeing as the latter diets tend to be more calorically dense and less bulky than the former. Moreover, plant-eating animals rely on gut microorganisms to break down many of the food substances they take in and therefore need a “chamber” where their gut microbes can live and do their fermentative work.
Another thing that separates animals that eat a lot of plants from those that eat mostly meat is that the latter tend to have more acidic stomachs (23). This isn’t surprising, seeing as an acidity acts like a barrier against food-borne pathogens and also because hydrochloric acid plays a role in protein digestion.
Where does our species, Homo sapiens, fit into all of this? We’re somewhere in the middle between the lions and cows mentioned earlier. We’re not wired exclusively for meat-eating; however, we’re not structured exclusively for plant consumption either. We’re omnivorous.
The thing that seems to elude some vegans and vegetarians is that a large body of evidence shows that our ancestors transitioned over from eating a largely plant-based diet to eating a higher quality, more meat-based diet some ~ 2.5-3 million years ago (3, 24, 25, 26). This idea is not only supported by archeological research (e.g., examinations of stone tools), but also by studies looking into the evolution of the human body. As more meat, and perhaps also other energy-rich foods such as tubers, were incorporated into the human diet, the large intestines of our ancestors started shrinking (27). One doesn’t have to be a genius to understand why; all that’s needed is a basic understanding of nutrition and evolution.
Animal source foods are primarily digested in the upper parts of our digestive systems, in particular the small intestine. Fibrous plant foods, on the other hand, are largely broken down by gut bacteria that dwell deep down in our large intestines. You don’t need a huge large intestine to break down a meat-heavy diet; hence, it’s not surprising that our ancestors’ colons shrank as a result of selective processes when they started eating more animal source foods. Not only has the human colon gotten smaller throughout our evolutionary history, but the human stomach also seems to have gotten more acidic (23), which is another indication that our ancestors gradually started eating more meat.
The morphological research clearly refutes the notion that we are designed to eat exclusively meat or plants. We’re clearly designed to eat a mix of the two. Moreover, it’s important to point out that none of the animal species that are in close proximity to us on the tree of life consume the milk of another animal or eat a grain-based diet. We don’t really know for certain exactly what the anatomy of a mammal that is designed to eat a diet rich in grains, dairy foods, and processed foods looks like, seeing as no such mammal exists.
5. Nutritional research
RCTs, observational studies (which we’ll talk a little about later on), and systematic reviews and meta-analyses are far from the only types of studies that are useful for learning about human nutrition. Over the most recent centuries, we humans have made great strides forward when it comes to elucidating the composition and characteristics of the food we eat. We’ve “broken down” various types of foodstuffs and given names – vitamin C, protein, fiber and so on – to their constituent parts. We’ve also looked into how the consumption of different types of foods affects various metabolic and inflammatory parameters.
This brings us over to something that’s really fascinating about the original human diet, and that is that it has certain nutritional characteristics that clearly separate it from “modern diets” (9, 10, 28). Among other things, the foods that were a part of Paleolithic diets have a low-moderate energy density, high satiety index score (29), and high nutrient density (30). Moreover, when compared with cereal grains, they all have a much lower carbohydrate density, and when compared to fatty dairy foods (e.g., butter, cream, cheese), they have a much lower content of saturated fat and total fat. Furthermore, when compared with cereal grains and dairy foods, Paleo foods are low in antinutrients, hormones, and/or other potentially problematic compounds. Hence, it’s not surprising that the Paleolithic diet is so therapeutic.
A large body of evidence shows that these discrepancies between the original human diet and modern diets are at the root of many of the diseases and health problems that plague the modern man (8, 9, 31, 32).
6. Mammalian research
As pointed out earlier, it’s abnormal for a mammal to eat a diet that contains large quantities of grains and dairy foods. The thing that eludes a lot of people is that the milk of each mammalian species that is present here on Earth was specifically designed, via natural selection, to support the growth and development of the young of that species.
Milk is not just this white liquid that is rich in calcium, protein, and fat. Rather, it is a very special type of food that has potent immunomodulatory properties and contains a variety of compounds that up until very recently were not a part of the adult human diet. From an evolutionary perspective, it’s very abnormal for a human adult to drink milk. Hence, it’s not surprising that the consumption of milk has been found to be associated with a variety of adverse health effects (11, 33, 34).
As pointed out earlier, the fact that some people can digest milk without experiencing gastrointestinal distress does not mean that it’s necessarily healthy for these folks to drink milk. Some of the issues with milk can be remedied via fermentation; however, others remain pretty much regardless of the type of processing technique that is employed.
The story is somewhat similar for grains. None of the free-living species on this Earth that we most closely relate to consume a grain-heavy diet. Domesticated animals on the other hand are often given grains. This is undoubtedly part of the reason why they are not as healthy as their wild counterparts. This simple fact, that domesticated animals that are fed grain-heavy diets tend to get fat and sick, should get us to think twice about eating a lot grains. Obviously, our biology differs quite a bit from that of for example a cow; however, we’re no different from the cow in that we too get sick and fat if we eat a diet that matches poorly with our evolved biology.
Unlike animals, plants can’t run away from predators (e.g., mammals that want to eat them). They have evolved other ways of defending themselves. One of the things they do is that they produce metabolites that are toxic to their “foes”. Some plant foods, such as cereal grains, are particularly rich in these types of secondary metabolites, some of which are capable of disrupting various physiological processes within the human body (1, 7).
It’s believed that our primal ancestors ate a great diversity of different plants; hence, they didn’t expose themselves to very large quantities of just one or a couple of secondary metabolites, seeing as different plants produce different toxins. Many early farmers and contemporary humans, on the other hand, consume large quantities of just one or a couple of plant species. Not only that, but many of the plant species that we consume today have only been a part of the human diet for a short time, meaning that we may not have evolved a way to effectively handle the toxins and protein structures they contain.
Most mainstream nutritionists have never learned to pay attention to these things. Instead of looking at how things work in nature, they spend all their time sifting through clinical studies and government-produced nutritional guidelines. This is unfortunate, because it’s impossible to make sense of what different organisms are designed to eat if one doesn’t look into the role that different foods play in the diets of various wild animals and the interactions that take place between organisms and their nutritional environment.
7. Anthropological research
Over the most recent centuries, many explorers and scientists have visited non-westernized, traditional societies that live or lived largely cut off from the modernized world. Some of these travelers, such as the legendary investigator Weston A. Price, documented the health and physical fitness condition of the people they met on their travels. Whereas some of the reports from these travelers are fairly superficial and subjective and of limited detail, others are based on comprehensive health examinations.
The most striking thing about the studies, books, and reports that cover the health of traditional populations is that they pretty much all indicate that non-westernized people who consume a hunter-gatherer style diet are largely free of chronic diseases such as diabetes, colon cancer, and celiac disease (10, 35, 36, 37, 38, 39). Moreover, when compared to westerners, they are in much better cardiovascular and metabolic health, as measured via assessments of various blood markers (10, 35, 36, 39). For example, when the Swedish medical doctor Staffan Lindeberg and his colleagues visited Kitava in 1989, an Island in Papua New Guinea, they found that the people who lived there were in excellent health. Acne, cancer, and heart disease were all but absent and nobody was overweight (35, 36, 37).
Some non-westernized people who consume traditional diets that contain certain non-Paleo foods have also been shown to be fairly healthy; however, in general, it seems that there is a gradual decline towards worse and worse health as we move from hunter-gatherer type diets towards western-style diets.
Perhaps needless to say, other factors besides diet are important up in all of this. For example, most traditional people are quite physically active and spend a lot of time outdoors, which cannot be said for the typical westerner. Hence, these types of studies don’t prove causality. With that said, there is no doubt that one of the primary reasons why the Kitavans and other traditional, non-westernized people are so healthy is that they eat a healthy diet. This statement is supported by the fact that the results from the studies in this area all point in the same direction and that every time a group of traditional people transitions over to eating a more westernized diet, negative health outcomes follow (10, 38).
8. Microbiome research
The trillions of microorganisms that colonize our bodies have a profound impact on our health and well-being. Among other things, they regulate our immune systems, shape our behavior and thoughts, and break down some of the food we eat (40, 41, 42). Given this, it’s obviously important that we take good care of our resident friendly bugs, as well as do what we can to keep unfriendly critters at bay.
It’s well established that the human microbiome has changed a lot over the past 10.000 years (43, 44, 45). These alterations, which generally come across as being unfavorable, can partly be attributed to changes in the human diet. Highly processed foods are obviously particularly problematic in this regard; however, other types of newly introduced dietary items are troublesome as well.
Of note, several studies have linked the consumption of very sugary and/or starchy foods, including both refined and whole grains, with increased growth of proinflammatory oral bacteria such as Streptococcus mutans (12, 13, 14, 43, 46, 47). Furthermore, a number of studies have found that the consumption of foods that have a very high fat density, such as cream, sets the stage for translocation of bacterial endotoxins from the small intestine into systemic circulation, endotoxemia, and chronic inflammation (48, 49, 50).
When we think about it, it’s not really surprising that modern foods with a nutrient configuration dissimilar to that of the foods we’re evolutionarily accustomed to eating are liable to alter our resident microbial communities in such a way that our health suffers. Natural selection acts to adapt organisms to their environment. Microbes are an important part of our milieu; hence, it goes without saying that microbes constitute one of the selective entities that have acted – and continue to act – upon the human genome.
Up until not so long ago, all humans on this planet ate a hunter-gatherer diet. It’s reasonable to assume that the human biology has evolved to match well with the type of microbiota that is produced by such a diet.
When our ancestors’ diets changed with the Agricultural Revolution, their microbiotas also changed (43, 46, 47). The grain-heavy diet they started eating produced microbiotas that matched poorly with our ancestors’ genetic make-up; a statement supported by the finding that dental caries and periodontal diseases were more common among early farmers than among preagricultural humans (1, 3, 43, 46, 47 ). In addition to starch, grains also contain fiber; however, much of this fiber is of the insoluble type and is not accessed by colonic bacteria.
Just like our Neolithic forebears, our oral health suffers if we eat a lot of starchy and/or sugary foods, as highlighted by our need of dentists and ‘chemical solutions’ – toothpaste, mouthwashes, and the like – to keep caries-causing bacteria at bay. Just try going to bed without brushing your teeth with toothpaste following a grainy day of eating, and you’ll likely quickly notice that something feels “off”.