Ancestral. Primal. Wild. Paleolithic. All things old are new again when it comes to nutrition. But is it legit or just a fad? Conflicting advice abounds. Understanding what’s supposed to make up a “healthy” diet can leave your head spinning. Some consider the Paleo diet to be the perfect human diet. Popularized by Dr. Loren Cordain, it’s a metabolic diet plan designed to help you shed unwanted pounds and ward off diseases caused by our standard modern diet.

Let’s explore what the Paleo diet is, what it isn’t and what research says.

Caveman Cuisine: What is the Paleo Diet?

The Paleo diet refers to a dietary lifestyle that is meant to be similar to the way people ate during the Paleolithic era, which was the earlier part of the Stone Age that began about 2.5 million years ago. This was a time before organized farming and one in which survival depended on hunting, gathering and other primal skills. Modern interpretation of the Paleo diet varies, but generally includes grass-fed meat, eggs, lots of vegetables and some fruits, nuts and healthy fats.

So what did cavemen eat? The reality is that the versions of meat, vegetables, fruits, nuts and other foods that people in the Paleolithic era ate were different than what is available to us now. Animals were much leaner and fruits and vegetables were small and often inedible. Only after the organization of villages and the advent of farming practices about 10,000 years ago (around the time of the Neolithic period) did we start to cultivate meat, vegetables, fruits and nuts that resemble what we have today.

Even if the food we have today (thankfully) is a little different than what our Paleolithic ancestors had, the thinking behind this ancestral diet is that if we eat the way our bodies evolved, we can avoid many of the chronic inflammatory ailments that humans face today, like obesity, cancer, heart disease and autoimmune diseases.

But cavemen died in their 20s, right? Why would we want to eat like them? We could go down the internet rabbit hole of arguments about the actual lifespan of people during that time and whether or not their cause of death was related to diet or because they were eaten by tigers. However, a more relevant question might be, “Is this lifestyle healthy for me at this time?”

What’s on the Paleo Diet Menu?

Generally speaking, a Paleo diet shopping list includes:

• Grass-fed, pasture-raised, wild or game meat
• Fish, preferably wild-caught
• Eggs
• Vegetables, non-starchy (no green beans or peas)
• Fruit, non-starchy
• Tree nuts
• Tubers like sweet potatoes, yuca, cassava (white potatoes are controversial)
• Oils from coconut, avocado, olive, nuts and other non-grain sources that are rich in beneficial polyunsaturated fatty acids
• Herbs and spices
• Natural sweeteners like honey, maple syrup and agave
• Other “Paleo friendly” condiments like coconut aminos, vinegar and certain specially-prepared sauces
• Other things that our early ancestors may have eaten like grubs and insects

Foods to Avoid

The Paleo diet is designed to avoid the following foods:

• Dairy
• All grains, including quinoa, corn, soy, oats and rice
• White potatoes (depending on your philosophy and tolerance for them)
• Refined sugar
• Refined, industrial, inflammatory oils (corn, safflower, soy, etc.)
• Legumes like beans, lentils, peas, soy and peanuts
• Artificial sweeteners
• Alcoholic beverages
• Excess salt

Dairy and the Paleo Diet

Next to bread, giving up dairy is a tough adjustment for people. Why is dairy a no-no on the Paleo diet? The idea is that our earliest ancestors didn’t consume milk from any other animal. In theory, we don’t need it. We can get all the nutrients found in milk through other, evolution-friendly sources.

However, given that dairy products do contain a lot of nutrition and are pretty hard to avoid, some people may need additional reasons to give it up. Well, 80 percent of the adult population worldwide are lactose intolerant, and a smaller number have legitimate milk protein allergies. In addition, some claim that dairy is inflammatory, an assertion that has yet to be confirmed through data. The bottom line on dairy? Some people do okay with it while others feel much better then they eliminate it.

Meat and the Paleo Diet

A cornerstone of the Paleo diet is meat. This understandably is a deterrent for some people for reasons ranging from preference to ethical to budgetary. But is meat bad for you? Like dairy, it depends on who’s asking, who’s eating it and what type of meat is involved.

The general dietary advice used to be to limit red meat and to stick to lean cuts like chicken breast to keep consumption of saturated fat intake 10 percent of total calories per day. By doing this, it was believed people could avoid inflammatory conditions and minimize dietary cholesterol — both of which were highly implicated in chronic diseases like diabetes and heart disease. If you were to see a cardiologist today, he or she would probably give you the same advice based on decades-old research. Studies still focus on this issue and yield mixed results, sometimes indicating that reasonable serving sizes of red and fatty meats don’t necessarily increase your risk for these conditions.

Aside from the saturated fat and cholesterol content of some meats, there’s another potential drawback. A relationship may exist between consumption of red meat and cancer, especially when the meat is cooked at temperatures higher than 300 degrees F. Research is ongoing here as well. To confuse matters, studies sometimes lump red meat with processed meat, the latter of which isn’t recommended in large amounts on the Paleo diet.

The Paleo diet, while it does suggest grass-fed beef as a Paleo protein option, also allows for many other types of protein like pasture-raised chicken, eggs and wild caught fish. Despite the bad rap that meat gets, it is a great source of the appetite-squashing, muscle-building protein, vitamins and minerals that Paleo proponents believe we’re underconsuming.

Soy and the Paleo Diet

Soy is not part of the Paleo diet since it is a legume. Whether it should be part of any diet, actually, is highly questionable. The controversy around soy as a whole food or food additive (like texturized vegetable protein) centers around its phytoestrogen content. The phytoestrogens in soy can disrupt the functioning of the thyroid gland and sex hormones in males and females. It may be especially harmful in babies and children.

If you’re going to eat soy, the conventional wisdom is to eat small amounts, only on occasion, which are preferably fermented.

Paleo Diet Variations

The Paleo diet as we know it today has been around for a while now. Different tribes have since formed with their own Paleo-type diet philosophies. For example, some Paleo proponents advocate for the occasional consumption of some dairy like grass-fed butter, ghee and kefir.

Another variation ignores the no-alcohol rule. Some people just aren’t willing to give up alcoholic beverages completely so they choose “Paleo-friendlier” options like wine and tequila (since it’s made from agave) over grain-heavy beverages like beer.

And others can’t afford or don’t have access to 100 percent grass-fed or pasture-raised meats, so they choose the next best option, whatever that might be for them.

Another version of the Paleo diet is called the Paleo Autoimmune Protocol. Adopted by people looking to manage or reverse autoimmune conditions, this highly restrictive diet also leaves out eggs, nightshade vegetables (white potatoes, tomatoes, eggplants, peppers, etc.), certain spices, coffee and nuts.

The Wild Diet, introduced by health coach James Abel, is very similar to the Paleo diet in that it promotes the elimination of processed food, especially processed carbohydrates, in favor of high-quality, nutrition-dense whole foods. Cheese, butter, wine and chocolate are all given the green light.

Then there’s the Primal diet. It is essentially like the Paleo diet, asserting that health and wellness improve when people avoid farmed food.

Planning Your Meals

Does eating a diet consisting primarily of bananas drizzled with honey and sweet potatoes mean you’re following the Paleo diet? Technically yes, but that’s not the way the diet was designed. There is a suggested way to plan. In other words, a Paleo pyramid.

According the Dr. Cordain (the founder of the Paleo diet as we know it now), the macronutrient breakdown should be roughly:

• 20-35 percent protein from meat, eggs, or fish
• 35-45 percent carbohydrates from non-starchy fruit and vegetables
• 20-45 percent anti-inflammatory fat from sources like nuts, avocados, coconut and olives

Paleo Diet Benefits

Now that we have an idea of what the Paleo diet is, why would someone choose to adopt a lifestyle – yes, lifestyle – that can seem so restrictive, especially in such a delicious, processed food-rich world? There are actually many reasons. And once you get used to a new way of eating, it’s actually not restrictive at all. It can open your mind and palate to new things!

Weight Loss

Many find that they initially drop a few pounds when first following the Paleo diet. Why? This can be explained by a decrease in empty-calorie, processed foods for more nutrient-dense ones. The Paleo diet also helps to control appetite thanks to an emphasis on high quality proteins and fiber.

However, research shows that the diet can help some people change their bodies’ metabolisms, helping to keep weight off long term.

In one study, 58 overweight postmenopausal women followed either a diet low in fat and cholesterol or the Paleo-type diet. After two years, those who followed the Paleo-type diet saw a greater reduction in subcutaneous fat, as well as lower triglyceride levels and better insulin sensitivity.

Another study of 105 moderately obese people, 39 of whom had type 2 diabetes, found that following a Paleo-style diet that restricted specific processed foods led to overall significant weight loss after two years.

There was even a study that tried to examine the effects of the Paleo diet while keeping body weight the same. Despite efforts to keep study participant’s weight stable, their weight decreased. This was an unexpected outcome.

While there aren’t many specific studies to back this up, the Paleo diet plan seems to work well for people with an “endomorph” body type. Endomorphs tend to naturally have a little more fat, a little less muscle and gain weight easily.

However, not all studies show that the Paleo diet results in weight loss.

Better Blood Sugar

With or without weight loss, the Paleo diet promotes better blood sugar control and can improve the metabolic profiles of people with type 2 diabetes. Research shows it’s even more effective than the dietary advice touted by the American Diabetes Association. And for some, it can begin working right away.

By now, lots of research has been done on the relationship between the Paleo diet and factors that contribute to the onset and complications of diabetes. Here are just a few examples of what scientists found:

One study examined the effect of a Paleo diet on 32 people with type 2 diabetes. After 12 weeks, participants lost weight, but also lost a significant amount of fat around the liver. Insulin sensitivity greatly improved in peripheral and fat tissue.

Another study involving 13 men and women with type 2 diabetes found that compared to the “Diabetes diet,” the Paleo diet more effectively improved blood lipids, HbA1c, waist circumference, weight and blood pressure.

Research finds that introducing exercise along with Paleo dietary changes is even more effective. Studies show different ways this plays out. For example, the combination can improve cardiac function by directly impacting heart ventricles. Exercise plus diet also reversed diabetes-related cognitive changes by acting on the part of the brain called the hippocampus. And not surprisingly, exercise can increase the rate of fat loss.

Reduces Inflammation

Inflammation has become synonymous with unhealthy living. But what exactly is it? We can all recognize acute inflammation when we hurt ourselves and the site of injury becomes red and, well, inflamed. That’s a good thing! But low level, chronic inflammation is implicated in many diseases like cardiovascular disease, diabetes, arthritis, allergies and autoimmune conditions. Inflammatory markers like c-reactive protein and erythrocyte sedimentation rate can be measured in the blood.

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Fans of the Paleo diet cite its anti-inflammatory properties. Many hold the theory that the food we eat today is not what we’re meant to eat based on our evolution and therefore causes inflammation that leads to chronic illness. Is this true?

Research is mixed. Some studies do show that eating a Paleo diet results in decreased inflammation markers. A review from 2016 looking at multiple studies concluded that the Paleo diet does, in fact, reduce inflammation and oxidative stress.

The anti-inflammatory effect of the Paleo diet can be attributed to a better balance of omega-3 to omega-6 fatty acids. Replacing sugar-laden processed food with antioxidant-rich fruits and vegetables also helps.

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Paleo vs. the Other Plans

If you’re looking to drop a few pounds, intervene in your health, feel better, or just clean up your diet, there are a lot of diets to provide inspiration. How does Paleo match up to some of the more popular ones?

Paleo vs. Mediterranean Diet

The Mediterranean diet is a favorite among doctors and dietitians. It’s an eating philosophy that expresses nostalgia for the past. Not quite as far back as the Paleolithic era, but rather pre-1960s when processed, industrial food took over the Mediterranean. This diet emphasizes lots of olive oil and vegetables, some fruit, a little high-quality meat and dairy and a bit of whole grain and red wine to round it out. It’s considered heart-healthy, antioxidant-rich, diabetic-friendly, easy to stick to and adaptable to what’s available and preferred among different countries and cultures.

Both the Paleo and Mediterranean diets are linked to lower rates of mortality.

Paleo vs. Atkins

The Atkins diet, developed by Dr. Robert Atkins in the 1960s, used to be very controversial. It’s stood the test of time, however, and decades later the diet and the brand are going strong. This diet promotes weight loss and blood sugar control by heavily restricting carbohydrates in a series of four phases. Like Paleo, the diet centers around protein and vegetables. Unlike Paleo, however, the Atkins diet allows dairy products.

Both diets are shown in studies to help with weight loss and improve metabolic profiles in people with diabetes and other metabolic disorders.

Paleo vs. Whole 30

The Whole 30 diet was created by Melissa Hartwig and Dallas Hartwig and gained popularity beginning around 2007. It is the strictest version of the Paleo diet, but is meant to only last 30 days — a full 30 days. If you mess up, even a little, you’re asked to start again from Day 1. Why? This program challenges people to not only alter their metabolism, but to take a good hard look at their lifestyle, preferences, habits and priorities. Like the standard Paleo diet, people tend to lose weight (although stepping on the scale is forbidden) and many claim to feel better.

Like Atkins, Whole 30 is a brand. There are products, resources, online communities, even podcasts to help people navigate what to eat and how to avoid pitfalls.

Paleo Dos

There are some things you can do to set yourself up for success on the Paleo diet. For example:

• Plan ahead. Make sure you have a stocked fridge with emergency protein so you can make Paleo-friendly choices when hangry.
• Bring a Paleo-friendly dish to share at gatherings. This will ensure you have something to eat while not placing demands on your host.
• Drink plenty of water.

Paleo Don’ts

On the flip side, there are some suggested “don’ts,” including:

• Don’t be militant. If you’re finding success with the diet, that is wonderful. But don’t lose friends over it!
• Try not to rely too heavily on “Paleo” convenience foods. Frozen Paleo waffles are fine in a pinch or as a special treat, but the point of the diet is to eat food as clean and unprocessed as possible.
• Don’t sweat it if you fall off track. This isn’t the Whole 30 diet. If you give in to indulgences, you can hop right back on the wagon at any time.

Potential Drawbacks

Despite thousands of people claiming to feel better, lose weight and reverse metabolic diseases as a result of the Paleo diet, there are skeptics and critics. And for every study that shows why people might be feeling better, there are researchers pointing to evidence against it. What, exactly, are the potential drawbacks of the Paleo diet?

For one thing, parts of the scientific community can’t support a plan that touts red meat as an acceptable protein option. For decades, doctors and scientists believed it contributed to cardiovascular disease and death. New, larger observational studies, however, are finding that this more likely applies to processed meat, not unprocessed red meat.

The exclusion of dairy also presents a problem for some. Since dairy contains so much calcium, there is a concern that people will increase their risk for conditions like osteoporosis.

It also replaces inexpensive processed food with more expensive whole foods. Since many people don’t have the resources or access to Paleo-friendly food, it’s unfortunately only available to people with relative means.

The Paleo diet also carries a heavier carbon footprint.

The Bottom Line

So, what is the Paleo diet in a nutshell? It’s a way of eating that emphasizes high-quality, minimally processed, low-glycemic food. By focusing on clean protein and lots of fruits and vegetables, people can vastly increase their intake of nutrients while decreasing consumption of sugar, chemical additives and even calories. Studies show it helps improve metabolism, insulin sensitivity, appetite control and markers of cardiovascular disease. The emphasis on anti-inflammatory fats helps correct the omega-3 to omega-6 fatty acid imbalance that our modern diet offers. The downside? It is a lifestyle and requires commitment, and possibly a bigger grocery budget.