I'd say that looking at their idea of a healthy diet bottom is exactly where we want to be.

Well the problem with going against conventional wisdom is that no one who accepts convention will think you are wise.

But that is not really a problem for me.

My basic problem with the CW regarding exercise and has a terrible long term effectiveness- 2% maintain over two years according to the last study I can find (20% over a year, but I don't consider that long term)

If the usual eat right and exercise recommendation was a drug I doubt it would get FDA approval.

But instead of focusing on that failure of CW it is instead insisted that we just are not trying hard enough. And when blame becomes part of science it loses it claim to being science in my world.

He who laughs last, laughs best.

I'm about 30 pounds lighter now, I'm stronger, I'm toned, and I can run like a man half of my age. I'm also eliminating medications I've been on for about 5 years. Coming in last sure feel good.

Where I take issue: they do the breakdown on how the diet stacks up in protein, carbs and fat...and each paragraph says how paleo does or does not meet the "government's recommendations." Based on today's headlines about figures in our government, I'm gonna stick with what I know works and isn't more about some powerful food lobby and whose pockets they are lining...

Barfing all over the place wouldn't even give a fair picture representation of what I think of the "nutritionalists" that are responsible for these rankings.

Did you see the Volumetrics diet that ranked #5? Did you see what you can eat on this 'diet'? This is where the stupidity of human nature astounds me. "Go ahead and eat any freaking thing you want, so long as yada yada yada...." Ridiculous. Can you lose weight? Perhaps, but you might die of heart disease and diabetes several weeks later.

Anyway, I could pick apart and annihilate a lot of other parts of this, but really it's not worth our time. This is bogus.

Most of what is said about the Paleo diet on your second link is actually positive. There's some misinformation about fats and stuff, but I found the info to be fairly accurate and positive. So I'm not sure where the nutritionalists felt these points would garner a last place ranking amoung these other disgusting diets. Seems like something weird is going on with the ranking choices.

Do you see the pictures of food for many of the other diets? Pancakes and syrup... French Toast... wtf???

Look at what they say as a key positive for "Medifast" >> "Nutritionally Sound". Really? Shakes, Bars, Oatmeal, low fat dairy, lean meats, cheesepuffs?

Idiotic. I like to be a positive person in general, but this hurts my belief in people to see this. Blecckkkk.

Thanks for posting this Jess. As much as it hurts, I suppose it's good to be aware of it. But I gotta go read something intelligent now so I can remember that there are people that don't have mashed potatoes for brains.

Ridiculous, but completely expected. They say that so much is unknown about it because there have not been studies around it. Of coutrse, the only studies they look at are from the major grant whore research firms that are sponsored by the Corn Refiners Association and others like it.

Of course, we could sit and pick through all the things that they say about but that would take forever. The biggest thing that I notice is just the general reliance on not only SAD nutrition data, but also SAD supporting science to back it all up. Saying things like "shunning dairy and grains, you’re at risk of missing out on a lot of nutrients." Such as? Also still harping on fat causing heart disease. Really?

So as I said, ridiculous, but not the least bit surprising.

They mention that "the government says" or the "government recommends" numerous times throughout. If over the last 30 years the government has said this, that, or the other, and people are still getting fatter, unhealthier, and more diseased, they're clearly missing the common denominator in all this.

Mei-ling hit it on the head, questioning common sense. Or, as the old saying goes "if you always do what you've always done, you'll always get what you've always gotten." Clearly the top-rated and "best" diets haven't worked. Wouldn't it make even a tiny bit of sense to try something completely opposite (i.e. paleo)?

I found this part funny:

"Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients. Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems."

What nutrients are in grains that I can't get from fruits and veggies?

I also think it's lame there is no ability to comment on the site.

Well, if the conventional diet recommendations are resulting in how people currently look and feel, and considering what the overall state of human health is, I'd say doing the exact opposite of what everybody else is doing is a great place to start.

Being at the bottom of their upside down rating system lets me know the paleo diet is actually on top.

“First they ignore you, then they laugh at you, then they fight you, then you win.” ~ Mahatma Gandhi

They said you can't get enough Vitamin D and Calcium in the Paleo diet, but in the Atkins diet review said that 3 oz of sockeye salmon would get you the Vit D you need. Then in the South Beach diet they recommend spinach and sesame seeds to... get your calcium. Sounds like the individuals who rated each diet didn't talk to each other, and don't have the same nutritional background. They appear to have assigned the Paleo Diet rating to an intern.

This is a misleading title for this post. It was ranked the 20th BEST diet (out of a possible hundreds/thousands of different diets), not the worst diet. Being top 20 in USNews is a fair amount of exposure for this lifestyle and I'm glad to see it on that list at all. We all know it should be #1, but got to start somewhere ;)

"How much does it cost?

It may be pricey—the produce section and meat counter are among the priciest corners of the grocery store."

That statement says it all. What a sad predicament we find ourselves in, when the "experts" recommend eating things that come in boxes from a factory rather than from a farm because it's cheaper.

I couldn't understand the bit where they suggest Paleo diets don't help diabetes sufferers and that most diabetes doc suggest grains and diary! Good call to keep people insulin and medication dependent. Also hilarious given that his son's diabetes was the motivation for Art DeVany to develop his Paleo diet in the first place.

Ummm....DId I misread, or did they down grade Paleo because it doesn't allow "milk and cookies."?????? 'Nuff said.

The more I read this, the more ridiculous it becomes. The Slim-Fast one is just frustrating.

Slim-Fast products contain adequate vitamins, minerals, and nutrients for the typical adult. A French Vanilla Shake, for example, contains 35 percent of the daily recommended vitamin A, 35 percent of vitamin D, 100 percent of vitamin C, and 50 percent of recommended calcium.

There’s a wide variety of flavors, but if you don’t like the taste, the diet isn’t for you; you’re allowed only one home-cooked meal a day.

It seems that this article measures each diet against the US government requirements / recommendations. What it doesn't do is measure results.

Until there is a big 5 year study with a bunch of people sticking to all of these diets in a controlled environment and we can then compare the results (don't hold your breath), the only thing the nutrition publications can do is compare the diets to "recommendations". Nevermind that it is these recommendations that made the public so unhealthy to begin with.

The fallacy is that the article basically says "if you follow the government recommendations, you'll be healthy" and "if you're on a diet, we'll compare it to recommendations to tell you how healthy it is". The problem is that the recommendations DON'T make people healthy. This is like saying "the best way to get a job is to have a pompadour hair style" and then comparing all hair styles to the pompadour and providing elaborate rankings on how closely they match. But the basic premise is wrong.

You wonder where they get their data too. For instance it says that it is "unknown" if the Paleo diet helps with diabetes. Yet you can Google up dozens of testimonials that it does. You can also find testimonials that it helps with IBD, weight loss, skin and hair conditions, energy levels, and a host of other things. But I guess until this data is found in a government-funded study, it doesn't count. And guess what, the government will never fund such a study.

Purveyors of conventional wisdom seem to be in a full-court press against Paleo lately, the success stories must make them nervous.

Does it have cardiovascular benefits?

Unknown. While some studies have linked Paleo diets with reducing blood pressure, bad “LDL” cholesterol, and triglycerides (a fatty substance that can raise heart disease risk), they have been few, small, and short. And all that fat would worry most experts.

Science: yes

"Experts": no

Can it prevent or control diabetes?

...Control: One small study comparing a Paleo and a traditional diabetes diet in 13 type 2 diabetics showed the Paleo diet resulted in lower levels of hemoglobin A1C, a measure of blood sugar over time. The approach needs to be studied more before strong conclusions can be drawn, but most diabetes experts recommend a diet that includes whole grains and dairy products.

Science: yes

"Experts": no

If you look at the Atkins diet review, it's exactly the same... even though Atkins has outperformed DASH in studies.

This review is clueless.

This result is great news if you ask me.

How about that Ornish diet?

The experts considered the Ornish diet “very safe,” with an average score of 4 stars. A menu that emphasizes lots of produce and whole grains and cuts back on fat certainly shouldn’t do any harm.

Yes, of course, lots of whole grains and almost no fat... that shouldn't do any harm.

How about that DASH diet?

Mirroring the federal government's 2010 Dietary Guidelines, the diet came in at No. 1 in this category.

AMAZING!

Mental note: Do not read USN-Health

"... by nutritionists, specialists in diabetes and heart disease, and other diet experts..." "...paleo was considered the worst..." - - - shouldn't that 'conclusion' serve rather as a sort of 'badge of honor'?)

Well in 1 year I lost 150+lbs, my doctor says I'm am very healthy for my age. I am not even close to needing blood pressure, statins or diabetes medications. I'll stick with what got me here. Looking at friends who have diabetes, it would appear from my view they diet they are on contributes to elevated blood sugar levels. What do I know? I'm just a caveman. In a society where you are rare if you are not on some form of medication, I think it fits my question everything personality types.

Under each diet it says "Did this diet work for you?" Paleo has the least amount of "no's" at 13 and the "yes's" are currently at an astounding 222, bested only by Weight Watchers. I think that speaks louder than the article's rankings.

I'm sure many of you have already read this, but I checked the thread above and didn't find a link. Prof. Cordain refutes the article pretty well here:

http://robbwolf.com/2011/06/09/us-news-best-diets/

Sorry if it's a repeat.

Hi Doc,

I'm not sure if you've seen this or not, but US News ranked Paleo last of 20 diets claiming a lack of scientific evidence and no-long term weight maintenance guidelines. I'm not sure if you'd be interested in defending it or not, but if you'd be willing to provide specific refutations of their claims, I'd like to write a response piece for the Colorado State University Collegian to run next Wednesday, my deadline is Saturday.

Thanks. http://health.usnews.com/best-diet/paleo-diet

http://health.usnews.com/best-diet/best-overall-diets

Seth Stern

June 8, 2011

Hi Seth,

Good to hear from you and many thanks for your continued support of the Paleo Diet. I hadn’t seen this piece, but I appreciate that you have brought it to my attention. 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 writer’s 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. You have my permission to syndicate my response and or your write up for the CSU Collegian to any of the major news services including AP and UPI. Additionally, I will copy a number of colleagues and scientists worldwide with this message to ensure that it will be widely circulated on the web, blogs and chat groups.

The writer of this article suggests that the Paleo Diet has only been scientifically tested in “one tiny study”. This quote is incorrect as five studies (1-7); four since 2007, have experimentally tested contemporary versions of ancestral human diets and have found them to be 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.

The first study to experimentally test diets devoid of grains, dairy and processed foods was performed by Dr. Kerin O’Dea at the University of Melbourne and published in the Journal, Diabetes in 1984 (6). In this study Dr. O’Dea gathered together 10 middle aged Australian Aborigines who had been born in the “Outback”. They had lived their early days primarily as hunter gatherers until they had no choice but to finally settle into a rural community with access to western goods. Predictably, all ten subjects eventually became overweight and developed type 2 diabetes as they adopted western sedentary lifestyles in the community of Mowwanjum in the northern Kimberley region of Western Australia. However, inherent in their upbringing was the knowledge to live and survive in this seemingly desolate land without any of the trappings of the modern world.

Dr. O’Dea requested these 10 middle aged subjects to revert to their former lives as hunter gatherers for a seven week period. All agreed and traveled back into the isolated land from which they originated. Their daily sustenance came only from native foods that could be foraged, hunted or gathered. Instead of white bread, corn, sugar, powdered milk and canned foods, they began to eat the traditional fresh foods of their ancestral past: kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey. At the experiment’s conclusion, the results were spectacular, but not altogether unexpected given what known about Paleo diets, even then. The average weight loss in the group was 16.5 lbs; blood cholesterol dropped by 12 % and triglycerides were reduced by a whopping 72 %. Insulin and glucose metabolism became normal, and their diabetes effectively disappeared.

The first recent study to experimentally test contemporary Paleo diets was published in 2007 (5). Dr. Lindeberg and associates placed 29 patients with type 2 diabetes and heart disease on either a Paleo diet or a Mediterranean diet based upon whole grains, low-fat dairy products, vegetables, fruits, fish, oils, and margarines. Note that the Paleo diet excludes grains, dairy products and margarines while encouraging greater consumption of meat and fish. After 12 weeks on either diet blood glucose tolerance (a risk factor for heart disease) improved in both groups, but was better in the Paleo dieters. In a 2010 follow-up publication, of this same experiment the Paleo diet was shown to be more satiating on a calorie by calorie basis than the Mediterranean diet because it caused greater changes in leptin, a hormone which regulates appetite and body weight.

In the second modern study (2008) of Paleo Diets, Dr. Osterdahl and co-workers (7) put 14 healthy subjects on a Paleo diet. After only three weeks the subjects lost weight, reduced their waist size and experienced significant reductions in blood pressure, and plasminogen activator inhibitor (a substance in blood which promotes clotting and accelerates artery clogging). Because no control group was employed in this study, some scientists would argue that the beneficial changes might not necessarily be due to the Paleo diet. However, a better controlled more recent experiments showed similar results.

In 2009, Dr. Frasetto and co-workers (1) put nine inactive subjects on a Paleo diet for just 10 days. In this experiment, the Paleo diet was exactly matched in calories with the subjects’ usual diet. Anytime people eat diets that are calorically reduced, no matter what foods are involved, they exhibit beneficial health effects. So the beauty of this experiment was that any therapeutic changes in the subjects’ health could not be credited to reductions in calories, but rather to changes in the types of food eaten. While on the Paleo diet either eight or all nine participants experienced improvements in blood pressure, arterial function, insulin, total cholesterol, LDL cholesterol and triglycerides. What is striking about this experiment is how rapidly so many markers of health improved, and that they occurred in every single patient.

In an even more convincing recent (2009) experiment, Dr. Lindeberg and colleagues (2) compared the effects of a Paleo diet to a diabetes diet generally recommended for patients with type 2 diabetes. The diabetes diet was intended to reduce total fat by increasing whole grain bread and cereals, low fat dairy products, fruits and vegetables while restricting animal foods. In contrast, the Paleo diet was lower in cereals, dairy products, potatoes, beans, and bakery foods but higher in fruits, vegetables, meat, and eggs compared to the diabetes diet. The strength of this experiment was its cross over design in which all 13 diabetes patients first ate one diet for three months and then crossed over and ate the other diet for three months. Compared to the diabetes diet, the Paleo diet resulted in improved weight loss, waist size, blood pressure, HDL cholesterol, triglycerides, blood glucose and hemoglobin A1c (a marker for long term blood glucose control). This experiment represents the most powerful example to date of the Paleo diet’s effectiveness in treating people with serious health problems.

So, now that I have summarized the experimental evidence supporting the health and weight loss benefits of Paleo Diets, I would like to directly respond to the errors in the U.S. News and World Report article.

1. “Will you lose weight? No way to tell.”

Obviously, the author of this article did not read either the study by O’Dea (6) or the more powerful three month crossover experiment by Jonsson and colleagues (9) which demonstrated the superior weight loss potential of high protein, low glycemic load Paleo diets. Similar results of high protein, low glycemic load diets have recently been reported in the largest randomized controlled trials ever undertaken in both adults and children. A 2010 randomized trial involving 773 subjects and published in the New England Journal of Medicine (8) confirmed that high protein, low glycemic index diets were the most effective strategy to keep weight off. The same beneficial effects of high protein, low glycemic index diets were dramatically demonstrated in largest nutritional trial, The DiOGenes Study (9), ever conducted in a sample of 827 children. Children assigned to low protein, high glycemic diets became significantly fatter over the 6 month experiment, whereas those overweight and obese children assigned to the high protein, low glycemic nutritional plan lost significant weight.

1. “Does it have cardiovascular benefits? Unknown.”

This comment shows just how uninformed this writer really is. Clearly, this person hasn’t read the following papers (1 – 6) which unequivocally show the therapeutic effects of Paleo Diets upon cardiovascular risk factors.

“And all that fat would worry most experts.”  

This statement represents a “scare tactic” unsubstantiated by the data. As I, and almost the entire nutritional community, have previously pointed out, it is not the quantity of fat which increases the risk for cardiovascular disease or cancer, or any other health problem, but rather the quality. Contemporary Paleo Diets contain high concentrations of healthful omega 3 fatty acids, monounsaturated fatty acids and long chain polyunsaturated fatty acids that actually reduce the risk for chronic disease (10-18).
3. “Can it prevent or control diabetes? Unknown.”
Here is another example of irresponsible and biased journalism which doesn’t let the facts speak for themselves. Obviously, the author did not read the study by O’dea (6) or Jonsson et al. (2) which showed dramatic improvements in type 2 diabetics consuming Paleo diets.

“but most diabetes experts recommend a diet that includes whole grains and dairy products.”  

If the truth be known, in a randomized controlled trial, 24 8-y-old boys were asked to take 53 g of protein as milk or meat daily (19). After only 7 days on the high milk diet, the boys became insulin resistant. This is a condition that precedes the development of type 2 diabetes. In contrast, In the meat-group, there was no increase in insulin and insulin resistance. Further, in the Jonsson et al. study (2) milk and grain free diets were shown to have superior results in improving disease symptoms in type 2 diabetics. 4. “Are there health risks? Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients.”

Once again, this statement shows the writer’s ignorance and blatant disregard for the facts. Because contemporary ancestral diets exclude processed foods, dairy and grains, they are actually more nutrient (vitamins, minerals and phytochemicals) dense than government recommended diets such as the food pyramid. I have pointed out these facts in a paper I published in the American Journal of Nutrition in 2005 (13) along with another paper in which I analyzed the nutrient content of modern day Paleo diets (12 ). Most nutritionists are aware that processed foods made with refined grains, sugars and vegetable oils have low concentrations of vitamins and minerals, but few realized that dairy products and whole grains contain significantly lower concentrations of the 13 vitamins and minerals most lacking in the U.S. diet compared to lean meats, fish and fresh fruit and vegetables (12, 13).

“Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems” . Actually, the most recent comprehensive meta analyses do not show fresh meat consumption whether fat or lean to be a significant risk factor for cardiovascular disease (20-25), only processed meats such as salami, bologna, bacon and sausages (20).

References

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.

8. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, Astrup A; Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010 Nov 25;363(22):2102-13

9. Papadaki A, Linardakis M, Larsen TM, van Baak MA, Lindroos AK, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesová M, Holst C, Astrup A, Saris WH, Kafatos A; DiOGenes Study Group. The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study. Pediatrics. 2010 Nov;126(5):e1143-52

10. Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes. In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126.

11. Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets.Am J Clin Nutr. 2000 Mar;71(3):682-92.

12. Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24.

13. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.

14. Kuipers RS, Luxwolda MF, Dijck-Brouwer DA, Eaton SB, Crawford MA, Cordain L, Muskiet FA. Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet. Br J Nutr. 2010 Dec;104(11):1666-87.

15. Ramsden CE, Faurot KR, Carrera-Bastos P, Cordain L, De Lorgeril M, Sperling LS.Dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global, and modern perspectives. Curr Treat Options Cardiovasc Med. 2009 Aug;11(4):289-301.

16. Cordain L, Eaton SB, Miller JB, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr. 2002 Mar;56 Suppl 1:S42-52

17. Cordain L, Watkins BA, Florant GL, Kelher M, Rogers L, Li Y. Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease. Eur J Clin Nutr. 2002 Mar;56(3):181-91

18. Carrera-Bastos P, Fontes Villalba M, O’Keefe JH, Lindeberg S, Cordain L. The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol 2011; 2: 215-235.

19. Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8.

20. Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010 Jun 1;121(21):2271-83

21. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010 Oct;45(10):893-905. Epub 2010 Mar 31.

22. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010 Mar 23;7(3):e1000252.

23. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. Curr Atheroscler Rep. 2010 Nov;12(6):384-90.

24. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):502-9

25. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46

Hi Doc,

I'm not sure if you've seen this or not, but US News ranked Paleo last of 20 diets claiming a lack of scientific evidence and no-long term weight maintenance guidelines. I'm not sure if you'd be interested in defending it or not, but if you'd be willing to provide specific refutations of their claims, I'd like to write a response piece for the Colorado State University Collegian to run next Wednesday, my deadline is Saturday.

Thanks. http://health.usnews.com/best-diet/paleo-diet

http://health.usnews.com/best-diet/best-overall-diets

Seth Stern

June 8, 2011

Hi Seth,

Good to hear from you and many thanks for your continued support of the Paleo Diet. I hadn’t seen this piece, but I appreciate that you have brought it to my attention. 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 writer’s 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. You have my permission to syndicate my response and or your write up for the CSU Collegian to any of the major news services including AP and UPI. Additionally, I will copy a number of colleagues and scientists worldwide with this message to ensure that it will be widely circulated on the web, blogs and chat groups.

The writer of this article suggests that the Paleo Diet has only been scientifically tested in “one tiny study”. This quote is incorrect as five studies (1-7); four since 2007, have experimentally tested contemporary versions of ancestral human diets and have found them to be 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.

The first study to experimentally test diets devoid of grains, dairy and processed foods was performed by Dr. Kerin O’Dea at the University of Melbourne and published in the Journal, Diabetes in 1984 (6). In this study Dr. O’Dea gathered together 10 middle aged Australian Aborigines who had been born in the “Outback”. They had lived their early days primarily as hunter gatherers until they had no choice but to finally settle into a rural community with access to western goods. Predictably, all ten subjects eventually became overweight and developed type 2 diabetes as they adopted western sedentary lifestyles in the community of Mowwanjum in the northern Kimberley region of Western Australia. However, inherent in their upbringing was the knowledge to live and survive in this seemingly desolate land without any of the trappings of the modern world.

Dr. O’Dea requested these 10 middle aged subjects to revert to their former lives as hunter gatherers for a seven week period. All agreed and traveled back into the isolated land from which they originated. Their daily sustenance came only from native foods that could be foraged, hunted or gathered. Instead of white bread, corn, sugar, powdered milk and canned foods, they began to eat the traditional fresh foods of their ancestral past: kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey. At the experiment’s conclusion, the results were spectacular, but not altogether unexpected given what known about Paleo diets, even then. The average weight loss in the group was 16.5 lbs; blood cholesterol dropped by 12 % and triglycerides were reduced by a whopping 72 %. Insulin and glucose metabolism became normal, and their diabetes effectively disappeared.

The first recent study to experimentally test contemporary Paleo diets was published in 2007 (5). Dr. Lindeberg and associates placed 29 patients with type 2 diabetes and heart disease on either a Paleo diet or a Mediterranean diet based upon whole grains, low-fat dairy products, vegetables, fruits, fish, oils, and margarines. Note that the Paleo diet excludes grains, dairy products and margarines while encouraging greater consumption of meat and fish. After 12 weeks on either diet blood glucose tolerance (a risk factor for heart disease) improved in both groups, but was better in the Paleo dieters. In a 2010 follow-up publication, of this same experiment the Paleo diet was shown to be more satiating on a calorie by calorie basis than the Mediterranean diet because it caused greater changes in leptin, a hormone which regulates appetite and body weight.

In the second modern study (2008) of Paleo Diets, Dr. Osterdahl and co-workers (7) put 14 healthy subjects on a Paleo diet. After only three weeks the subjects lost weight, reduced their waist size and experienced significant reductions in blood pressure, and plasminogen activator inhibitor (a substance in blood which promotes clotting and accelerates artery clogging). Because no control group was employed in this study, some scientists would argue that the beneficial changes might not necessarily be due to the Paleo diet. However, a better controlled more recent experiments showed similar results.

In 2009, Dr. Frasetto and co-workers (1) put nine inactive subjects on a Paleo diet for just 10 days. In this experiment, the Paleo diet was exactly matched in calories with the subjects’ usual diet. Anytime people eat diets that are calorically reduced, no matter what foods are involved, they exhibit beneficial health effects. So the beauty of this experiment was that any therapeutic changes in the subjects’ health could not be credited to reductions in calories, but rather to changes in the types of food eaten. While on the Paleo diet either eight or all nine participants experienced improvements in blood pressure, arterial function, insulin, total cholesterol, LDL cholesterol and triglycerides. What is striking about this experiment is how rapidly so many markers of health improved, and that they occurred in every single patient.

In an even more convincing recent (2009) experiment, Dr. Lindeberg and colleagues (2) compared the effects of a Paleo diet to a diabetes diet generally recommended for patients with type 2 diabetes. The diabetes diet was intended to reduce total fat by increasing whole grain bread and cereals, low fat dairy products, fruits and vegetables while restricting animal foods. In contrast, the Paleo diet was lower in cereals, dairy products, potatoes, beans, and bakery foods but higher in fruits, vegetables, meat, and eggs compared to the diabetes diet. The strength of this experiment was its cross over design in which all 13 diabetes patients first ate one diet for three months and then crossed over and ate the other diet for three months. Compared to the diabetes diet, the Paleo diet resulted in improved weight loss, waist size, blood pressure, HDL cholesterol, triglycerides, blood glucose and hemoglobin A1c (a marker for long term blood glucose control). This experiment represents the most powerful example to date of the Paleo diet’s effectiveness in treating people with serious health problems.

So, now that I have summarized the experimental evidence supporting the health and weight loss benefits of Paleo Diets, I would like to directly respond to the errors in the U.S. News and World Report article.

1. “Will you lose weight? No way to tell.”

Obviously, the author of this article did not read either the study by O’Dea (6) or the more powerful three month crossover experiment by Jonsson and colleagues (9) which demonstrated the superior weight loss potential of high protein, low glycemic load Paleo diets. Similar results of high protein, low glycemic load diets have recently been reported in the largest randomized controlled trials ever undertaken in both adults and children. A 2010 randomized trial involving 773 subjects and published in the New England Journal of Medicine (8) confirmed that high protein, low glycemic index diets were the most effective strategy to keep weight off. The same beneficial effects of high protein, low glycemic index diets were dramatically demonstrated in largest nutritional trial, The DiOGenes Study (9), ever conducted in a sample of 827 children. Children assigned to low protein, high glycemic diets became significantly fatter over the 6 month experiment, whereas those overweight and obese children assigned to the high protein, low glycemic nutritional plan lost significant weight.

1. “Does it have cardiovascular benefits? Unknown.”

This comment shows just how uninformed this writer really is. Clearly, this person hasn’t read the following papers (1 – 6) which unequivocally show the therapeutic effects of Paleo Diets upon cardiovascular risk factors.

“And all that fat would worry most experts.”  

This statement represents a “scare tactic” unsubstantiated by the data. As I, and almost the entire nutritional community, have previously pointed out, it is not the quantity of fat which increases the risk for cardiovascular disease or cancer, or any other health problem, but rather the quality. Contemporary Paleo Diets contain high concentrations of healthful omega 3 fatty acids, monounsaturated fatty acids and long chain polyunsaturated fatty acids that actually reduce the risk for chronic disease (10-18).
3. “Can it prevent or control diabetes? Unknown.”
Here is another example of irresponsible and biased journalism which doesn’t let the facts speak for themselves. Obviously, the author did not read the study by O’dea (6) or Jonsson et al. (2) which showed dramatic improvements in type 2 diabetics consuming Paleo diets.

“but most diabetes experts recommend a diet that includes whole grains and dairy products.”  

If the truth be known, in a randomized controlled trial, 24 8-y-old boys were asked to take 53 g of protein as milk or meat daily (19). After only 7 days on the high milk diet, the boys became insulin resistant. This is a condition that precedes the development of type 2 diabetes. In contrast, In the meat-group, there was no increase in insulin and insulin resistance. Further, in the Jonsson et al. study (2) milk and grain free diets were shown to have superior results in improving disease symptoms in type 2 diabetics. 4. “Are there health risks? Possibly. By shunning dairy and grains, you’re at risk of missing out on a lot of nutrients.”

Once again, this statement shows the writer’s ignorance and blatant disregard for the facts. Because contemporary ancestral diets exclude processed foods, dairy and grains, they are actually more nutrient (vitamins, minerals and phytochemicals) dense than government recommended diets such as the food pyramid. I have pointed out these facts in a paper I published in the American Journal of Nutrition in 2005 (13) along with another paper in which I analyzed the nutrient content of modern day Paleo diets (12 ). Most nutritionists are aware that processed foods made with refined grains, sugars and vegetable oils have low concentrations of vitamins and minerals, but few realized that dairy products and whole grains contain significantly lower concentrations of the 13 vitamins and minerals most lacking in the U.S. diet compared to lean meats, fish and fresh fruit and vegetables (12, 13).

“Also, if you’re not careful about making lean meat choices, you’ll quickly ratchet up your risk for heart problems” . Actually, the most recent comprehensive meta analyses do not show fresh meat consumption whether fat or lean to be a significant risk factor for cardiovascular disease (20-25), only processed meats such as salami, bologna, bacon and sausages (20).

References

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.

8. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, Astrup A; Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010 Nov 25;363(22):2102-13

9. Papadaki A, Linardakis M, Larsen TM, van Baak MA, Lindroos AK, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesová M, Holst C, Astrup A, Saris WH, Kafatos A; DiOGenes Study Group. The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study. Pediatrics. 2010 Nov;126(5):e1143-52

10. Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes. In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126.

11. Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets.Am J Clin Nutr. 2000 Mar;71(3):682-92.

12. Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24.

13. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.

14. Kuipers RS, Luxwolda MF, Dijck-Brouwer DA, Eaton SB, Crawford MA, Cordain L, Muskiet FA. Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet. Br J Nutr. 2010 Dec;104(11):1666-87.

15. Ramsden CE, Faurot KR, Carrera-Bastos P, Cordain L, De Lorgeril M, Sperling LS.Dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global, and modern perspectives. Curr Treat Options Cardiovasc Med. 2009 Aug;11(4):289-301.

16. Cordain L, Eaton SB, Miller JB, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr. 2002 Mar;56 Suppl 1:S42-52

17. Cordain L, Watkins BA, Florant GL, Kelher M, Rogers L, Li Y. Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease. Eur J Clin Nutr. 2002 Mar;56(3):181-91

18. Carrera-Bastos P, Fontes Villalba M, O’Keefe JH, Lindeberg S, Cordain L. The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol 2011; 2: 215-235.

19. Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8.

20. Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010 Jun 1;121(21):2271-83

21. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010 Oct;45(10):893-905. Epub 2010 Mar 31.

22. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010 Mar 23;7(3):e1000252.

23. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. Curr Atheroscler Rep. 2010 Nov;12(6):384-90.

24. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):502-9

25. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46

Just wanted to make sure everyone knew that, as noted by someone else, individuals can vote or give feedback on each diet and whether or not it worked for you. Might be worth a minute of your time to provide feedback to these numskulls.

Cast your vote for paleo

To US News Health's defense, and at least on Twitter, they admitted to 'dropping the ball' as I put it:

@USNewsHealth you really dropped the ball :( RT @PaleoHacks: Have you seen Dr. Cordain's rebuttal? http://goo.gl/fb/d9PSc

Their response:

@briangm We have, and we certainly appreciate the thoughtful feedback.

I hope this means that they will retract or amend their report.