There's no evidence that people eating low-fat diets based on whole grains and legumes are actually free (or nearly free) from modern diseases -- only that they fare better than people on highly processed/industrial diets. The notion that they're "healthy" is relative. If a grain/legume/low-fat-dairy-heavy diet brings heart disease mortality down to 150 deaths per 100,000 instead of 200 deaths, can we really call that successful, or only less terrible?

I doubt that any diet can completely eradicate disease, but IMO, ones rich in grains/legumes/low-fat dairy only seem good because the baseline is Lean Cuisines and Cocoa Puffs.

The "people who eat grains, etc. are healthier" argument would only be legit if we compared that kind of diet to something paleo-style and found the grain eaters had superior health outcomes. It's useless to compare low-fat-whole-grain to a standard industrial diet and then extrapolate the results to paleo, like the linked article seems to do.

By the way, the guy who was quoted for that "grains, beans, and low-fat dairy are healthy" statement (Keith Ayoob) wrote a book called The Uncle Sam Diet, which is based on the 2005 USDA guidelines for Americans. It's pretty clear what perspective he's coming from.

Common Wisdom for the past 60 years has dictated that a healthy diet consists of "whole grains, legumes, and low fat."

So, people who have been trying to be healthy for the past 60 years have eaten this way. Hence, the research would tend to show that "healthy" people eat this way. They also eat less processed crap, exercise more, etc.

Then comes along the Paleo diet, and throws a curve ball into the Common Wisdom sphere of reference. We say, “humans will be healthier eating healthy amounts of animal fat, no grain and no legumes the way our bodies were intended”. The establishment is searching for research to justify our point of view, and all they can find is “meat will kill you”. Meat will kill you if you eat it deep fried and slathered in sugar sauce. This is how the “meat eaters” have been eating it, because people who eat more meat have tendended to be less conscious of their health (due to that CW thing again).

Bottom line, we are creating a new reference point, and so until enough time goes by to establish a proper baseline (i.e there are actually Paleo people getting ready to die from old age) nobody will have any concrete statistics to judge. We will just have to go on pesky science and historic reference.

WebMD: Where every symptom you have = cancer.

The hunter gatherer diet is on a 1 million year hot streak.

That's some fad!

Uncle Sam has been spoon feeding us grain and dairy as food groups since around 1950.

60 years and counting!!!

Not a fad?

Hmmmmm.

The 'evidence' they cite from WebMD is just asking some nutritionists:

“People who eat diets high in whole grains, beans, and low-fat dairy tend to be healthier because these foods are nutrient-rich and there are mountains of research about the health benefits of diets that include, not exclude, these foods,” says Keith Ayoob, EDd, RD, an assistant professor at New York's Albert Einstien School of Medicine.

I used to think (when I was around 18) that nutrient density was the be all and end all of health. Indeed, in my innocence I didn't pay any attention to the idea of a macronutrient, except insofar as I wanted to get enough protein. But actually, being "nutrient-rich" isn't really a good marker- lots of different diets can be nutrient rich and indeed getting enough micronutrients ought to be very easily achieved.

As to the "mountains of evidence," well, as we know, there isn't mountains of evidence for most of these claims (I especially like Peter's series on fruit and vegetables, even though I still eat lots of vegetables). In any case all the evidence really just compares SAD to SAD + wholegrains or equivalent (basically, higher fibre, lower palatability, actually got some micronutrients in it SAD). I'm not surprised that if you take any obesogenic diet and add some fibre and subtract some taste, that you're going to see modest benefits.

American Dietetic Association spokeswoman Heather Mangieri, MS, RD, says, "This diet has some great aspects, but the limitations make it another diet that people go on but can’t sustain for a number of reasons, including a lack of variety, [cost], and potential nutrient inadequacies" due to the elimination of certain food groups.

This is, of course, nonsense. Lack of variety is clearly not a drastic problem for a diet, as we can see from the various HG groups who subsist on about 5 foodstuffs (often with one staple dominating) all year. Impugning a diet with being "unsustainable" on the basis that people eating it want to eat junk and junk isn't in the diet is unreasonable. Also almost any combination of animal + plant seems to me to be plenty of variety. Cost is definitely not an issue. I eat very cheaply on a paleo diet- less than £5 a day, whereas a Subway or a pizza from a supermarket costs about £6 or £4 respectively. Of course I also eat conventional meat, but I've yet to see even any plausible suggestions as to why this would be a bad thing. Nutrient inadequacies from the loss of food groups is equally silly. The only one I can imagine is lack of calcium, but tbh if you assume that humans need something that would have been physically impossible for them to attain for almost all of their evolution then I think you ought to look again at your theory.

David Katz, MD, the author of Way to Eat, tells WebMD by email that “eating more foods direct from nature is far better than the typical American diet, but how the Paleo-type diet compares in terms of long-term outcomes to an Asian, Mediterranean, vegan, or other optimized diet, we just don’t know.”

Of course, his complaint that we don't have a long term comparison of the diets also extends to the SAD/Food pyramid diet, since all we have here is comparisons of people eating a more or less standard diet, from which we extrapolate associations. Frankly I don't see the need to compare each individual diet pattern to every other before we form a judgement. We already have lots of data about the benefits and harms of protein, animal fat, omega 3:6 ratios, excess PUFA, grains, fructose etc. etc. so whatever the benefits of holistic analysis, it's not merely unnecessary, but unjustifiably conservative to insist on scepticism until a direct head to head study has been done of any diet permutation you might try. This is especially peculiar given that 'paleo' contains a very wide spectrum of diets (as mediterranean does in the real world, but not for the purposes of trials).

The one study I have seen comparing paleo to the mediterranean diet showed that paleo beat the mediterranean convincingly for satiety and thus weight loss. The diet was interesting insofar that the increase in satiety was somewhat independent of carb reduction (fig 9) and protein increase (fig 8) and fibre, energy density etc. didn't seem to make much difference. That suggests that the paleo does beat the mediterranean diet (and ironically, I suppose counts against my suggestion above that we shouldn't holistically compare diets head to head, since it's not obvious that any of the variables suggested above cause the difference).

They didn't say it was bad. That's progress!

I don't understand why they need "research". Why isn't it enough to understand biochemistry and then observe the effects of different foods on a cellular level?

I don't think we can ever get a concensus on a definition of healthy so there should be no point in research that looks to prove what is "healthy."

What I like is that the comments seem overwhelmingly pro-Paleo.