FREQUENTLY ASKED QUESTIONS
What relevance do cavemen have to life in the 21st century?
In the current climate of concern regarding both physical and mental health, and in light of the increasing pressure and stress that many are exposed to, it makes sense to study previous generations and to examine their way of life in comparison to ours. There is no doubt that many of our ancestors – both relatively recently and from many millennia ago –faced difficulties that we cannot even comprehend. However, there are positive lessons that we can learn from the way they lived at different times and in different locations. Nutrition, fitness, a sense of community or social cohesion, family support within the group, traditional methods of cooking, building and creating – these are just a few of the things that we can study. For some, the wider term of ‘Ancestral Health’ is considered more suitable to this endeavour. Using the word ‘Paleo’ gives us a foundation upon which to build, by examining the way that we have lived for the majority of our time on the earth. It then allows us to examine the subsequent changes – and the effects of those changes both good and bad – in the hope of bringing light to bear on some of the problems we now face as a species.
Cavemen only lived to around 30 didn’t they? Why would I use them as an example of health?
From archaeological records, we do indeed know that cavemen lived to only around 30 years of age. Looking at the reasons for this, we know that they were predated by large animals, succumbed to accidents while hunting for food, fell prey to infections or injuries and died in difficult childbirth. However, should they manage to get past these hurdles, we also know that they went on to live relatively long lives without suffering with many of the diseases that are common today.
Are you suggesting that we run around with spears and cook our prey over an open fire?
The Paleo, primal or ancestral lifestyle is a template, a ‘blueprint’ in the words of Mark Sisson. We are not seeking to replicate the life of hunter-gatherers in today’s modern world, but trying to take what is beneficial about their lifestyle and adapting it to our own. We can look back at various times in history to learn and revive traditions or skills that may have been long forgotten. We do this because they are valuable and because we think that there may be something to gain by adapting this knowledge. When we learn from the past, it is not because we want to return to the past. They are two very different things.
We have evolved to eat these relatively new foods haven’t we?
It is true that various groups around the world have evolved in a relatively short amount of time to tolerate certain foods. We think immediately of lactose intolerance and its prevalence in African and Asian populations compared to that of Northern Europeans. Again with carbohydrates and the salivary amylase gene that allows us to digest them more successfully than non-human primates (again differing between populations). While many people may suffer no discernible problems from such foods, it may be that others would find it beneficial to exclude or reduce them. For some people, tolerating a food is not the same as thriving on a food and it would appear that the western diet coupled with the rise in diseases such as diabetes and atherosclerosis, as well as all sorts of allergies and digestive problems, tells us that something is not right.
What about modern Hunter-Gatherer societies that eat a diet high in carbohydrates i.e the Kitavans? They are healthy aren’t they?
It is true that there are varying amounts of carbohydrates in the diet of modern hunter-gatherers, with people such as the Kitivans (around 70% carbohydrates) being at the extreme end of carbohydrate consumption (the Inuit eat practically no carbohydrates at all). These people have eaten their traditional diets for a very, very long time. These diets are comprised of ‘real’ food rather than processed rubbish – it is their natural diet. However, we are not Kitivans and some people cannot tolerate high levels of carbohydrates; especially if they are already unwell with conditions such as diabetes. Personal experimentation is the key, but always built upon the foundation of traditional ways of eating
Isn’t the maxim ‘everything in moderation’ correct when it comes to diet?
This is the most bizarre argument and seems to have been the mantra that has led us down the path to confusion. The implication is that as long as we do not eat a lot of them, eating foods that are bad for us is acceptable. Carbohydrate (sugar) is addictive and many people they cannot tolerate even minimal amounts without craving and consuming more and ending up on a rollercoaster of blood sugar swings. Grains can irritate the gut and cause permeability and inflammation. Is it right to say that we should only eat these foods in moderation? Why eat them at all? If only a ‘moderate’ amount of food can induce these effects, where is the sense in arguing for its regular inclusion in a healthy diet? We would not argue for all things in moderation when it comes to other harmful substances, so why with food?
Secondly, what is ‘moderation’? How are we to ensure that we are eating in moderation? The consumer is bombarded on nearly every aisle of the supermarket by processed foods that are high in pro-inflammatory Omega-6. A quick look on the average ingredients list reveals a myriad of unpronounceable additives. A stop off at a service station reveals shelf upon shelf of wheat and sugar-laden goods. Where is the ‘moderation’ in this? The availability and choice of food open to us does not present a picture of ‘moderation’, so is it right to argue that we can sustain a diet based on choosing ‘all things in moderation’? Our choices are not choices made from a selection of foods that reflect the adage ‘all things in moderation’, they are made in supermarkets and food outlets where the majority of products are either highly processed or contain artificial additives or harmful ingredients. Our choices are skewed before we even begin.
Where is the definitive proof that the Paleo lifestyle can help with the prevention of certain illnesses?
We can find papers, articles and testimonials to ‘prove’ many things. Critics complain that we can just pick the evidence to fit our theory; a research paper that ‘proves’ a diet works, another paper that ‘proves’ the opposite. When it comes to scientific data, we are unsure, confused, and distrustful (see Tom Naughton’s wonderful talk ‘Science for Smart People’). Let’s take a step back. Rather than cite a list of research papers and testimonials (although please do see some of the medical articles over on the Resources page) let’s look at what we do know ourselves – without any reference to the science (for now):
- We know that lifestyle – and in particular diet – has a profound effect on our health and wellbeing
- We know that there is something fundamentally wrong with the modern lifestyle and diet
- We know that the instances of diseases such as diabetes, Alzheimer’s, and atherosclerosis are increasing
- We know that people live increasingly stressful lives
- We know that the dietary advice given over the last few decades has not worked
- We know we are doing something wrong on a scale never before witnessed in our history
Read the articles, the books, the blogs and the research papers and make a decision for yourself. Science is not about providing definitive, permanent proof. It is about putting forward a hypothesis, testing that hypothesis through experiment, and revising the hypothesis if needed in the light of new evidence.
My doctor thinks that this is a load of old rubbish and he’s a qualified medical professional. Why is he wrong?
Most doctors carry out very little training in nutrition. They have hectic work lives that often (understandably) do not allow them to research independently and keep up with developments in other areas. Many are wedded to a low-fat, high carbohydrate ‘healthy’ diet and the idea that high cholesterol is bad and that fat clogs our arteries. Many look to statins and blood pressure medications and a myriad of other drugs to deal with the symptoms, rather than find the root of the problem. They are caught up in a system where big drugs companies call the shots, and the more drugs prescribed, the bigger the profit. Many have a minimal amount of time to see each patient and resources are often scarce. Like the rest of us, they live in a world where the media bombards us with very specific messages about diet and tries desperately to flog us foods that are ‘healthy’. What hope do we have but to take our diets into our own hands? It took us decades and decades to become wedded to the lipid-hypothesis until we have reached a point where it is the accepted wisdom and practically heresy to disagree. How long will it take us to turn this oil tanker around? There is not time for many people to wait until everyone ‘agrees’ on this. We have to do our own research, look at the hypothesis and the rapidly accumulating evidence in its favour, and make a decision for ourselves. Life is short.
What is the difference between Paleo and Primal?
Both Paleo and Primal are based on ancestral health principles and both advocate a return to a Paleolithic template for nutrition. Although the Primal diet may include some forms of dairy (butter, heavy cream, aged cheese), the Paleo diet can also incorporates some limited forms of dairy (butter, heavy cream) if well tolerated (as with Primal). Some Paleo adherents avoid dairy completely though.
Professor Cordain, author of ‘The Paleo Diet’ originally advised low levels of saturated fats and this distinctly set the Paleo diet apart from the more relaxed PB guidelines on saturated fats. Professor Cordain has revised his stance on saturated fat around 2005 (with a revised Paleo Diet book published 2011) in the light of increasing evidence that it has no direct link to heart disease (except when consumed in the context of a high carbohydrate pro-inflammatory diet). Both Paleo and Primal adherents recognise the need to avoid saturated fat from grain fed and factory farmed animals (which results in abnormal Omega 3-6 ratios) as much as possible.
To sum up, Paleo and Primal have much, much more in common than any slight differences between them – especially when in comparison to the standard recommended diet. Both approaches advocate a return to the earliest, traditional diet known to man as a blueprint for contemporary health.
So isn’t this just another version of Atkins?
Looking back on the Atkins diet, it is clear that many of its principles are shared by the Paleo template: the avoidance of excessive and processed carbs, the requirement of fat to satiate appetite and control hunger, the acknowledgement of animal protein as an important food source, the caution regarding fruit, the need to limit starchy vegetables according to goals, the avoidance of calorie counting, the importance of stabilising blood sugar levels. Dr Atkins states in his book New Diet Revolution: ‘Remember that fresh meat, fish, fowl, vegetables, nuts, seeds and occasional fruits and starches are the foods nature intended you to eat’. (p.221). It is also important to remember that the extremely low carbohydrate phase of the diet was just that – an introductory phase – and for long term maintenance, carbs were increased. This does tend to get forgotten when people discuss Atkins. However, the diet also recommended low-carbohydrate processed foods such as ‘sugar free pancake syrup’ and salad dressings, soya flour, reduced sugar sauces, peanut butter (legumes), wholemeal bread, and various other foods that would definitely not be on the Paleo shopping list. Despite this, I believe the Atkins diet must be seen in the context of the mainstream dietary advice that it challenged and also against the millions of people (myself included) that tried the diet and experienced tremendous weight loss. The main principles are sound and for some there is a natural flow from Atkins into the Paleo/Primal scene.
This all sounds expensive to me – do you spend a lot on food?
The first thing that we noticed upon fully starting the diet is the amount of time it took to shop was drastically reduced. There are whole aisles in the supermarket that we no longer venture down. Inevitably this means spending less as we focus on meat, fish, eggs, vegetables and some frozen or fresh berries. We try to pick cuts of meat that are not too expensive (saving the steaks and joints for a treat). Offal is cheap too and we try to eat that on a regular basis. We stock up on fish around every six weeks for the freezer and eat quite a lot of wild, tinned fish too. Apart from the meat and fish, coconut oil is probably the most expensive thing that we buy, but it goes a long way (we get ours from Real Foods). Our food choices are very important and that is reflected in the time and effort we take to track down the best we can. The ‘best’ choice is not always the most expensive choice.
Here is some more advice on the affordability of the Paleo diet:
What about the 80/20 rule?
I have to say that as soon as we fully changed our eating habits, there was no real desire to have 20% ‘cheat’ days. Apart from the odd dessert while eating out and a drink at the weekends, we stick to the diet constantly unless we are in a situation with absolutely no choice at all and we need to eat (that has happened on a couple of occasions to me and perhaps more with Richard due to travel). Sometimes when friends pop in for tea (or we go to their homes) we make Paleo-friendly biscuits or cakes to eat (see the recipe section). However, if a friend brings a gift of biscuits or if we go to friends and are offered some home-made treats, I do have one. Despite this, I just don’t see the point of an 80/20 regime (although if it works for some people that’s great). I know that we can’t have 100% control over the food we eat because that’s life, but if we control as much as we can, then the times when we do eat non-Paleo foods don’t seem so bad.
What about eating out?
Mostly we prefer to cook at home because we then have complete control over what we eat and because we love cooking and trying new recipes. But there are times when it’s nice to have something cooked for us and so we just try to do our best and not worry too much. I always look for the most ‘meat and vegetable’ based dish I can find and ask them to replace certain foods (potatoes, rice, etc.) with extra meat or vegetables instead. The plates of bread go untouched! We do tend to avoid Indian or Chinese restaurants only because it can be difficult to find suitable dishes but with most other restaurants I would say that it is fairly easy to choose the more Paleo-friendly options. Richard sometimes caves in (no pun intended) and has a pudding or we just have some coffees with cream. The main thing is not to stress – we just do the best we can.
How do I persuade someone to try the diet?
As ever, I turn to the inimitable Robb Wolf and his thoughts on this:
In his comments following Denise Minger’s presentation ‘How to Win an Argument with a Vegetarian’ at AHS 2011 (around 33m in), Robb stresses the importance of helping people who want help. Arguing with vegetarians, vegans or followers of the government recommended ‘low fat, healthy-wholegrain’ diet is definitely not the purpose of this website.
How on earth can you cut out all those foods?
I know it seems that you have to cut so much out, but believe me we don’t miss it at all. Never in a million years did I think I would be able to give up bread and cakes, or jams and chutneys. I can’t stress this enough – I never thought that I would be able to do it and neither did my mother and Richard. I would say that the majority of our food previously was made up of all the foods that we now no longer eat. As I have said elsewhere, if you want to make a ‘Paleo- friendly’ (and I say this in the loosest of terms) cake or biscuit for a treat, there are a myriad of fantastic sites out there to provide recipes. The focus is now on what we can eat, and I have to say I wonder what on earth we were eating before this. The variety of foods in this diet is amazing and we are never, ever bored. There are so many recipes that I want to try that it would take us a lifetime to get through them all, so if you are thinking of giving this a shot, don’t ever feel that you will be limited in your food choices because we have found that this is just not the case – in fact it is the opposite.
What do you eat instead of bread?
Ah the million dollar question! When talking to people, I have found the most resistance to the idea of giving up bread. They are baffled as to what we eat instead of bread and take on a tinge of hysteria about going without toast or sandwiches. Making our own bread is tied to so many ideas of cosiness and self-sufficiency that it is almost impossible to think about it purely as food and the thought of giving it up seems tantamount to deprivation for many people.
Firstly, we need to understand why bread (and grain in general) is bad for us. Secondly, we need to replace bread with something that is beneficial.
Toast for breakfast – eat more eggs or bacon cooked with butter or coconut oil
Sandwich for lunch – eat a good portion of meat or fish and some greens tossed in butter
As a side to soup – make sure your soup has meat in it or is followed by a good portion of protein and fat
As a side to a main course – eat more meat or fish with good fats and veg in the main course
As a snack to fill up between meals – eat some cold meat, nuts, avocado, fish, olives, slice of hard cheese (if tolerated), pate and veg
Don’t forget, you should eat enough ‘real food’ to make you full. The most important thing to remember is that bread is just filler if you think about it. We just put some fat on it and/or stick some meat between it to make it palatable. There are very few people who will eat dry bread. Same with pasta – we need to toss it in fat (olive oil), flavourings (garlic) or sauces (tomato) to eat it. Would we eat a bowl of plain pasta? Or rice? Not eating bread is one of the biggest changes that you can make.