The Healthiest Way to Eat Paleo

There have been about a half dozen studies published on Paleo-type diets, starting around 20 years ago. For example, in what sounds like a reality TV show: ten diabetic Australian Aborigines were dropped off in a remote location to fend for themselves, hunting and gathering foods like figs and crocodiles.

In Modern Meat Not Ahead of the Game, my video on wild game, I showed that kangaroo meat causes a significantly smaller spike of inflammation compared to retail meat like beef. Of course, ideally we’d eat anti-inflammatory foods, but wild game is so low in fat that you can design a game-based diet with under 7 percent of calories from fat. Skinless chicken breast, in comparison, has 14 times more fat than kangaroo meat. So you can eat curried kangaroo with your cantaloupe (as they did in the study) and drop your cholesterol almost as much as eating vegetarian.

So, how did the “contestants” do? Well, nearly anything would have been preferable to the diet they were eating before, which was centered on refined carbs, soda, beer, milk, and cheap fatty meat. They did pretty well, though, showing a significantly better blood sugar response—but it was due to a ton of weight loss because they were starving. Evidently, they couldn’t catch enough kangaroos, so even if they had been running around the desert for seven weeks on 1,200 daily calories of their original junky diet, they may have done just as well. We’ll never know, though, because there was no control group.

Some of the other Paleo studies have the same problem: They’re small and short with no control groups, yet still report favorable results. The findings of one such study are no surprise, given that subjects cut their saturated fat intake in half, presumably because they cut out so much cheese, sausage, or ice cream. In another study, nine people went Paleo for ten days. They halved their saturated fat and salt intake, and, as one might expect, their cholesterol and blood pressure dropped.

The longest Paleo study had been only 3 months in duration, until a 15-month study was conducted—but it was done on pigs. The pigs did better because they gained less weight on the Paleo diet. Why? Because they fed the Paleo group 20 percent fewer calories. The improvement in insulin sensitivity in pigs was not reproduced in a study on people, however. Although, there were some benefits like improved glucose tolerance, thanks to these dietary changes: The Paleo group ate less dairy, cereals, oil, and margarine, and ate more fruits and nuts, with no significant change in meat consumption.

A follow-up study also failed to find improved glucose tolerance in the Paleo group over the control group, but did show other risk factor benefits. And no wonder! Any diet cutting out dairy, doughnuts, oil, sugar, candy, soda, beer, and salt is likely to make people healthier and feel better. In my video Paleo Diet Studies Show Benefits, you can see a day’s worth of food on the Standard American Diet, filled with pizza, soda, burgers, processed foods, and sweets, versus a Paleo diet, which, surprisingly, has lots of foods that actually grew out of the ground.

But the Paleo diet also prohibits beans. Should we really be telling people to stop eating beans? Well, it seems hardly anyone eats them anyway. Only about 1 in 200 middle-aged American women get enough, with more than 96 percent of Americans not even reaching the minimum recommended amount. So telling people to stop isn’t going to change their diet very much. I’m all for condemning the Standard American Diet’s refined carbs, “nonhuman mammalian milk”, and junk foods, but proscribing legumes is a mistake. As I’ve noted before, beans, split peas, chickpeas, and lentils may be the most important dietary predictor of survival. Beans and whole grains are the dietary cornerstones of the longest living populations on Earth. Plant-based diets in general and legumes in particular are a common thread among longevity blue zones around the world.

The bottom line may be that reaching for a serving of kangaroo may be better than a cheese danish, “but foraging for…[an] apple might prove to be the most therapeutic of all.”


I’ve reported previously on Paleo’s disappointing results in Paleo Diets May Negate Benefits of Exercise.

The underlying philosophy behind “caveman” diets may be flawed in the first place. See:

So, What’s the Natural Human Diet? Watch the video!

The wild game video I mentioned is Modern Meat Not Ahead of the Game. Kangaroo is kind of the Australian version of venison. Note that it also matters how the animals are killed. See Filled Full of Lead and Lead Contamination in Fish and Game.

And, for more on the musical fruit, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Reversing Massive Obesity With Diet

Dr. Walter Kempner introduced the first comprehensive dietary program to treat chronic kidney disease and, in doing so, also revolutionized the treatment of other disorders, including obesity. Kempner was Professor Emeritus of Medicine at Duke, where he came up with the so-called rice diet, which basically consisted of rice, sugar, fruit, and fruit juices, was extremely low in sodium and fat, and included no animal fat, no cholesterol, and no animal protein. The sugar was added as a source of calories so people wouldn’t lose too much weight. But some people need to lose weight, so he started treating obese patients with a lower calorie version of the diet, which I discuss in my Can Morbid Obesity Be Reversed Through Diet? video.

He published an analysis of 106 patients who each lost at least 100 pounds. Why 106? Kempner simply picked the last 100 people who lost more than 100 pounds, and, by the time he finished reviewing their charts, 6 more had joined the so-called century club. Average weight loss among them was 141 pounds. “This study demonstrates that massively obese persons can achieve marked weight reduction, even normalization of weight, without hospitalization, surgery, or pharmacologic intervention…[O]ne important fact to be gained from this study is that, despite the misconception to the contrary, massive obesity is not an uncorrectable malady. Weight loss can be achieved, massive obesity can be corrected, and it can be done without drastic intervention.”

Well, Kempner’s rice diet is pretty drastic, so definitely don’t try this at home. In fact, the rice diet is dangerous. It’s so restrictive that it may cause serious electrolyte imbalances, unless the patient is carefully medically supervised with frequent blood and urine lab testing. Dangerous? Says who? Said the world’s number-one advocate for the rice diet: Dr. Kempner himself.

The best, safe approximation of the diet, meaning low in sodium and without fat, protein, or cholesterol from animals, would be a vitamin B12-fortified diet centered around whole, unprocessed plant foods. However, even a medically supervised rice diet could be considered un-drastic compared to procedures like getting one’s internal organs stapled or rearranged, wiring someone’s jaws shut, or even undergoing brain surgery.

Attempts have been made to destroy the parts of the brain associated with the sensation of hunger, by irradiation or going in through the skull and burning them out. “It shows how ineffective most simpler forms of treatment are that anyone should think it reasonable to produce irreversible intracranial lesions in very obese patients.” The surgeons defended these procedures, however, explaining that their “justification in attempting the operation is, of course, the very poor results of conventional therapy in gross obesity, and the dark prognosis, mental and physical, of the uncorrected condition.” In reply, a critic countered, “Such strong feelings [about how dark the prognosis is] run the risk of being conveyed to the patient, to the effect of masking the operative dangers and steam-rolling the patient’s approval.” The surgeon replied, “If any ‘steamrolling’ is taking place, it comes rather from obese patients who sometimes threaten suicide unless they are accepted for experimental surgical treatment.”

As of 2013, the American Medical Association officially declared obesity a disease, by identifying the enormous humanitarian impact of obesity as requiring the medical care and attention of other diseases. Yet the way we treat diseases these days involves drugs and surgery. Anti-obesity drugs have been pulled from the market again and again after they started killing people—an unrelenting fall of the pharmacological treatment of obesity.

The same has happened with obesity surgeries. The procedure Kempner wrote about was discontinued because of the complication of causing irreversible cirrhosis of the liver. Current procedures include various reconfigurations of the digestive tract. Complications of surgery appear to occur in about 20 percent of patients, and nearly one in ten of which may be death. In one of the largest studies, 1.9 percent of patients died within a month of the surgery. “Even if surgery proves sustainably effective, the need to rely on the rearrangement of [our] anatomy as an alternative to better use of feet and forks [that is, diet and exercise] seems a societal travesty.”


For more on Kempner and his rice diet, see my videos:

Learn more on the surgical approach in Reversing Diabetes with Surgery and Stomach Stapling Kids.

And, for more on weight, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

From Adequate Nutrition to Optimum Nutrition

Research in human nutrition over the past four decades has led to many discoveries as well as a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. As I discuss in my video Reductionism and the Deficiency Mentality, however, the “prevalence of epidemics of diet-related chronic diseases, especially obesity, type 2 diabetes, osteoporosis, cardiovascular diseases, and cancers, dramatically increases worldwide each year.” Why hasn’t all this intricate knowledge translated into improvements in public health? Perhaps it has to do with our entire philosophy of nutrition called reductionism, where everything is broken down into its constituent parts; food is reduced to a collection of single compounds with supposed single effects. “The reductionist approach has traditionally been and continues today as the dominant approach in nutrition research.” For example, did you know that mechanistically, there’s a chemical in ginger root that down-regulates phorbol myristate acetate-induced phosphorylation of ERK1/2 and JNK MAP kinases? That’s actually pretty cool, but not while millions of people continue to die of diet-related disease.

We already know that three quarters of chronic disease risk––diabetes, heart attacks, stroke, and cancer—can be eliminated if everyone followed four simple practices: not smoking, not being obese, getting a half hour of exercise a day, and eating a healthier diet, defined as more fruits, veggies, and whole grains, and less meat. Think what that could mean in terms of the human costs. We already know enough to save millions of lives. So, shouldn’t our efforts be spent implementing these changes before another dollar is spent on research such as figuring out whether there is some grape skin extract that can lower cholesterol in zebra fish or even trying to find out whether there are whole foods that can do the same? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see whether hawthorn leaves and flowers have the potential to help? Even if they did and even if it worked in people, too, wouldn’t it be better to simply not clog our arteries in the first place? This dramatic drop in risk and increase in healthy life years through preventive nutrition need not involve superfoods or herbal extracts or fancy nutritional supplements—just healthier eating. When Hippocrates supposedly said, “Let food be your medicine and medicine be your food,” he “did not mean that foods are drugs, but rather, that the best way to remain in good health is to maintain a healthy diet.” (Note: Hippocrates probably never actually said that—but it’s a great sentiment anyways!)

The historical attitude of the field of nutrition, however, may be best summed up by the phrase, “Eat what you want after you eat what you should.” In other words, eat whatever you want as long as you get your vitamins and minerals. This mindset is epitomized by breakfast cereals, which often provide double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude “is good for the food industry but not actually good for human health.” Why not? Well, if food is good only for a few nutrients, then you can get away with selling vitamin-fortified Twinkies.

We need to shift from the concept of merely getting adequate nutrition to getting optimal nutrition. That is, we shouldn’t just aim to avoid scurvy, but we should promote health and minimize our risk of developing degenerative diseases.

Bringing things down to their molecular components works for drug development, for example, discovering all the vitamins and curing deficiency diseases. In the field of nutrition, “[h]owever, the reductionist approach is beginning to reach its limits.” We discovered all the vitamins more than a half-century ago. When is the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor, the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, and hypertension? Ever heard of anyone with any of those? Of course we have. Yet we continue to have this deficiency mindset when it comes to nutrition.

When someone tries to reduce their consumption of meat, why is “where are you going to get your protein?” the first question they get asked, rather than “if you start eating like that, where are you going to get your heart disease?” The same deficiency mindset led to the emergence of a multibillion-dollar supplement industry. What about a daily multivitamin just “as ‘insurance’ against nutrient deficiency?” Better insurance would be just to eat healthy food.


Professor Emeritus T. Colin Campbell wrote a Whole book about this issue, and I’m looking forward to doing many more videos on the topic.

So, where do plant-eaters get protein? Check out Do Vegetarians Get Enough Protein? to learn more.

The concept of optimal, rather than merely adequate, nutrition is illustrated well in this video about fiber: Lose Two Pounds in One Sitting: Taking the Mioscenic Route.

Other videos on reductionism include

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: