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:

How to Reverse Type 2 Diabetes

 

Diabetes reversal, not just treatment, should be a goal in the management of type 2 diabetes. Type 2 diabetes can be reversed not only with an extremely low calorie diet, but it can  also be reversed with an extremely healthy diet. Could it be because an extremely healthy diet is also low in calories? This is the topic of my video Diabetes Reversal: Is It the Calories or the Food 

Study subjects lost as much weight on a green, leafy vegetable-packed plant-based diet as those who were on a semi-starvation diet based on liquid meal replacements. So, does it matter what we’re eating as long as we’re eating few enough calories to lose 15 pounds a month?

Even if diabetes reversal is just about calorie restriction, instead of subsisting off largely sugar, powdered milk, corn syrup, and oil (common ingredients in some liquid diet drinks) on the plant-based diet at least one can real food—in fact, as many low-cal veggies as desired. So, even if it only works because it’s just another type of calorie-restricted diet, it’s certainly a healthier version. But, even participants in the study who did not lose weight—or even gained weight eating enormous quantities of whole healthy plant foods—appeared to improve their diabetes. Thus, the beneficial effects of this kind of diet appear to extend beyond weight loss.

The successful treatment of type 2 diabetes with a plant-based diet goes back to the 1930s, providing “incontestable evidence” that a diet centered around vegetables, fruits, grains, and beans was more effective in controlling diabetes than any other dietary treatment. In a randomized controlled trial, insulin needs were cut in half and a quarter of the subjects ended up off insulin altogether. But, again, this was a low-calorie diet. Walter Kempner at Duke University School of Medicine reported similar results 20 years later with his rice and fruit diet studies, showing for the first time documented reversal of diabetic retinopathy in a quarter of his patients, something never even thought possible. One patient, for example, was a 60-year-old diabetic woman already blind in one eye and who could only see contours of large objects with the other. Five years later, while on the diet, instead of her vision getting worse, it got better. She “could make out faces and read signs and large newspaper print,” and got off insulin, had normal blood sugars, and had a 100-point drop in her cholesterol. Another patient went from only being able to read big headlines to being able to read newsprint four months later. What was behind these remarkable reversals? Was it because the diet was extremely low-fat or because there was no animal protein or animal fat? Or, was it because the diet was so restrictive and monotonous that the patients lost weight and improved their diabetes that way?

To tease this out, we needed a study where researchers switched people to a healthy diet, but forced them to eat so much they didn’t lose any weight. Then, we could see if a plant-based diet has unique benefits independent of all the weight loss. For that, we had to wait another 20 years until a study in the 1970s. In it, diets were designed to be weight-maintaining. Participants were weighed every day, and, if they started losing weight, the researchers made them eat more food—in fact, so much food that some of the participants had trouble eating it all, but they eventually adapted. Thus, there were no significant alterations in body weight despite restrictions of meat, dairy, eggs and processed junk, and there were enough whole plant foods—whole grains, beans, vegetables, and fruit—to provide 65 grams of fiber a day, four times what the Standard American Diet provides.

The control diet they used was the conventional diabetic diet, which actually had nearly twice the fiber content of the Standard American Diet, so it was probably healthier than what they had been used to eating. So, how did the even healthier diet group do? With zero weight loss, did the dietary intervention still help? The study compared the number of units of insulin with which subjects had to inject themselves daily before and after going on the plant-based diet. Overall, despite no change in weight, insulin requirements were cut about 60 percent, and half of the diabetics  were able to get off insulin altogether. Was this after five years, or after seven months, as had been the case in the other studies discussed above? No.

It was after 16 days.

To be clear, we’re talking about diabetics who had had diabetes as long as 20 years, injecting 20 units of insulin a day, getting off insulin altogether in as few as 13 days, thanks to less than two weeks on a plant-based diet. Patient 15, for example, had injected 32 units of insulin while on the control diet, and then, 18 days later, none. Lower blood sugars on 32 units less insulin.

That’s the power of plants.

As a bonus, their cholesterol dropped like a rock to under 150 on average in 16 days, making them nearly heart attack proof as well. Just as “moderate changes in diet usually result in only modest reductions” in cholesterol, asking people with diabetes to make moderate changes often achieves equally moderate results, which is one possible reason why most end up on oral drugs, injections, or both. Everything in moderation may be a truer statement than people realize. Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, moderate amputations. Moderation in all things is not necessarily a good thing.

The more we, as physicians, ask from our patients, the more we—and they—get. The old adage, “shoot for the moon,” seems to apply. It “may be more effective than limiting patients to small steps that may sound more manageable but are not sufficient to actually prevent disease progression.”


Although I have dozens of videos about diabetes, I think Diabetes Reversal: Is It the Calories or the Food may be the single most powerful one I‘ve made. Please share this life-changing, life-saving video with anyone you know who has type 2 diabetes or is at risk for the dreaded disease. As far as I’m concerned, it should be required viewing for every healthcare practitioner. I wish I had seen it when I was a medical student!

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This is the final installment of a three-part series. If you missed the first two, check out Reversing Diabetes with Surgery and Reversing Diabetes with Food.

For more on the remarkable work of Dr. Kempner, see:

For more related videos, give one of these a try!

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:

A Super Healthy Plant-Based Diet vs. Diabetes

We’ve known that type 2 diabetes could be reversed by an extreme reduction in food intake for nearly a century and a half, since the 1870 siege of Paris during the Franco-Prussian War. This has been demonstrated experimentally. By starving people enough, you can reverse diabetes. Diabetes specialists “have long known that the tiny proportion of iron-willed people [with diabetes] who can substantially decrease their weight and maintain this, can exhibit a return to normal metabolism.”

“A label is required to allow doctors to recognize and appropriately manage this subgroup who were willing to do anything to get rid of their diabetes. These are the Health Motivated. At the time of diagnosis, the Health-Motivated individuals will benefit from being advised that they are likely to be able to reverse their diabetes completely” by losing up to one-fifth of their body weight. And then—and only then—if they “show that they are not sufficiently strongly motivated should the routine guidelines for managing Type 2 diabetes be rolled out,” which include lots of drugs. Unfortunately, the control of blood sugar with medication has proven to be unsustainable and may actually exacerbate obesity, making us put on more weight and, thus, creating a vicious cycle.

There has got to be a better way.

Instead of starving oneself by eating less food, what if we just ate better food? What if we ate a diet that emphasizes all-you-can-eat greens, lots of vegetables, beans, nuts, seeds, and some whole grains, and is at least 90 percent plant-based? This would be a diet including at least one big salad every day (like a pound of raw greens), veggie-bean soup, a handful of nuts and seeds, fruit at every meal, a pound of cooked greens, and some whole grains, but no refined grains, junk food, or oil, and a restriction on animal products. Thirteen diabetic men and women followed this diet for an average of seven months.

How did they do?

Hemoglobin A1C is considered the best measure of blood sugar control. Below six is normal—that is, non-diabetic. The official American Diabetes Association target, however, is to get diabetics at least down to seven. Anything above seven is uncontrolled diabetes. In my video Reversing Diabetes with Food, you can see a stunning chart that plots how the study participants’ hemoglobin A1C levels responded over time after they start plowing in the plants. All subjects had had diabetes for at least seven years, and they started off with hemoglobin A1C levels ranging from as low as 6 to as high as 12. After they began following the plant-heavy diet,  their levels consistently dropped, month after month. After about seven months, their average A1C dropped from a diabetic 8.2 down to a non-diabetic 5.8. The majority dropped down to normal, and this is after dropping most of their medications.

Now, this was a pilot study with only a handful of people, no control group, and including only people who could actually stick to the diet—essentially, a retrospective case series, considered one of the weakest forms of published evidence. However, the magnitude of the effect they found indicates that a high nutrient-density diet can be very effective for some people.


In Reversing Diabetes with Surgery, another one of my videos, I discussed how type 2 diabetes can be reversed with an extremely low-calorie diet. And, as I’ve just shown, type 2 diabetes can also be reversed with an extremely healthy diet—but is that because it is also low in calories? That’s the million-dollar question I answer in Diabetes Reversal: Is It the Calories or the Food?.

You may be aware that I’ve touched previously on the ability of healthy diets to prevent and treat type 2 diabetes. (See Plant-Based Diets and Diabetes and Plant-Based Diets for Diabetes if you haven’t yet watched those videos or want a refresher.) It’s so exciting to be plugging in the final puzzle pieces.

What about the benefits of blood sugar medications and more moderate diets? I discuss that topic in When Drugs and Diets Don’t Lower Diabetes Deaths.

Other videos of interest 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: