Paleo Diet: A Complete Beginner’s Guide to Healthier Living

The Paleo Diet, otherwise known as the “Caveman Diet,” is hugely popular right now. And lots of people want to know how it plays out with diabetes…

The DiabetesMine Team has taken a deep dive here into what this eating plan entails, and what nutrition experts and research have to say about it.

What is Paleo?

The basic idea of ​​the Paleo Diet is to go back to our dietary roots. That is, the name is short for “paleolithic,” referring to the Stone Age, when humans had a very simple diet of whole, unprocessed foods. The theory here is that if we go back to eating that way, we will all be healthier and more toxin-free.

This diet is super-trendy right now as almost a modern “panacea,” but the premise is based on scientific evidence about what early humans ate.

Established by health researcher Loren Cordrain, Paleo assumes that humans were genetically and evolutionarily designed to eat foods that were available during the Paleolithic era, compared to the agricultural-based diet that has only developed in the last 10,000 years – and even more so the processed and chemically-based diet of the last hundred years.

The diet consists of lean meats, vegetables, fruits, and nuts. What’s missing are all the processed foods, grains, dairy, and legumes, along with simple sugars and artificial sweeteners. Because, you know… cavemen didn’t eat that kind of stuff.

According to experts, the Paleo diet is high in protein, fiber, and healthy fats; high in potassium salt intake and low in sodium salt (the healthier option); and provides dietary acid-base balance as well as high intake of vitamins, minerals, plant phytochemicals, and antioxidants. It’s also fairly low-carb – a plus for those of us with diabetes, to be sure!

But for many people, it’s hard to make a long-term commitment to swear off ALL grains, pasta, bread and rice, dairy products, beans and peanuts, potatoes and processed foods.

Still, the Paleo Diet has a huge following, has inspired something called the Kinship Health movement , and now even has its own annual conference in Austin, TX: Paleo f(x) , billed as “the world’s premier wellness event, encompassing health, nutrition, fitness, sustainability, and everything in between.”

Health benefits of the Paleo diet?

Paleo adherents believe that eliminating certain foods from the diet reduces inflammation in the body, and people will enjoy health benefits such as weight loss, reduced swelling, clearer skin, and more energy.

You might wonder why the Paleo Diet cuts out whole grains, dairy, and legumes, when we’ve been told for decades that those things are good for us?

The answer is that some health experts attribute the rise in heart disease, cancer, type 2 diabetes and other diseases to our 10,000-year-old “agricultural diet.” In fact, most Americans consume far more carbohydrates than we really need on a daily basis, and our waistlines prove it . Many experts now believe that carbohydrates, especially processed foods but also grains, stimulate appetite because the brain doesn’t respond to those nutrients the same way it does to meat and vegetables. Think about it: how many of you can eat one corn chip after another without stopping? How many of you can say the same thing about chicken breast?

“Legumes and whole grains contain some of the highest concentrations of anti-nutrients of any food,” Paleo founder Cordrain writes . “These compounds often increase intestinal permeability and cause a condition called ‘ leaky gut ,’ a necessary first step in almost all autoimmune diseases. Furthermore, a leaky gut likely underlies chronic, low-grade inflammation, which underlies not only autoimmune diseases, but also heart disease and cancer.”

But there’s also plenty of research showing that whole grains and legumes are good for you, but that simply aiming for anti-nutrients will cause problems for your gut.

Some experts simply point out that grains have fewer benefits compared to fruits and vegetables, therefore due to the potentially unpleasant consequences they believe we should stick to a grain-free diet. Additionally, many people also report seeing health improvements when going gluten-free.

Dairy is probably the most controversial part of the Paleo movement. The reason: dairy can actually be really good for you. But it can also be bad for you. Dairy that comes from hormone and antibiotic infused cows that live in incredibly close quarters should probably be avoided. Full-fat and even raw (if you can find it) dairy is recommended because it has a good mix of protein, fat, and carbs.

Additionally, the dangers of saturated fat and cholesterol, which originally scared many people away from the ultra-low-carb Atkins diet, are now believed to have been overstated. Recent research shows that dietary saturated fat and cholesterol do not raise the body’s cholesterol. The foods that replaced them, like margarine, may actually be causing more disease than the foods health authorities originally blamed. So enjoy those eggs!

While the health benefits of Paleo eating have been much hyped, many experts doubt that it is better than a Mediterranean, Ketogenic or Vegan diet which also focus on whole foods but are less restrictive.

The Paleo Diet and Diabetes

There’s actually a heated scientific debate going on about it right now, according to Dr. Steve Parker, an Arizona hospitalist and author of ” The Paleobetic Diet .”

He points out the lack of hard scientific data on what is the best way to eat for people with diabetes (see the Research section below).

“When I began exploring the Paleolithic diet as a way to treat diabetes several years ago, my first concern was whether it provided enough basic nutrition. That is, enough vitamins, minerals, essential fatty acids, fiber, protein, etc. I convinced myself that it is indeed sufficient,” Dr. Parker says.

When asked if he specifically recommends Paleo for PWDs (people with diabetes), he says, “As your readers know, every case of diabetes is unique… Whether type 1 or 2, PWDs have varying degrees of insulin resistance and sensitivity, which will affect food choices. The individual PWD may need to experiment with different diets to see which ones are best for (them), based on overall sense of well-being, glycemic control, other co-occurring medical conditions, age, cost, food preferences, etc.”

We asked the same question to a number of experts and the consensus seemed to be that Paleo eating is basically “diabetes neutral,” meaning it’s not inherently better or worse for people with diabetes than most other diets.

“Since the Paleo Diet completely eliminates the typical foods in sight — desserts, pizza, French fries, sweetened beverages, etc. — people who strictly follow the plan often have improved blood sugar levels, healthier cholesterol levels, reduced triglycerides, more energy, better sleep, and other improvements. They may even drop a few pounds. But these gains are very likely a result of eating less (or no) highly processed, nutrient-poor, and calorie-dense foods and not so much a result of the specific Paleo plan,” says Jill Weisenberger, a Virginia-based dietitian nutritionist, certified diabetes educator (CDE), and certified health and wellness coach.

Susan Weiner, a dietitian nutritionist and CDE in New York City who is also a published author and was named AADE’s 2015 Certified Diabetes Educator of the Year, reminds us that animals and plants have evolved significantly since the days of our ancestors. Therefore, what we eat now is not the same nutritionally as what our ancestors ate.

“It’s also important to point out that our ancestors simply had shorter lifespans than we do, and therefore may not have developed many of the diseases that we have today,” Weiner says. “In addition, ‘Paleo’ friendly fruits and vegetables were very different from what is available in agriculture today. So it’s not as simple as making a one-to-one comparison to what our ancestors ate 10,000 years ago… our ancestors (cavemen) also didn’t just live in one place, they ate differently depending on their environments.”

Some principles of the Paleo Diet, such as reducing consumption of processed foods and limiting salt and sugar intake, can be beneficial for people with diabetes, Weiner says. “However, trying to completely eliminate all processed foods from your diet for the rest of your life is challenging (to say the least), and can put a lot of pressure on a person who has diabetes and other daily concerns around diabetes management.”

Weiner adds that completely cutting out beans, legumes, and dairy products may be too restrictive for some people who have diabetes and may have other health consequences such as reduced fiber intake. She notes two other drawbacks as well: overly restrictive diets can exacerbate eating disorder behaviors, and it can also be expensive to buy the organic foods suggested on this diet plan.

Christel Oerum, a longtime type 1 and diabetes advocate who is a certified personal trainer, bikini fitness champion, and founder of TheFitBlog , looks at the Paleo Diet through the eyes of a knowledgeable patient and health coach. She says:

“I like many of the underlying ideas of the Paleo Diet, primarily the focus on eating ‘real’ unprocessed foods. I’m also a fan of getting enough protein and not being afraid of healthy fats. However, from a diabetes perspective I find the Paleo Diet’s approach to carbohydrates a bit challenging. While it’s not a low-carb diet per se, it does restrict a large number of complex carbohydrates (only sweet potatoes are allowed) while still allowing more high-glycemic carbohydrates like honey and dried/fresh fruit. I have nothing against high-glycemic carbohydrates in small amounts and at the right times, but including them in large amounts makes good blood sugar management very challenging.”

Research on the Paleo Diet says

There are, in fact, precious few research studies done on the effects of the Paleo Diet — just a couple of short-term studies, including a relatively small number of people, experts tell us.

Weisenberger points to a “ small but well-designed study ” from 2009, in which 13 people with type 2 diabetes ate both a Paleo Diet and a non-Paleo Diet for three months each. On average, they had lower weight, A1C, triglycerides, and diastolic blood pressure levels after consuming the Paleo Diet.

“But this does not suggest to me that the Paleo Diet is superior to other diet plans. That is because following the Paleo Diet resulted in a consumption of less carbohydrates (an average of 71 g less daily), fewer calories (an average of ~300 calories less daily), and less saturated fat (an average of 8 g less daily), among other differences. These are very large differences. I suspect that if the calorie and carbohydrate content of the diet were kept identical, the results would be more similar. Changes in glucose tolerance did not differ between the two diet periods, by the way,”

Weiner highlights a similar 2011 UC San Francisco study in which two small groups of people with type 2 diabetes ate either a Paleo or Mediterranean diet for several weeks. The results showed that the Paleo group had improvements in blood pressure, blood sugar, and cholesterol levels.

But she also has reservations about reading too much into these results. “The people in the study may not have been grocery shopping and preparing healthy meals before adopting healthier habits (in the study) like eating less processed foods and more vegetables,” she says. “More research needs to be done to see if this type of eating plan has long-term effects on blood sugar levels and diabetes.”

Note that in U.S. News and World Report’s 2014 ranking of the Best Diets Overall (compiled with the help of top health and nutrition experts), Paleo tied for last in a group of 32 diets, with this comment: “Experts took issue with the diet on every measure. Regardless of the goal — weight loss, heart health, or finding a diet that’s easy to follow — most experts concluded that dieters would be better off looking elsewhere.” No. 1.? The government-developed (Dietary Approaches to Stop Hypertension) diet.

Best and Worst Paleo Foods for Diabetes

Experts agree that lean meats, vegetables, and nuts are all good choices for PWDs, but as Oerum notes, Paleo’s emphasis on fruit (with all its natural sugar) definitely gives some people pause.

Interestingly, the participants assigned to the Paleo Diet who lowered their HbA1c levels consumed less carbohydrates overall, but they consumed more fruit—almost twice as much as the control group. “I know a lot of PWDs who fear eating fruit because of the sugar content. This should help alleviate that concern,” Weisenberger says.

Many Paleo bloggers and their readers readily admit that “eating like a caveman” is more of a general principle, since there was no single caveman diet. It’s kind of like talking about some day eating like a human. The Caveman diet likely varied from primarily meat to primarily plants, depending on where the cavemen lived. Plus, many Paleo adherents now add different ingredients to “paleo-correct” certain foods, such as kale chips, spaghetti bolognese made with spaghetti squash, and banana bread with almond flour. Definitely not something a caveman would have dined on! But all great options for diabetes, actually.

For her part, Weiner says: “I believe in individualized nutrition choices for people with diabetes. Small, sustainable adjustments to current meals are often most effective in helping positively impact your blood sugar. Try to reduce your intake of processed foods and add in more fresh vegetables and lean protein. It doesn’t matter what you call “meals that work best for you and your diabetes.”

What does she eat? Lots of vegetables, some fruits, nuts, fish, lowfat and nondairy items, and all types of plant-based proteins, along with chicken, turkey, beef, etc.

A Low Carb Version of Paleo

Paleobetic author Dr. Parker sums it up this way: “In the same way that nature has designed each animal species to thrive on certain foods, we humans are healthiest eating specific nature-made foods, not artificial ones… The Paleo diet is a reasonable one for diabetes. A low-carb version should be even better.”

“Why do I prefer carbohydrate restriction?” he writes to us. “For T2D, it minimizes diabetes drug use. The problem with most of our diabetes drugs is that we don’t know

long-term safety and side effects (metformin and insulin are exceptions). For example, it took us 15-20 years to figure out that metformin can cause vitamin B12 deficiency. Taking three or four high doses of diabetes drugs is an open N=1 experiment with unknown outcomes. For T1D, carb restriction allows for minimization of insulin dosage, which in many people cuts down on their episodes of hypoglycemia.

“In addition, many experts believe high insulin levels (hyperinsulinemia) contribute to some of the complications of diabetes and aging, such as vascular disease and high blood pressure. A type 1 PWD who is overweight and uses more than 70-80 units of insulin per day is probably insulin resistant and hyperinsulinemic. Why not reduce carbohydrates and insulin dosage?”

He adds that if he had diabetes himself, he would follow a diet limited to 30 to 100 grams per day of carbohydrates, definitely on the lower end if he had type 1.

“These carbohydrate chains are possible with a Bernstein diet, low-carb Mediterranean, low-carb Paleo and maybe even vegetarian,” he adds. 
“I doubt that the popular generic Paleo diet book diets reduce carbs below 100 grams. 
They usually don’t even give carb counts, which I think is important. 
My personal choice at this stage would be low-carb Mediterranean simply because we have good long-term studies that show (it) is healthy.”

A “Paleobetic” Experience

The internet is full of testimonials from people who have “gone paleo” and reported a good experience. One example is T1D Lindsay Swanson, who wrote a guest post on Joslin Diabetes

The Center blog reports that “living paleo has diminished that relentless burden immensely through consistency and stability.”

When diabetes advocate and former DiabetesMine team member Allison Nimlos first experimented with the Paleo Diet back in 2013, she experienced some amazing results right off the bat. She shared:

1. My blood sugar started dropping right away. It only took a couple of days before I noticed my blood sugars were lower and more consistent throughout the day. After a few more days, I started having a fair share of low blood sugars!
2. My basal insulin is affected by my diet more than my bolus ratios. When I first started dropping frequently – a 3-4 low blood sugar a day – I thought I had to cut everything. Turns out, I needed to drop my Lantus by 10%, but I didn’t have to do anything to my bolus ratios. (Yet.)
3. I have the best control in recent memory, but it’s not perfect. Like anything that involves adjustments and adaptations, the Paleo Diet is hardly a cure-all. Now that I’ve taken less insulin, there are fewer opportunities for me to go low and more chances for me to go high. You can never expect anything — not a diet, not a medication, not an insulin pump — to run the show for you.
4. If you eat low-carb, you need to bolus for protein . This was the biggest shocker for me. After asking my friends, I discovered that bolusing for about half of the protein is what I need to do to prevent a post-meal spike. Gary Scheiner, author and CDE at Integrated Diabetes Services , explained: “Because your central nervous system needs glucose to function, if your diet is lacking in carbohydrates, the liver will convert some dietary protein to glucose. So it is usually necessary to bolus for some of your protein when you have a meal that is very low in carbohydrates.” For me, a low-carb meal is anything under 30 grams of carbohydrates.
5. My skin and energy levels are improving. Not really diabetes related, but definitely benefits!

Allison ended up derailing the Paleo Diet after just 7 months because she found it too difficult to maintain. “But I appreciate what I’ve learned from my experience… and exposure to different types of recipes,” she writes. “I’ve learned to appreciate different cuts of meat, the types of substitutions you can make with vegetables (try spaghetti squash instead of pasta!) and the magic of spices.”

And she reminds us not to get too hung up on the “history” or “legitimacy” of the “caveman diet.”Paleo foods for diabetes

“Almost everyone who actually follows the Paleo Diet realizes that it is not historically accurate. It is not meant to duplicate any kind of historical diet that our ancestors ate. What it is trying to do is get us to eat clean, natural, and unprocessed healthy foods. There are a variety of reasons (enthusiasts) advocate a no-grain, no-legume, no-dairy diet — anything that you canread about in the book “It Starts with Food” or by searching the Internet – but ultimately they just want people to eat foods that are healthy and won’t cause any digestive harm.

Excellent point. 
It seems the fundamental value of the Paleo Diet and others like it is to get people to become conscious consumers of as many 
clean, unprocessed foods as possible. 
And that’s a win for diabetes care, no doubt.