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The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups


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Purpose: The intent of the present study was to examine the nutritional characteristics of a contemporary diet based upon Paleolithic food groups and to determine how these characteristics may impact the risk of chronic disease. Methods: Nutritional software was employed to ascertain the macro and trace nutrient characteristics of a diet composed of commonly available modern foods, but devoid of processed foods, dairy products and cereal grains. The rel- ative contribution of plant and animal foods to the experi- mental diet was based upon average values previously determined in 229 hunter gatherer societies. Results: The analysis revealed that except for vitamin D, which would have been supplied by endogenous synthesis in hunter gatherers, it is entirely possible to consume a nutri- tionally balanced diet from contemporary foods that mimic the food groups and types available during the Paleolithic. Despite the elimination of two major food groups, the trace nutrient density of the experimental diet remained excep- tionally high. The macronutrient content of the experimen- tal diet (38 % protein, 39 % fat, 23 % carbohydrate by ener- gy) varied considerably from current western values. Conclusions:
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The Nutritional Characteristics
of a Contemporary Diet
Based Upon Paleolithic Food Groups
Loren Cordain, PhD1*
1Department of Health and Exercise Science, Colorado State University,
Fort Collins, Colorado
* Correspondence:
Loren Cordain, PhD
Department of Health and Exercise Science
Colorado State University
Fort Collins, CO 80526
Phone: 970-491-7436 Fax: 970-491-0445
Summer 2002
The intent of the present study was to examine the
nutritional characteristics of a contemporary diet based
upon Paleolithic food groups and to determine how these
characteristics may impact the risk of chronic disease.
Nutritional software was employed to ascertain the
macro and trace nutrient characteristics of a diet composed
of commonly available modern foods, but devoid of
processed foods, dairy products and cereal grains. The rel-
ative contribution of plant and animal foods to the experi-
mental diet was based upon average values previously
determined in 229 hunter gatherer societies.
The analysis revealed that except for vitamin D, which
would have been supplied by endogenous synthesis in
hunter gatherers, it is entirely possible to consume a nutri-
tionally balanced diet from contemporary foods that mimic
the food groups and types available during the Paleolithic.
Despite the elimination of two major food groups, the trace
nutrient density of the experimental diet remained excep-
tionally high. The macronutrient content of the experimen-
tal diet (38 % protein, 39 % fat, 23 % carbohydrate by ener-
gy) varied considerably from current western values.
Contemporary diets based upon Paleolithic food
groups maintained both trace and macronutrient qualities
known to reduce the risk of a variety of chronic diseases in
western populations.
There is a growing awareness among evolutionary biol-
ogists that humans like all species are genetically adapted to
the environment of their ancestors–that is, to the environ-
ment that their ancestors survived in and the environment
that consequently conditioned their genetic makeup.1-3 At
the same time, there is growing awareness that the pro-
found changes in the environment (e.g. in diet and other
lifestyle conditions) that began with the introduction of
agriculture and animal husbandry 10,000 years ago
occurred too recently on an evolutionary timescale for the
human genome to adjust.1-3 As a result of the mismatch
between the contemporary human diet and our genetically
determined physiology, many of the so-called diseases of
civilization have emerged.4-8 Previous studies have exam-
ined the dietary characteristics of humans living during the
Paleolithic,6,9,10 as well as of historically studied hunter-
gatherer societies,11,12 and their authors have suggested that
15 JANA Vol. 5, No. 3
Summer 2002 Vol.5, No. 3 JANA 16
the nutritional qualities of these diets may have therapeutic
value in the treatment of chronic disease. Although it is no
longer possible or practical for contemporary men and women
in western, industrialized countries to adopt and follow the
exact dietary patterns of humans living during the Paleolithic,
it is certainly possible to emulate the essential characteristics
of historically studied hunter-gatherer diets with common
foods and food groups available in all supermarkets.
The intent of this study was to examine the nutritional
qualities of a contemporary diet based upon Paleolithic
food groups and to characterize how these qualities may
impact health and well being.
Formulation of a Contemporary Diet Based Upon
Paleolithic Food Groups
In the United States and other western nations, foods
generally are organized into one of five food groups: 1)
bread, cereal, rice and pasta group, 2) fruit group, 3) veg-
etable group, 4) milk, yogurt and cheese group, and 5) meat,
poultry, fish, dry beans, eggs & nuts group.13 The formula-
tion of a contemporary diet based upon Paleolithic foods
groups necessarily excludes two of these major groups
(grains and dairy) because these foods were rarely or never
consumed by contemporary or Paleolithic hunter-gather-
ers.9,11,14-15 Additionally, within food group #5, dry beans
and legumes were not included in the analysis because, like
cereal grains, these foods did not become dietary staples
until Neolithic times.16 Finally, all modern processed foods
containing mixtures of grains, refined sugars and oils, salt,
and food additives were likewise excluded from the model
because these food mixtures became part of the human
dietary repertoire only following the Agricultural and
Industrial Revolutions.9,11,14-15 Consequently, the present
model utilized only the following contemporary food types:
fruits, vegetables, meats, poultry, fish and nuts/seeds. For
each food type, only the most commonly consumed foods in
the U.S. diet were incorporated into the model. These were
then randomly arranged into three meals and snacks utiliz-
ing dishes that were not dissimilar from those normally
found in traditional western diets. The example diet was
then analyzed for macro and trace nutrients using nutrition-
al software (Nutritionist 5, First Data Bank, San Bruno, CA).
The 20 most commonly consumed fruits, vegetables,
and fish in the United States were employed in the random
meal selections (Table 1).17 For the 20 most commonly con-
sumed vegetable foods in the United States, two foods (pota-
toes and corn) were excluded from the model because corn
is a cereal grain, and potatoes maintain nutrient properties
(high glycemic and insulin responses)18 uncharacteristic of
traditional hunter-gatherer plant foods.19 Consequently, the
remaining 18 vegetable foods in Table 1 represent the food
choices available in the model.
For the meat food group, the four most commonly con-
sumed meats in the United States (beef, chicken, pork and
turkey)20 represented the meats of choice in the analysis.
Only very lean cuts of meat (turkey and chicken breasts
without skin, pork loin trimmed of fat, beef sirloin tip roast
trimmed of fat) that averaged 20 % fat by energy–a mean
value similar to that found in wild game meat21–were uti-
lized in the model. For the nuts/seeds group, 10 nuts and
seeds commonly consumed in the U.S. diet (almonds, wal-
nuts, pecans, filberts, brazil nuts, pistachio nuts, macadamia
nuts, coconut, sunflower seeds and pumpkin seeds) repre-
sented the available choices for this food type.
The primary consideration in the formulation of a “mod-
ern Paleolithic diet” is the relative contribution of each food
group to total energy intake. Compiled ethnographic studies
of 229 hunter-gatherer societies,11 as well as 13 quantitative
studies of hunter-gatherers12 have demonstrated that animal
foods contributed slightly more than half (55-65%) of the
daily energy, whereas plant foods would have made up the
remainder (35-45%) of the average daily caloric intake. Of
the energy obtained from animal foods, historically-studied
hunter-gatherers typically derived half of their energy from
aquatic animals and the other half from terrestrial animals.11
Animal food intake would have also been constrained by the
physiologic protein ceiling, which has been shown to occur
between 30 to 41% of total energy.11
In hunter-gatherer diets, the balance of total dietary ener-
gy (35-45%) derived from plant foods would have been quite
erratic in how it would have been apportioned among the var-
ious plant food groups due to varying environmental and eco-
logical considerations.11 Hence, in the formulation of a mod-
ern diet based upon Paleolithic food groups, the plant food
energy was arbitrarily divided equally among fruits, vegeta-
bles and nuts/seeds. Figure 1 displays the food type energy
weightings assigned to the example “Modern Paleolithic”
diet. Using these energy weightings for each of the five food
types, the diet outlined in Table 2 was formulated.
Figure 1. Apportionment of daily energy to the five food
types in a contemporary diet based upon Paleolithic food
17 JANA Vol. 5, No. 3 Summer 2002
Nutritional Characteristics of a Contemporary
Paleolithic Diet
Table 3 presents the macronutrient intake and other
qualities of the example diet analyzed from foods listed in
Table 2. The macronutrient characteristics of the example
diet, protein (38% energy), carbohydrate (23% energy), fat
(39% energy) are similar to values demonstrated in histori-
cally studied hunter-gatherer societies but different from
values (16% protein, 49% carbohydrate, 34% fat) in tradi-
tional western diets.11 Despite its relatively low carbohy-
drate content (23% energy), the contemporary Paleolithic
diet contained 42.5 g of plant fiber.
The contemporary Paleolithic diet contains more fat
(39% energy) than average values (34% energy) found in
western diets,11 however this extra fat occurs entirely as a
consequence of a greater intake of both polyunsaturated
(PUFA) and monounsaturated (MUFA) fats. Although more
than 50% of the energy in the contemporary Paleolithic diet
is derived from animal foods, the saturated fat content (7.0%
energy) falls within recommended healthful limits ( < 10%
energy).13 The contemporary Paleolithic diet is characterized
by a high intake of total omega 3 (n3) fatty acids (9.6 g) and
a relatively low intake of omega 6 (n6) fatty acids, which in
turn yield a total dietary n6/n3 of 1.5 to 1. The cholesterol
content of the contemporary Paleolithic diet is higher (461
mg) than recommended values (300 mg).13 The contempo-
Table 1. Top 20 most common fruits, vegetables and fish
sold in the United States.17
Table 3. Macronutrient and other dietary characteristics in
a contemporary diet based on Paleolithic food groups for
females (25 yrs, 2200 kcal daily energy intake).
Table 2. Sample 1-day menu for a modern diet based upon
Paleolithic food groups for females (25 yrs, 2200 kcal daily
energy intake).
Vol.5, No. 3 JANA 18Summer 2002
rary Paleolithic diet contains 12.5 times more potassium than
sodium. Except for calcium, all trace nutrients occur in con-
siderably greater quantities than the recommended daily
allowances (RDAs) (Table 4).
The results of this analysis demonstrate that it is entire-
ly possible to consume a nutritionally balanced diet from
commonly available contemporary foods that emulate the
food types available to Paleolithic hunter gatherers.
Despite the elimination of two major food groups (dairy and
cereals), the trace nutrient density of the diet remains
exceptionally high. Moreover, the diet maintains numerous
nutritional characteristics that have been demonstrated to
reduce the risk of a variety of chronic diseases.
Potential Nutritional Shortcomings of the
Contemporary Paleolithic Diet
Table 4 shows that the calcium intake (691 mg) would
be considerably lower than the RDA (1000 mg), while the
protein intake (217 g) would be more than 4 times recom-
mended values (50 g). Because increased dietary protein
increases obligatory loss of urinary calcium, it has been sug-
gested that a calcium (mg)/protein (g) ratio of >20:1 may
protect against bone loss.22 The calcium/protein ratio of the
contemporary Paleolithic diet (3.2 :1) is considerably lower
than that in the average U.S. diet (10.7:1)23 and therefore
might be expected to increase the risk for bone demineraliza-
tion, osteoporosis, and osteopenia. However, analyses of the
skeletons of ancestral humans living during the Paleolithic
24,25 as well as more recently studied hunter-gatherers26 have
shown these people maintained robust, fracture-resistant
bones, free from signs and symptoms of osteoporosis despite
consuming no dairy products. Their robust bones may be
due in part to greater activity levels (bone loading)24 and
greater sunlight exposure (increased vitamin D synthesis,
hence increased calcium absorption). However, more impor-
tantly it is likely that Paleolithic hunter gatherers would have
been in positive calcium balance despite a relatively low cal-
cium intake because the calciuretic effects of a high meat diet
were countered by high fruit and vegetable intake.11,12
Ingestion of meat protein induces calciuresis because
the oxidation of sulfur-containing amino acids presents a
net acid load to the kidney, which in turn must buffer the
acid load from base that ultimately is derived from calcium-
containing bone mineral salts.27 Previous studies have
demonstrated that ingestion of an alkalinizing agent pre-
vented the calciurea which normally accompanies high pro-
tein diets,28 and that when base is administered at a dose
sufficient to neutralize endogenous acid production, calci-
um balance is improved, bone resorption is reduced, and
bone formation is increased.29 In western diets, meats,
Table 4. Trace nutrients in a modern diet based on
Paleolithic food groups for females (25 yrs, 2200 kcal daily
energy intake).
Table 5. The potential renal acid load (PRAL) in the exam-
ple diet. Values for PRAL were adapted from Remer and
Manz’s database.30 (+) values are acid-producing,(-)values
are base-producing.
Summer 200219 JANA Vol. 5, No. 3
cheeses, and cereal grains yield high potential renal acid
loads30 and hence may promote osteoporosis by producing
a net metabolic acidosis.27 In contrast, fruits and vegetables
yield a net alkaline renal load,30 and high fruit and veg-
etable diets have been shown to reduce urinary calcium
excretion rates.31 Accordingly, in hunter-gatherer popula-
tions consuming high protein diets, a concomitant con-
sumption of high levels of fruits and vegetables may have
countered the calciuretic effects of a high protein diet.
In the present model, the net renal ionic load was
slightly alkaline with base producing foods (-53.2) out-
weighing acid producing foods (51.4) (Table 5).
Consequently the high protein intake of the example diet
would not have caused an increased calciuresis, and sub-
jects consuming a similar diet likely would remain in calci-
um balance despite a calcium intake lower than the RDA.
Vitamin D
The contemporary Paleolithic diet provides no dietary
vitamin D. Except for the livers of certain marine mammals
and fish, there are relatively few sources of vitamin D in the
normal food supply. In most hunter-gatherers, vitamin D
would have been obtained via the body’s synthesis of this
hormone from ultraviolet irradiation (sunlight exposure) of
cholesterol in the skin. Only with the fortification of mar-
garine and milk, beginning in the mid 20th century, has vit-
amin D been widely available in the food supply.
Table 3 shows that the cholesterol intake (461 mg) for
the model diet is more than 50% higher than recommended
values (300 mg).13 However, it should be noted that dietary
cholesterol has a relatively minor impact on serum choles-
terol levels.32 The recently developed Howell et al. equa-
tion33 [serum cholesterol (mg/dL) = 1.918 x SFA –
0.900 x PUFA + 0.0222 x cholesterol; where SFA = %
saturated fat energy, PUFA = % polyunsaturated fat energy,
and cholesterol = dietary cholesterol (mg)] reveals that a
reduction in dietary cholesterol from 461 mg (the value in
the example diet) to 300 mg (recommended value) would
only lower serum cholesterol levels by 3.5 mg/dL.
Additionally, in the example diet the ratio of polyunsaturat-
ed fatty acids to saturated fatty acids (P/S) is 1.5.
Schonfeld and colleagues34 have shown that when the
P/S was = 0.8, the addition of 750 mg of dietary cholesterol
did not elevate serum LDL cholesterol concentrations in
healthy, normal men. Consequently, the high P/S in the
contemporary Paleolithic diet likely would counter any ele-
vations in serum cholesterol that potentially could have
occurred from increased dietary cholesterol.
Potential Nutritional Benefits of the Modern Paleolithic
Dietary Protein
Perhaps the most striking difference between the typi-
cal western diet and the current model diet lies in the much
higher protein intake. Although a high protein ingestion
can increase the rate of progression in renal dysfunction,35
a recent clinical trial has demonstrated that a high protein
diet (26% energy) had no adverse effects upon renal func-
tion in subjects with no pre-existing kidney disease.36
Because protein has more than three times the thermic
effect of either fat or carbohydrate37 and because it has a
greater satiety value than fat or carbohydrate,37,38 increased
dietary protein may represent an effective weight loss strat-
egy for the overweight or obese. Recent clinical trials have
demonstrated that calorie-restricted high protein diets are
more effective than calorie-restricted high carbohydrate
diets in eliciting weight loss in overweight subjects.39,40
There is an increasing body of evidence that suggests
high protein diets may improve blood lipid profiles41-45 and
thereby lessen the risk for cardiovascular disease (CVD).
Wolfe and colleagues have shown that the isocaloric substi-
tution of protein (23% energy) for carbohydrate in moder-
ately hypercholesterolemic subjects resulted in significant
decreases in total, LDL and VLDLcholesterol, and TG while
HDL cholesterol increased.43 Similar blood lipid changes
have been observed in type II diabetic patients in conjunc-
tion with improvements in glucose and insulin metabo-
lism.41,42 Further, high protein diets have been shown to
improve metabolic control in type II diabetes patients.41,42,46
In obese women, hypo-caloric high protein diets improved
insulin sensitivity and prevented muscle loss, whereas hypo-
caloric high carbohydrate diets worsened insulin sensitivity
and caused reductions in the fat free mass.47
Epidemiological evidence supports the clinical data
showing a cardiovascular protective effect of dietary pro-
tein. Increased protein intake has been shown to be inverse-
ly related to CVD in a cohort of 80,082 women.48 Dietary
protein is also inversely related to serum homocysteine
concentration,49 an independent risk factor for CVD. Meat
eating populations have been shown to maintain lower plas-
ma homocysteine concentrations than non-meat eaters.50,51
In numerous population studies, summarized by Obarzanek
et al.,52 higher blood pressure was associated with lower
intake of protein. Recently, a four-week dietary interven-
tion of hypertensive subjects demonstrated that a high pro-
tein diet (25% energy) was effective in significantly lower-
ing blood pressure.53 Further, a number of population stud-
ies have established that stroke mortality is inversely relat-
ed to protein intake.54,55
Dietary Carbohydrate and Fiber
Table 3 reveals that the carbohydrate content (23%
energy) of the example diet is considerably lower than
average values (49% energy) in the U.S. diet,11 or suggest-
ed healthful ranges (55-60% energy).13,56 Although current
advice to reduce the risk of CVD is, in general, to replace
saturated fats with complex carbohydrate,13,56 there is
Vol.5, No. 3 JANA 20Summer 2002
mounting evidence to indicate that low fat, high carbohy-
drate diets may elicit undesirable blood lipid changes,
including reductions in HDL cholesterol and apolipoprotein
A-1, while concurrently elevating TG, VLDL cholesterol
and small dense LDL cholesterol.57-60 Collectively, these
blood lipid changes are associated with an increased risk for
CVD and other Syndrome X diseases.61
Table 6 shows both the glycemic index and glycemic
load (glycemic index x carbohydrate content in food por-
tion) in selected grain products, sugars/sweets, dairy foods,
fruits, and vegetables.62 High glycemic loads represent a
nearly universal characteristic of the typical western diet
because of a high reliance upon refined sugars and cereal
grains. Added sugars represent 16.1% of the energy con-
sumed in the average U.S. diet, whereas refined grain prod-
ucts comprise 85.3% of all the grains consumed in the
U.S.23 Table 6 reveals that dairy products maintain low
glycemic indices and loads, but paradoxically these foods
are highly insulinotrophic with insulin indices similar to
white bread.63 Consequently, the elimination of refined sug-
ars, grains and dairy products in the example diet produces
a low-carbohydrate diet (23% energy) in which all of the
carbohydrates are derived from fruits, vegetables, and
seeds/nuts with their universally low glycemic loads. High
glycemic load diets have been implicated in the develop-
ment of obesity,64 and observational studies suggest that
foods with a high glycemic load increase the risk for type II
diabetes65,66 and CVD.67
The fiber content (42.5 g) of the example diet is con-
siderably higher than values in the U.S. diet (15.1 g) and
higher than recommended values (25-30 g).56 Soluble fibers
modestly reduce LDL and total cholesterol concentrations
beyond those achieved by a diet low in saturated fat, and
fiber, by slowing gastric emptying, may reduce appetite and
help to control caloric intake.68
Dietary Fat
The total fat content (39% energy) of the example diet
is 30% higher than recommended intakes.13,56 However, it
should be noted that the overall dietary lipid profile is
health-promoting and anti-atherogenic.
There is now substantial evidence to indicate that the
absolute amount of dietary fat is less important in lowering
blood lipid levels and reducing the risk for CVD than is the
relative concentrations of specific dietary fatty acids.69-72
Low (22% energy) and high (39% energy) fat diets which
had identical (polyunsaturated/saturated) (n3/n6) and
(monounsaturated/total fat) fatty acid ratios produced no
significant differences in total or LDL cholesterol following
a 50 day trial.72 Hypercholesterolemic fatty acids include
12:0, 14:0, 16:0, and trans-9 18:1,73 whereas monounsatu-
rated (MUFA)70,74 and polyunsaturated (PUFA)73 fatty
acids are hypocholesterolemic, and 18:0 is neutral.74 Omega
3 PUFA have wide-ranging cardiovascular protective
capacities including lowering of plasma VLDL cholesterol
and triacylglycerol (TG) concentrations.69 Consequently, it
is entirely possible to consume relatively high fat diets that
do not necessarily produce a plasma lipid profile that pro-
motes CVD72,75 given sufficient MUFA,70 PUFA,60 and an
appropriate n6/n3 PUFA ratio69 relative to the hypercho-
lesterolemic fatty acids.
Although more than 50 % of the energy in the contem-
porary Paleolithic diet is derived from animal foods, the
saturated fat content (7.0% energy) not only falls within
recommended healthful limits ( < 10 % energy),13,56 but
also within limits (<7 %) for individuals with elevated LDL
cholesterol concentrations or CVD.76 The dominant fats in
the example diet are cholesterol lowering MUFA (17.2 %
energy) and PUFA (10.4 % energy). MUFA may also con-
fer additional cardiovascular protective effects beyond low-
ering serum cholesterol by its ability to reduce LDL oxi-
dizability, a key step in the atherosclerotic process.77
Table 6. Glycemic indices and glycemic loads of various
food groups. Glycemic load = (glycemic index x carbohy-
drate content in 10g portions). The glycemic reference is
glucose with a glycemic index of 100. Data adapted from
Foster-Powell et al.62
Glycemic Glycemic
Summer 200221 JANA Vol. 5, No. 3
The example diet is rich in omega 3 fatty acids (9.6 g)
compared to the average value (2.3 g) found in the U.S.
diet.78 Numerous studies have reported the beneficial
effects of an increased omega 3 fatty acid intake in CVD
patients.79-82 A 20% reduction in overall mortality and a
45% reduction in sudden death after 3.5 years were report-
ed in subjects with preexisting CVD when given 850 mg of
omega 3 fatty acids (20:5n3 and 22:6n3) either with or
without vitamin E.82 Omega 3 fatty acids may operate to
reduce CVD mortality via a number of mechanisms includ-
ing reductions in serum VLDL and triacylglycerol concen-
trations, thrombic tendencies, and the incidence of ventric-
ular arhythmias.66
Dietary Sodium and Potassium
Because no processed foods or added salt are included
in the example diet, the sodium intake (726 mg) is appre-
ciably lower than average U.S. values (3,271 mg)23 or rec-
ommended values (2,400 mg).56 Further, since potassium-
rich fruits and vegetables comprise 30% of the daily ener-
gy, the potassium content (9,062 mg) of the example diet is
nearly 3.5 times greater than average values (2,620 mg) in
the U.S. diet.23 Diets rich in potassium and low in sodium
have been repeatedly demonstrated to be therapeutic for a
variety of chronic conditions including: hypertension,
stroke, kidney stones, and osteoporosis.83,84
Trace Nutrients
Table 4 demonstrates that, except for calcium, the
example diet is exceedingly rich in the 14 vitamins and
minerals most commonly deficient in the U.S. diet.23 A
meta-analysis investigating the relationship between CVD
and serum homocysteine concentrations has demonstrated
that as much as 10% of CVD risk was attributable to hyper-
homocysteinemia.85 The normal metabolism of homocys-
teine requires an adequate supply of folate, vitamin B6, vit-
amin B12 and riboflavin. Lower serum folate concentra-
tions and vitamin B6have been associated with increased
CVD risk.86 Because the fruits (15% energy) and vegeta-
bles (15% energy) in the example diet are rich sources of
folate, the intake of this vitamin is quite high (891 µg or
223% RDA). Additionally, the fish (27.5% energy) and
lean meats (27.5% energy) contained in the example diet
are rich sources of vitamin B6, and along with the fruits,
vegetables and seeds/nuts, combine to yield a high intake
(6.7 mg or 515 % RDA) of this vitamin.
Despite a high reliance upon low fat animal foods
(55% energy), the experimental diet would not have neces-
sarily elicited unfavorable blood lipid profiles because of
the hypolipidemic effects of high dietary protein (38 %
energy) and the relatively low level of low glycemic index
dietary carbohydrates (23%). Although total fat intake (39%
energy) would have been higher than that found in western
diets, total saturated fat (7.0% energy) fell well within
healthful limits (10% energy). Important qualitative differ-
ences in fat intake, including relatively high levels of
MUFA and PUFA and a lower n6/n3 fatty acid ratio, also
would have served to reduce the risk for CVD. Other char-
acteristics of the example diet, including a high intake of
antioxidants, fiber, vitamins, and phytochemicals along
with a low salt intake would further deter the risk of CVD
and other chronic diseases.
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... Fourth, we used two additional approaches for analysing dietary measurements: baseline diet only and a time-dependent approach across the follow-up. Lastly, as Cordain et al. showed that contemporary PDs are deficient in calcium, we analysed the PD score with the exclusion of calcium [30]; furthermore, we included eggs as characteristic of the PD as proposed by Frassetto et al. to assess the influence on BC risk [31]. ...
... These potential benefits should be considered in light of the differences between the contemporary PD and the traditional PD of our ancestors. For instance, there is ample evidence supporting a high intake of animal protein in the traditional PD [39], whilst animal protein originating from lean meats and seafood constitutes the majority of energy intake in contemporary PDs [30]. Moreover, compared to contemporary whole-food diets, such as the Mediterranean diet, the superiority of PDs could be attributed to the restriction of grains [40]. ...
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Background The Palaeolithic diet (PD) has gained popularity globally. There is emerging evidence of its putative health benefits as short-term effects on chronic diseases have been reported. We evaluated the association between long-term adherence to the PD and breast cancer (BC) risk among postmenopausal women. Methods 65,574 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort were followed from 1993 to 2014. Incident BC cases were identified and validated. The PD score was calculated using dietary intake self-reported at baseline (1993) and follow-up (2005) or baseline only if censored before follow-up. Multivariable Cox proportional hazards regression models were used to estimate BC hazard ratios (HR) and 95% confidence intervals (CI). Results Over a mean follow-up of 20 years, 3968 incident BC cases occurred. An increase of 1 standard deviation in the PD score was associated with an 8% lower BC risk, fully-adjusted model: HR1-SD 0.92, 95% CI; 0.89, 0.95. Compared to women with low adherence to the PD, women with high adherence had a 17% lower BC risk, HRQ5 vs Q1 0.83, 95% CI; 0.75, 0.92, Ptrend < 0.01. When considering BC subtypes, we observed the same pattern of association (Pheterogeneity > 0.10 for all). Conclusions High adherence to a PD characterised by fruit, vegetables, nuts, fish, and lean meat and limited in dairy, grains, legumes, refined sugar, and alcohol was associated with a lower BC risk. The lack of heterogeneity according to BC subtypes could indicate the involvement of non-hormonal mechanisms. The protocol is registered at as NCT03285230. Registry The protocol is registered at as NCT03285230.
... Die Paleo-Ernährung im Gesundheitstest indirekte Bewertung Eine moderne Steinzeiternährung, wie sie in Industrieländern empfohlen und praktiziert wird, ist eine omnivore Kostform, meist mit einem hohen Fleisch-und Fischanteil, ergänzt um Gemüse, Obst und Nüsse (▶ Abb. 1) [50]. ...
... Die Zufuhr an einfach ungesättigten Fettsäuren und langkettigen ω-3-Fettsäuren istverglichen mit den Empfehlungen von Fachgesellschaftenhoch, ebenso der ω-3 : ω-6-Quotient (etwa 2 : 1); die Zufuhr an gesättigten Fettsäuren ist mit etwa 7,5 Energie% relativ gering. Bedingt durch den reichlichen Verzehr von Gemüse, werden mit der Steinzeitkost üblicherweise vergleichsweise hohe Mengen an Ballaststoffen (> 30 g pro Tag), vorwiegend in löslicher Form, zugeführt [50]. [60]. ...
... where BMR is the basal metabolic rate, [PR] or [LC] stand for the additional energy costs of pregnancy or lactation, respectively, and PAL is the physical activity level (Hockett, 2012). Using an estimate for a Neanderthal woman's BMR of 1465 kcal/day and [LC] = 1.9 MJ/day (≈450 kcal/day) (Butte & King, 2005) (Cordain, 2002;Klement et al., 2021) does not negatively affect pregnancy and even may exert beneficial effects compared to a modern standard diet. There are even some case studies from pregnant mothers on long-term ketogenic diets due to epilepsy (van der Louw et al., 2017) or GLUT-1 deficiency syndrome (Kramer & Smith, 2021) that provide a proof-of-principle that healthy pregnancies and normal child development are possible with very low carbohydrate consumption. ...
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Objectives: In a recent paper, Hardy et al. (2022, Journal of Human Evolution 162: 103105) claim that the physiological Neanderthal requirement for plant carbohydrates may have reached 50%-60% of caloric intake, inferred from modern dietary guidelines and a putative need for high carbohydrate intake in pregnant/breastfeeding women and athletes. The aim of this article is to critically reexamine these arguments under the premise that hominins could adapt to hypercarnivorous diets and low carbohydrate consumption. Materials and Methods: Literature on ketogenic and carnivore diets was retrieved. A case report of a male rugby player voluntarily undertaking a carnivore diet under medical supervision is presented. Results: Human metabolism is highly flexible towards adapting to long-term low carbohydrate intakes by producing and utilizing ketone bodies. The evidence base of dietary guidelines is weak, and carbohydrate intake recommendations for athletes and during pregnancy/lactation are uncertain, making a translation to Neanderthal diets questionable. The studied rugby player maintained his sports performance and health over a 4-months period despite minimal carbohydrate intake. Discussion: Human physiology appears to have an extraordinary ability to utilize ketone bodies as a fuel for the brain and skeletal muscle, in particular also during exercise. The translation of dietary guidelines to Neanderthals and interpretation of studies in subjects not adapted to ketosis may be biased by a "glucocentric" perspective supposing that high carbohydrate intake is necessary for maintaining health. Allowing for the possibility of keto-adaption leads to a more coherent integration of archeological and physiological data. K E Y W O R D S carnivore diet, exercise nutrition, ketosis, paleolithic diet, pleistocene
... Bunun yanında glutensiz beslenmeyi göz önünde tutmaktadır. Paleo diyetinde süt, yumurta ve gluten içeren gıdalar kesinlikle yasaktır (Wahls & Adamson, 2014, Cordain, 2002 (Rodrigo & ark. 2014). ...
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Yetersiz beslenme ve engellilik durumu birçok ortak noktası nedeniyle yakından ilişkili iki kavramdır. Besine ulaşmanın zor olduğu durumlarda ya da yüksek düzeyde besin çeşitliliğinin bulunduğu fakat yetersiz beslenmenin yaygın olduğu ülkelerde yaşamını sürdüren çocuklarda gelişimsel bozukluklar, gecikmeler ve engellilik oranlarının yüksek olduğu bildirilmektedir. Bu oranların açıklayıcısı veya iki kavramın bağının oluştuğu noktalar ise yetersiz beslenmenin çocuklarda çeşitli farklı engellilik durumlarına neden olması veya katkıda bulunması ile birlikte; engellilik durumlarının da yetersiz beslenmeye neden olması veya katkıda bulunmasıdır. Özel gereksinimli çocuklarda beslenmenin önemi, gebelik döneminde annenin beslenmesine kadar dayandırılmaktadır. İlk 1000 gün boyunca, yani gebelikten 2. doğum gününe kadar optimal düzeyde beslenmenin, yeni doğanın sağlıklı gelişimi ve yaşamı için kritik öneme sahip olduğu yönünde görüş birliği vardır .......
... Bunun yanında glutensiz beslenmeyi göz önünde tutmaktadır. Paleo diyetinde süt, yumurta ve gluten içeren gıdalar kesinlikle yasaktır (Wahls & Adamson, 2014, Cordain, 2002 (Rodrigo & ark. 2014). ...
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OSB, yaşamın ilk yıllarında ortaya çıkmakta ve etiyolojisi kesin olarak bilinmemektedir. OSB oluşumunda tek bir faktörden çok, genetik ve çevresel faktörlerin çoklu mekanizmalar halinde etkili olduğu ileri sürülmektedir (Risch & ark.,2014). Bir meta-analizde, genetik faktörlerin OSB oluşumunda %74-93 oranında katkıda bulunmakla birlikte yine de tek başına yeterli olmadığı belirlenmiştir (Tick & ark.,2016). Ebeveyn yaşının ileri olması, endokrin bozucu kimyasal ve radyasyon maruziyeti, ilaç alımı, civa/kurşun/alimünyum gibi çevresel toksinlerin OSB oluşumunda etkili olabileceği bildirilmiştir (Lyall vd., 2017 & Cekici ve Sanlier., 2019). Prematüre doğum, annenin gebelik boyunca başta folik asit olmak üzere yeterli vitamin ve mineral alamaması, bozulmuş otoimmünitenin OSB oluşumunda etkili mekanizmalar arasında sayılmaktadır (Lyall & ark., 2017; Cekici & Sanlier., 2019). Anne-çocuk arasındaki psikososyal bağın yetersiz olmasının da OSB gelişiminde etkili olabileceği düşünülmektedir (Özeren,2013). İlk 6 ay ve 2. yaşa kadar elzem olan anne sütü tüketiminin, OSB riskini azalttığını gösteren bulgular mevcuttur (Say, Babadağı & Karabekiroğlu, 2015; Huang & ark., 2021)...........
... Paleo diyetinde süt, yumurta ve glüten içeren gıdalar kesinlikle yasaktır. (80,81) Paleo diyetinin modifiye edilmiş versiyonu, 2008'de Dr. Terry Wahls tarafından geliştirilip Wahls protokolünün bir kısmını oluşturmaktadır. Bu diyette ilgi çeken özellik bağırsak geçirgenliği ve MSS iltihabına katkıda bulunabilecek lektin içeren gıdaların yasaklanmasıdır. ...
... Diversified food selection since the Holocene played an important role in prehistoric humans' adaptation to different environments, promoting the formation of diverse subsistence strategies around the world, such as hunting-gathering, agriculture, and agropastoralism (Matuzeviciute et al., 2020;Wang et al., 2020;Zhuang, 2020;Wang et al., 2021;Irish and Usai, 2021). Fruits have also been considered to be important edible resources throughout the history of human evolution (Eaton et al., 1997;Cordain, 2002;Zheng et al., 2014;Fuller and Stevens, 2019). However, it still remains unclear what changes have taken place in fruit trees utilization by people (wild gathering or conscious cultivation) since the prehistoric period. ...
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The history of fruit-tree utilization by prehistoric people has become an important issue that has attracted increasing attention in recent years. However, the question of how people used fruit trees has not yet been answered; in particular, the impacts of different subsistence strategies on human behavior regarding fruit-tree utilization (wild gathering or conscious cultivation) have not yet been considered. Here, we present the results of charcoal identification of fruit trees from 16 dated archeological sites in the northeastern Tibetan Plateau (NETP) spanning the period c. 5,200-2,600 BP. We combine this with reported multidisciplinary evidence to explore the history of fruit-tree utilization as well as its relation to the subsistence strategy in the NETP during the late Neolithic and Bronze Age. Our results demonstrate that Rosaceae [Prunus L., Prunus Padus L., Maloideae L., and Malus baccata (L.) Borkh], Elaeagnaceae (Hippophae L. and Elaeagnus angustifolia L.), and Rhamnaceae (only Ziziphus Mill.) were used by people in the NETP, and there was a downward trend in the use of fruit trees during the late Neolithic and Bronze Age. This is in notable contrast to the situation in the Chinese Loess Plateau in the parallel period. The cold-dry climate during the Bronze Age seemed to be one of the reasons. The fruit trees used by people in the NETP were likely gathered from the wild rather than consciously cultivated, and the subsistence strategy of agropastoralism may have played a significant role during the processes.
... When compared with the standard American diet, the PD is typically higher in potassium, antioxidants, micronutrients, and fiber. 16,31 Of note, the PD has also been identified in short-term intervention studies as providing inadequate levels of iodide 32 and calcium. 33 While the Food and Nutrition Board of the Institute of Medicine provides recommended ranges (ie, 20%-35%, 10%-35%, and 45%-65% of energy from carbohydrate, protein, and fat, respectively) with respect to macronutrient intake, 34 there is ambiguity around recommended intakes for popular dietary patterns. ...
Public interest in the Paleo diet (PD) has been growing since 2002, following the publication of Dr Loren Cordain's book The Paleo Diet. The premise of this diet is rooted in the ancestral hunter-gatherer pattern of eating, including lean meat, fish/seafood, fruits, vegetables (leaves and tubers), and nuts. Many followers adopt the diet as a healthier alternative to the standard American diet. Today, however, the interpretation and practice of the PD vary. To promote an increased understanding of the PD and its potential health benefits and to also help clinicians better engage with patients following the PD, researchers should work to (1) standardize how PD is defined in the literature and (2) examine the nutrient composition of the PD.
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Purpose Patterns of change from the traditional Palaeolithic lifestyle to the modern lifestyle may partly explain the epidemic proportions of non-communicable diseases (NCDs). We investigated to what extent adherence to the Palaeolithic diet (PD) and the Palaeolithic-like lifestyle was associated with type 2 diabetes (T2D) and hypertension risks. Methods A study of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale) cohort, followed up for nearly 20 years. There were 3292 incident T2D and 12,504 incident hypertension cases that were validated. Dietary data were collected at baseline in 1993 via a food frequency questionnaire. The PD score and the Palaeolithic-like lifestyle score (PD, physical activity, smoking status, and body mass index [BMI]) were derived and considered in quintiles. Multivariable Cox regression models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident T2D and hypertension. Results In the fully adjusted models, a 1-SD increase of the PD score was associated with 4% and 3% lower risks of T2D and hypertension, respectively. Those in the highest versus the lowest quintile of the score had HR (95% CI) of 0.88 (0.79, 0.98) and 0.91 (0.86, 0.96) for T2D and hypertension, respectively (P-trend < 0.0001). Associations were stronger for the Palaeolithic-like lifestyle score; in the fully adjusted model, a 1-SD increase of the score was associated with 19% and 6% lower risks of T2D and hypertension, respectively. Risks lowered successively with each increase in quintile; those in the highest versus the lowest quintile had HR (95% CI) of 0.58 (0.52, 0.65) and 0.85 (0.80, 0.90) for T2D and hypertension, respectively (P-trend < 0.0001). Conclusions Our data suggest that adhering to a PD based on fruit, vegetables, lean meats, fish, and nuts, and incorporating a Palaeolithic-like lifestyle could be promising options to prevent T2D and hypertension.
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The aim of this study was to compare the digestibility and metabolic responses of western foods with traditional staples of two populations that show a susceptibility to diabetes, namely Australian Aborigines and Pacific islanders. Rate of starch digestion was studied in vitro in 37 foods (20 Australian Aboriginal bushfoods, 10 Pacific island foods, and 7 western foods), and rate of absorption of 9 foods (8 bushfoods and 1 western food) was studied in human volunteers. In vitro studies showed that 23 of 30 traditional foods were digested more slowly than 7 western foods. Six of 8 bushfoods produced significantly smaller areas under 3-h postprandial plasma glucose curves than potatoes in seven healthy Caucasian volunteers. There was a good correlation between starch digestibility and plasma glucose response. Our findings are consistent with the hypothesis that carbohydrate in traditional diets is slowly digested and absorbed and may once have been protective against diabetes.
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Objective: To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non-insulin-dependent diabetes mellitus. Design: Cohort study. Setting: In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load. Main outcome measure: Non-insulin-dependent diabetes mellitus. Results: During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, P trend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR= 1.47; 95% CI, 1.16-1.86, P trend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72, 95% CI, 0.58-0.90, P trend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake. Conclusions: Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.
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Insulin resistance (IR) and hyperinsulinemia are hallmarks of the metabolic syndrome, as are central adiposity, dyslipidemia, and a predisposition to type 2 diabetes, atherosclerotic cardiovascular disease, hypertension, and certain cancers. Regular exercise and calorie restriction have long been known to increase insulin sensitivity and decrease the prevalence of these disorders. The subsequent identification of AMP-activated protein kinase (AMPK) and its activation by exercise and fuel deprivation have led to studies of the effects of AMPK on both IR and metabolic syndrome-related diseases. In this review, we evaluate this body of literature, with special emphasis on the hypothesis that dysregulation of AMPK is both a pathogenic factor for these disorders in humans and a target for their prevention and therapy.
The aim of this study was to systematically compare postprandial insulin responses to isoenergetic 1000-kJ (240-kcal) portions of several common foods. Correlations with nutrient content were determined. Thirty-eight foods separated into six food categories (fruit, bakery products, snacks, carbohydrate-rich foods, protein-rich foods, and breakfast cereals) were fed to groups of 11-13 healthy subjects. Finger-prick blood samples were obtained every 15 min over 120 min. An insulin score was calculated from the area under the insulin response curve for each food with use of white bread as the reference food (score = 100%). Significant differences in insulin score were found both within and among the food categories and also among foods containing a similar amount of carbohydrate. Overall, glucose and insulin scores were highly correlated (r = 0.70, P < 0.001, n = 38). However, protein-rich foods and bakery products (rich in fat and refined carbohydrate) elicited insulin responses that were disproportionately higher than their glycemic responses. Total carbohydrate (r = 0.39, P < 0.05, n = 36) and sugar (r = 0.36, P < 0.05, n = 36) contents were positively related to the mean insulin scores, whereas fat (r = -0.27, NS, n = 36) and protein (r = -0.24, NS, n = 38) contents were negatively related. Consideration of insulin scores may be relevant to the dietary management and pathogenesis of non-insulin-dependent diabetes mellitus and hyperlipidemia and may help increase the accuracy of estimating preprandial insulin requirements.
The nutritional requirements of contemporary humans were almost certainly established over eons of evolutionary experience and the best available evidence indicates that this evolution occurred in a high-calcium nutritional environment. The exercise and dietary patterns of humans living at the end of the Stone Age can be considered natural paradigms: calcium intake was twice that for contemporary humans and requirements for physical exertion were also greater than at present. Bony remains from that period suggest that Stone Agers developed a greater peak bone mass and experienced less age-related bone loss than do humans in the 20th Century.
For many years, it has been known that archaic hominids had more robust long bones than do living populations, a fact that has been linked to their more physically strenuous lives. But many questions remain. How much stronger, for example, were Neanderthals than living humans? And what does this difference in strength tell us about the behavior of our ancestors? Recent research has shown that some of our earlier assumptions about robusticity and behavior in earlier humans are either simplistic or untrue. For example, it is now clear that although earlier humans were, on the average, stronger than living peoples, this is not invariably the case. Some modern human groups have even stronger humeri than those of Neanderthals. The fact that changes in robusticity do not always neatly coincide with subsistence or technological change suggests that interpretations derived in large measure from stone-tool technology and other artifactual evidence may be misleading. This new information on physical strength in earlier humans necessitates a reassessment of traditional ideas about earlier human behavior.
To calculate the effect of changes in carbohydrate and fatty acid intake on serum lipid and lipoprotein levels, we reviewed 27 controlled trials published between 1970 and 1991 that met specific inclusion criteria. These studies yielded 65 data points, which were analyzed by multiple regression analysis using isocaloric exchanges of saturated (sat), monounsaturated (mono), and polyunsaturated (poly) fatty acids versus carbohydrates (carb) as the independent variables. For high density lipoprotein (HDL) we found the following equation: delta HDL cholesterol (mmol/l) = 0.012 x (carb----sat) + 0.009 x (carb----mono) + 0.007 x (carb---- poly) or, in milligrams per deciliter, 0.47 x (carb----sat) + 0.34 x (carb----mono) + 0.28 x (carb----poly). Expressions in parentheses denote the percentage of daily energy intake from carbohydrates that is replaced by saturated, cis-monounsaturated, or polyunsaturated fatty acids. All fatty acids elevated HDL cholesterol when substituted for carbohydrates, but the effect diminished with increasing unsaturation of the fatty acids. For low density lipoprotein (LDL) the equation was delta LDL cholesterol (mmol/l) = 0.033 x (carb----sat) - 0.006 x (carb----mono) - 0.014 x (carb----poly) or, in milligrams per deciliter, 1.28 x (carb----sat) - 0.24 x (carb----mono) - 0.55 x (carb---- poly). The coefficient for polyunsaturates was significantly different from zero, but that for monounsaturates was not. For triglycerides the equation was delta triglycerides (mmol/l) = -0.025 x (carb----sat) - 0.022 x (carb----mono) - 0.028 x (carb---- poly) or, in milligrams per deciliter, -2.22 x (carb----sat) - 1.99 x (carb----mono) - 2.47 x (carb----poly).(ABSTRACT TRUNCATED AT 250 WORDS)