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Introduction to the Paleolithic Diet

April 21, 2008


Dr. Ben Balzer, general practitioner

Beverly Hills Medical Service

109 Morgan St

Beverly Hills NSW 2209

Tel 02 95023355 Fax 02 95024243

Ø The scientific study of nutrition from the perspective of the diet of the 2.4 million year history of humanity, including that of the modern surrogate- hunter-gathers.

Ø Particular reference to the implications of the dietary changes of the Agricultural Revolution of 5,000-12,000 years ago in Europe Africa Asia and America (“Neolithic Diet”)

Ø Part of a larger field known as evolutionary medicine.

Ø Based on the single assumption that the diet that we evolved with is the ideal diet. i.e. that we are genetically adapted to the diet that we evolved with.

Ø The primary tenet of evolutionary medicine is the discordance between our ancient genetically determined biology and the nutritional, cultural, and activity patterns of contemporary western populations, which leads to many of the so-called diseases of civilisation.

Ø The profound changes in the environment (e.g., in diet, activity and other lifestyle conditions), which began with the introduction of agriculture and animal husbandry approximately 10,000 years ago, occurred too recently on an evolutionary timescale for natural selection to adjust the human genome.

Ø Builds on the work of many others including Weston Price 1939, Burkitt and Trowell’s 1962 fibre hypothesis and then of Eaton Eaton Konner 1988 Paleolithic Prescription- (Pritikin like and very different to the modern model).

Ø 30% of energy in the average modern diet derives from Paleolithic foods, and the other 70% come from Neolithic foods. This gives an approximate range of 10 to 50% of energy being Paleolithic for most people, and 50-90% Neolithic.

Ø All diets have multiple dimensions e.g. the mainstream 7
1) Glycaemic load GL= GI x serving size
2) Fatty acid composition
3) Macronutrient composition
4) Micronutrient density
5) Acid/base balance,
6) Sodium/potassium ratio
7) Fibre content

Ø All of these dimensions are important and variation in ANY of these dimensions beyond the evolutionary tolerance has implications for our health.

Ø In general it has been found that all 7 of these dimensions are at optimal levels in the paleolithic diet. Therefore paleolithic diet devotees see much nutritional “progress” as simply “reverse engineering” of the paleolithic diet.

Ø As this diet is high in iron, it is not suitable for people with haemochromatosis.

7 Classical Dimensions of Nutrition

1) Glycaemic load GL= GI x serving size

Most carbs are low GI, overall approx 35% energy as carbs gives a low GI

Reduced risk of hyperglycaemia/ insulin resistance, obesity esp in combination with exercise

2) Fatty acid composition

Hi in omega 3

Low in omega 6

Low in saturated fat

Reduced risk of heart disease, obesity, glaucoma, depression arthritis asthma

3) Macronutrient composition

USA CHO (51.8%)(rec 55-60%)

fat (32.8%)(reco 30%)

protein (15.4%) (rec 15%)

Hunter gatherers CHO 22-40%, Protein 19-35%

Implications debated

4) Micronutrient density

3 to 10x increase in most vitamins and minerals

Vitamin and mineral deficiency unlikely

5) Acid/base balance,

Alkaline cf modern diet acidic

Osteoporosis, age-related muscle wasting calcium kidney stones, hypertension, and exercise-induced asthma and slow the progression

of age- and disease-related chronic renal insufficiency

6) Sodium/potassium ratio

Low sodium 1/5

Hi potassium 3X

Very low ratio

hypertension, stroke, kidney

stones, osteoporosis, gastrointestinal tract cancers, asthma,

exercise-induced asthma, insomnia, air sickness, high-altitude

sickness, and Meniere’s Disease

7) Fibre content

Very high eg 47g/day

Cf recommended level of 25-30g/day

Cf usual intake of 15g/day


appendicitis, hemorrhoids, deep vein thrombosis, varicose veins,

diverticulitis, hiatal hernia, and gastroesophageal reflux

Beyond the mainstream 7 dimensions


Very high quantity & variety. Vitamins, minerals, and other antioxidants

Possible role in prevention of IHD, cancer, macular degeneration etc.


High in quantity and variety, esp in roots

Possible role in sex hormone related illnesses.


lectins inc gluten

protease inhibitors


Very low in PD

Major role in coeliac disease. Possible role in autoimmunity

Foreign proteins- uncoded antigens may cross react with our self antigens

Very low in PD.

Eg Wheat germ agglutinin may cross react.

Possible role in autoimmunity

Leaky gut- promoted by lectins, casein, lactose

Lectins break down brush border, casein & lactose inhibit proteolysis and promote pinocytosis

Possible role in autoimmunity

Bacterial overgrowth- promoted by lectins, low fibre,

Bacterial overgrowth promoted in animals

Possible role in autoimmunity

Exorphins- opioid proteins in milk and wheat

These can stimulate or inhibit endorphin receptors.

Has not been explored, but theoretically opioids are involved in pain and addiction.

Cooking, processing, additives

Cooking may produce toxins such as heterocyclic amines, etc. Additives, eg MSG, aspartame, cyclamate.

Some are carcinogens. Toxicity of others is debated.

Soil erosion- our soils are not the same as in the Paleolithic period

Deficiency in minerals eg iodine and selenium is encouraged by irrigation

Re-emergence of iodine deficiency in Australia


Significant proportion of diet in some people

Toxicity- brain, liver, heart, vitamin deficiency

Phenotype (i.e. states of health and disease) is related to a complex interaction between itself and genes diet exercise sunlight toxins social psychological and other factors.

For millions of years, humans and their relatives have eaten meat, fish, fowl and the leaves, roots and fruits of many plants. One big obstacle to getting more calories from the environment is the fact that many plants are inedible. Grains, beans and potatoes are full of energy but all are inedible in the raw state as they contain many toxins. There is no doubt about that- please don’t try to eat them raw, they can make you very sick.

Around 10,000 years ago, an enormous breakthrough was made- a breakthrough that was to change the course of history, and our diet, forever. This breakthrough was the discovery that cooking these foods (grains, beans and potatoes) made them edible- the heat destroyed enough toxins to render them edible. Grains include wheat, corn, barley, rice, sorghum, millet and oats. Grain based foods also include products such as flour, bread, noodles and pasta. These foods entered the menu of New Stone Age (Neolithic) man, and Paleolithic diet buffs often refer to them as Neolithic foods.

The cooking of grains, beans and potatoes had an enormous effect on our food intake- perhaps doubling the number of calories that we could obtain from the plant foods in our environment. Other advantages were soon obvious with these foods:

· they could store for long periods (refrigeration of course being unavailable in those days)

· they were dense in calories- ie a small weight contains a lot of calories, enabling easy transport

· the food was also the seed of the plant- later allowing ready farming of the species

These advantages made it much easier to store and transport food. We could more easily store food for winter, and for nomads and travelers to carry supplies. Food storage also enabled surpluses to be stored, and this in turn made it possible to free some people from food gathering to become specialists in other activities, such as builders, warriors and rulers. This in turn set us on the course to modern day civilization. Despite these advantages, our genes were never developed with grains, beans and potatoes and were not in tune with them, and still are not.

Then followed the harnessing of dairy products around 5,000 years ago, which allowed man to obtain far more calories from the animal over its lifetime than if it were simply slaughtered for meat. Dairy products are interesting as they combine a variety of components- some of which our genes were ready for and some not. Whilst cows milk is ideal for calves, there are several very important differences between it and human milk. For example, the brain of a calf is only a tiny fraction of its body weight whereas humans have very big brains. Not surprisingly, cows milk is low in critical nutrients for brain development, particularly omega 3 fats.

Paleolithic Diet buffs refer to the new foods as Neolithic foods and the old as Paleolithic Diet foods. In simple terms we see Neolithic as bad and Paleolithic as good.

Since then, some other substances have entered the diet- particularly salt and sugar, and more recently a litany of chemicals including firstly caffeine then all other additives, colourings, preservatives, pesticides etc.

Grains, Beans and Potatoes (GBP) share the following important characteristics:

· They are all toxic when raw- there is no doubt about this- it is a fact that no competent source would dispute- they can be extremely dangerous and it is important never to eat them raw or undercooked. These toxins include enzyme blockers, lectins and other types. I will talk about them in detail later as they are very important.

· Cooking destroys most but not all of the toxins. Insufficient cooking can lead to sickness such as acute gastroenteritis.

· They are all high in carbohydrate, and once cooked this is often rapidly digestible- giving a high glycemic index (sugar spike). They have greatly increased the amount of carbohydrate in the diet and therefore the demand for insulin and this creates a strain on the body with a strong tendency towards diabetes. Europeans are more used to these foods, yet 20% of Europeans will develop diabetes. Races who have more recently been introduced to these foods are much more prone to diabetes which may affect of 50% of some groups of Aborigines, Polynesians and Eskimo and American Indians.

· They are extremely poor sources of vitamins (particularly vitamins A, B-group, folic acid and C), minerals, antioxidants and phytosterols.

Therefore diets high in grains beans and potatoes (GBP):

· Contain toxins in small amounts

· Have a high glycemic index (ie have a similar effect to raw sugar on blood glucose levels)

· Are low in many vitamins, minerals, antioxidants and phytosterols- ie they are the original “empty calories”

· Have problems caused by them displacing other foods

As grains, beans and potatoes form such a large proportion of the modern diet, you can now understand why it is so common for people to feel they need supplements or that they need to detoxify (ie that they have toxins in their system)- indeed both feelings are absolutely correct.

The essentials of the Paleolithic Diet are:

Eat none of the following:

· Grains– including bread, pasta, noodles

· Beans– including string beans, kidney beans, lentils, peanuts, snow-peas and peas

· Potatoes

· Dairy products

· Sugar

· Salt

· Processed factory manufactured foods

Eat the following:

· Meat, chicken and fish

· Fruit

· Vegetables (especially leafy greens and root vegetables, but definitely not including potatoes)

· Eggs – preferably omega 3 enriched types.

· Nuts –eg walnuts, brazil nuts, macadamia, almond. Do not eat peanuts (a bean) or cashews (a family of their own)

· Berries- strawberries, blueberries, raspberries etc.

Try to increase your intake of:

· Root vegetables- carrots, turnips, parsnips, rutabagas, Swedes

· Organ meats- liver and kidneys (I accept that many people find these unpalatable and won’t eat them)

1. Fat- medium amount. Excellent omega 3 and omega 6 amounts and ratio. Low in saturated fat. No trans-fat.

2. Protein- high levels of top quality protein from fish, meat/offal, nuts, eggs.

3. Carbohydrate- low to medium. Low Glycemic Index.

4. Fibre- 47g very high

5. Micronutrients:


Iron=5.82x current (2)

Zinc= 2.74x current(2) .

Calcium=1.67x current(2)

Sodium= 768mg/day =0.136x current(2) BUT difficult to obtain this low level in Western supermarket foods.

Potassium= 10,500 mg/day =2.97x current(2)

Na/K= .073 excellent (2) BUT difficult to obtain this low level in Western supermarket foods


Vitamin A & beta-carotene= very high (liver, kidney, root vegetables). 2.71x current (2)

Vitamins B= vitamin B1would be 4.6 mg or 417% the RDA, for B2, 281% theRDA, for B3 374% the RDA, for B6 369% the RDA, for B12 513% the RDA, for biotin 174% the RDA, for folate 506% the RDA, for pantothenic acid 209% the RDA (1)

Vitamin C= ~600mg excellent 8.38x current (2)

Vitamin E= excellent 3.11x current(2)


High in quantity and variety


High in variety. High levels in root vegetables. Although these levels aren’t as high as in soy products, it is not yet known which phytosterols are most important, particularly after bioconversion. Root vegetables also have lower antinutrient levels than soy products.


Enzyme inhibitors (protease/amylase inhibitors)= very low compared to

Standard Western Diet

Lectins= very low compared to Standard Western Diet.

Allergenic substances= generally low in Paleolithic foods.(3).

Undiscovered micronutrients and antinutrients:

Anyone who hasn’t changed their diet in the past 10 years on the basis of discoveries in antioxidants and phytosterols need not read this. If asked to guess which diet will have optimal levels of these, one can only resort to logical tools such as Occam’s Razor (“that the proposition with the least number of assumptions is most likely to be correct” is one common interpretation). As the Paleolithic diet is based on only one or two assumptions (eg ” the oldest diet is the best” or “the most natural diet is the best” or “The ideal diet for any animal is that which it eats in the wild. Humans are no exception.”). It then follow that it is the diet most likely to have optimal levels of undiscovered factors.

Associated illnesses:

Hunter-gatherer tribes eating a paleolithic style diet exhibit extremely low levels of the following illnesses that are major Western health problems:

Heart disease and stroke


Diabetes mellitus

Overweight and obesity


Rheumatoid arthritis



Paleolithic Diet References: has many links and email groups

The Paleo Diet book by Prof Loren Cordain has many references.

Eaton SB, Eaton SB III, Konner MJ Paleolithic Nutrition Revisited:A 12Year Retrospective on its Nature and Implications. European J. Clinical Nutrition (1997)61,207-216

Shahidi, Fereidoon ed Antinutrients and Phytochemicals in Food 1997,Culinary and Hospitality Industry Publications CHIPS

Cordain L, Cereal Grains: Humanity’s Double Edged Sword.

Evolutionary Aspects of Nutrition and Health. Diet, Exercise, Genetics and Chronic Disease World Review of Nutrition & Dietetics, 1999;84:19-73

Cordain L. Implications of Plio-Pleistocene Hominin Diets for Modern Humans. In: Early Hominin Diets: The Known, the Unknown, and the Unknowable. Ungar, P (Ed.), Oxford University Press, Oxford, 2006, pp 363-83

Loren Cordain, S. Boyd Eaton, Anthony Sebastian, Neil Mann, Staffan Lindeberg, Bruce A. Watkins, James H. O’Keefe, Janette Brand Miller. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54

Freed, D. BMJ 1999;318:1023-1024 ( 17 April )Do dietary lectins cause disease? (editorial)

Simopoulos, Artemis and Robinson, Jo The Omega Diet. Harper Perennial 1999 The Omega Plan (Australian Edition)

Eat Right and Take a Multivitamin

April 20, 2008

The New England Journal of Medicine — April 9, 1998 — Vol. 338, No. 15

This editorial by Godfrey P. Oakley, Jr., M.D. of Centers for Disease Control and Prevention highlights the roles of folate and folic acid supplementation.

Paleo diets have far more folate than standard western diets. The low level in the SWD explains why supplements help the average person. Furthermore, 20% of the population carry mutations (C677T) in folate enzymes that increase their requirements for folate/folic acid.


April 19, 2008

The Paleolithic Diet is the only diet that is over 2 million years old. While it is ideal for most people, there are exceptions. It is definitely not suitable for people with iron overload (haemochromatosis, hemochromatosis) as it is very high in iron. It is not suitable at this stage for people with kidney disease as it is high in protein. Its effect on gout is not yet known and it should be avoided in uncontrolled gout.

It is recommended that you have regular checkups from your registered licensed health care provider and follow their advice.

In pregnancy and other situations, care must be taken to observe advice from your registered licensed health care provider- for example to avoid foods that are at risk for Listeria infection in pregnancy.

The information in this website is of a general nature only and may not be suitable for you. It is not a substitute for advice from your registered licensed health care provider. This website is not intended to diagnose treat prevent or cure any illness.

Consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may increase your risk of food-borne illness, particularly in the elderly, in children, in pregnancy, and those with immunosuppression or chronic diseases such as gut diseases, diabetes or renal impairment. The risk may be worse in certain countries. If you are unsure, consult your doctor prior to changing your eating habits.

Wishing you the best of health

Dr Ben Balzer

Introduction to the Paleolithic Diet

April 19, 2008

Paleo-basics-handout-2007 Click me

Iodine Refs

April 19, 2008

Just go to the Medical Journal of Australia and type iodine in the search box. Most of the papers are freely available. The National Iodine Nutrition Study is the largest study. A good review paper on iodine and IQ is at

Why Beta-carotene & Vitamins C & E are potentially harmful

April 19, 2008

A C E supplements are potentially harmful.

According to the late Victor Herbert Vitamin C and Vitamin E and betacarotene are failures as supplements. Antioxidants don’t necessarily stop free radicals as the most potent free radical generator is iron- a reductant not an oxidant!. Vitamin C recharges Fe3+ back to Fe2+ which can then release another electron. This explains the poor performance of C in trials. Also C enhances digestion of iron and thus severely aggravates haemochromatosis which is an archetypal oxidative stress disease. If you are one of the large portion (about 10% of White and African populations) of the population who are a carrier for a haemochromatosis gene then Herbert indicates the Vitamin C dosages over 75mg per day will increase iron absorption to the same amount as being a full sufferer of haemochromatosis (homozygote with 2 haemochromatosis genes not one). Perhaps Vitamin C supplements over 75mg should carry a warning or be on prescription only!!!!!

Vitamin E is alpha tocopherol and there are several other tocopherols- of which gamma-tocopherol is probably the most important. Take Vitamin E and you won’t absorb your dietary gamma tocopherol and you will end up worse off than before! (Herbert)

Similarly beta carotene is one of hundreds of carotenes. Beta carotene stops you from absorbing the others. Hence beta carotene tablets increase lung cancer in smokers. In contrast dietary carotenes reduce lung cancer. Therefore diet derived beta carotenes statistically correlate strongly with less lung cancer- hence the trial of supplements which had the opposite effect to diet derived carotenes. A classical case of what happens when we combine overuse of inference- cause and effect had not been demonstrated. (Herbert)

I can’t find any body of evidence to show that CoEnzyme Q10 or alpha lipoic acid are harmful. Personally I recommend taking a wide variety of fruit and vegetables, and root vegetables (Red sweet potatoes, turnips, swedes).

Nobody has researched the antioxidant capacity of root vegetables, last I looked, and this is probably because turnips aren’t glamorous.

Also note that bilirubin is a major antioxidant, possibly one of the most important. Many people have genetically high bilirubin (Gilbert’s syndrome) and this may give them some protection. The only paper I found on heart disease showed a significant reduction with Gilberts, but probably needs more research.

On the other hand Folic acid, B12 and B6 seem very benefical except for one silly trial that involved intravenous B12 loading dosage.

One of the best references I found on free radicals & oxidative stress is
McCord J The evolution of free radicals and oxidative stress. Am J Med. 2000 Jun 1;108(8):652-9.
This was an introduction to a series of about 6 articles which are very high powered covering various organ systems etc. You can follow up other editions of the journal for the few weeks after to get the papers (online via academic subscription). The others are mainly by different authors.
McCord & Fridovich discovered superoxide dismutase (SOD) in the 60’s so he’s one of the leading authorities. Much antioxidant power is enzyme derived and SOD is the classic.

Of course, Paleolithic Diets are so rich in vitamins A C and E that there is no point in supplementing them anyway!

Ben Balzer

Brain nutrition overview links

April 19, 2008

Brain growth is limited by the availability of critical nutrients, not just kJ. Omega 3 and iodine are critical. See Steve Cunnane’s paper at from the Ghent symposium ( a symposium which mainly focuses on the aquatic ape hypothesis).

The Real Origins of Diseases- Mainly Nutritional?

April 19, 2008

The germ theory of disease is medicine’s main success area. It lead to immunisation and antibiotics. Besides infections, which diseases do we know the true origin of?

Infective, traumatic, toxic and a handful of the population have significant genetic disorders.
These are the only ones we can prevent and we have good methods of treating. We can also treat deficiencies and surgeons can treat regional complaints (eg kidney stones, appendicitis, gallstones- but as we do not know the cause we can’t prevent them).

This is the true irrationality of health- medicine is in such a primitive state that it only knows the origin of about 15% of disease! If that. We don’t know the true origin of cancer, arthritis, asthma, gallstones, kidney stones, appendicitis, diabetes type 1, autism. Much money is used looking for genetic origins, yet it is unlikely they will be found.

Actually I think they are all primarily nutritional in origin- that’s why I’m interested in nutrition!

Ben Balzer

Australian Schooling System is a major cause of the obesity epidemic

April 19, 2008

I’ll throw in my 2 cents and lay a huge portion of the blame on the school system. The school system (generally) rewards inactivity and provides no reward for activity. There is a solution.

Consider that selective school exams at end of year 4 and 6 are purely academic. In general, no consideration or acknowledgement for sport, dance, music, drama, or any other activity. Similarly for year 12 HSC (NSW at least). The students who haven’t dropped sport generally do so in year 11 or 12. They see it as a threat to their HSC performance and TER and might miss out on their course or university of choice. (Of course for elite athletes there are TER bonuses etc, but I’m looking at the kids in the middle). At the end of the HSC the top TER’s have a lot of kids who have sacrificed a lot, including their fitness to get there. Many have been in coaching colleges from year 4 all the way through. It leaves little time for sport dance music or any other activity. I worry that some of the kids outside our local coaching college look a bit stressed if not traumatised. No wonder some of them seem to have great marks and no communication skills. There are attempts to address this by other tests like the UMAT but it does not address the problem that sport has been dumped.

In NSW at least dropping sport for the HSC is thus almost inevitable. I view the HSC as being like an old car that has had too many accidents, too many repairs.

An alternative curriculum like the International Baccalaureate which is a designed system, is a much better alternative. Sport is compulsory, as is some community service, a language, theory of knowledge and recognition of culture etc. Overall it seems a very superior system. And certainly will produce a fitter healthier student, and hopefully one with a more rounded education. Dare I say a Renaissance person. The IB is available for senior school, middle school and junior school.

Some countries have adopted the IB for all levels of all their schools. It is growing rapidly. Queensland and Victoria have apparently looked at moving their government schools to IB.

I think that education is a nation’s greatest investment. Much of Australia’s current ongoing boom can be traced to the brain explosion of free then affordable universities introduced in 1972 by Whitlam. This got the best people into the hardest courses and we all benefit, even if it has gone of the rails a bit. I hope the 2020 conference looks firmly at providing the best education system for the nation’s future, and one in which sport and recreation has a firm role.

Ben Balzer