The Palaeolithic Diet

A 19th century Viennese doctor noticed that women giving birth were less likely to die if the attending doctor washed their hands in a chlorinated solution of lime before delivering a baby. (The normal practice was for doctors to go straight from doing an autopsy to delivering a baby without washing their hands).
Several publications by this Dr Semmelweis showed that mortality in childbirth could be reduced from 20% to 1% by this simple hand washing technique – yet he was ridiculed and forced to leave his job.

The outraged doctor then began writing open and angry letters to prominent obstetricians denouncing them as irresponsible murderers.
All, including his wife, believed he was losing his mind and Dr Semmelweis was committed to an asylum, where after being beaten by guards, he died at the age of 47 of septicaemia (ironically the very same illness that was killing the women that he was trying to save).

All because Dr Semmelweis went against the established scientific thinking of his time in an attempt to save the lives of women in childbirth.

The house where Dr Semmelweis was born is now a museum in his honour.

To those who have not yet come over to the Paleo way of eating, don’t give in to the ‘Semmelweis Reflex'; i.e. the reflex-like tendency to reject new evidence or new knowledge because it is unconventional.

I have used this story as a case in point because my friends and family are divided over my dietary views; a few might even go so far as to say that I am a little bit mad.
But then according to Aristotle, “No great mind has ever existed without a touch of madness”.

The reviewer’s burden is a light one when the book to be reviewed is bad. Then he can rock along comfortably, pointing to one egregious error of fact or misstep of interpretation after another. But a very good book is an onerous problem: book review editors frown at squeals of delight, however justified, and the quoting of one nugget of wisdom after another soon becomes a bore.
Mark Cohen’s latest, ‘Health and the rise of Civilization’, is, therefore, a problem.

The book is as provocative as his groundbreaking ‘The food crisis in prehistory’, and as useful to the bleary-eyed student of the human experience in its largest dimensions as two other recent and admirable works, Stephen Boyden’s ‘Western civilization in biological perspective’ and Thomas McKeown’s ‘The origins of human disease’.

Some anthropologists, tape recorder or camel’s hair brush in hand, build careers on the meticulous examination or disinterment of a single village. Cohen seizes whole continents and millennia-the entire Neolithic, for instance-as his bailiwick. In this book he exercises his knowledge, logic, and wisdom to answer the momentous question, what did and is civilization doing to our birth, morbidity, and mortality rates, and to our general health?
Once upon a time many of us believed in a golden age in the past in which youthful vitality was prolonged far into middle age, and death came late and with dignity. Then, in the nineteenth century, most of us signed on as Darwinists and embraced Lewis Henry Morgan’s theory of social evolution as a step-by-step progress upward from savagery to civilization, with the obvious implication that health improved and longevity of life increased with every such step. The thought that the growth or acquiring of civilization has been and still can be disastrous still strikes many as a contradiction in terms.

For several decades archaeologists, physical and cultural anthropologists, physicians, epidemiologists, demographers, historians, and observers in general have produced a large but scattered body of articles and books on exceptions to “the rule” that the rise or arrival of civilization, particularly European civilization, has accompanied an improvement in health. Mark Cohen has ploughed through the articles and books, and then has taken a very hard look at our preconceptions of what civilization is and what it means. A review is no place to try to summarize his intellectual journey (though I must note that the chapters on what we know about the health of contemporary hunters and gatherers and what we can derive about the well-being of our prehistoric ancestors from their bones are fascinating), but I will dare to summarize his conclusions.

They are, that hunters and gatherers usually had, and have, perhaps not a lot of but a sufficiency of quite nourishing food; that they, in their scattered bands, suffered and suffer from fewer infectious diseases than we do; that, on average, health and the length of life declined with the arrival of agriculture; and that the so-called primitives-the hunters and gatherers were and are probably better off than Third World city dwellers today.
Hunters and gatherers were and are saved from population explosion not by infections and high mortality, but by inconstant menstruation, a side effect of vigorous exercise and slight and fat-free diets, plus extended lactation, which possibly limits fertility. Infanticide also had and has a role, though to what extent is debatable.
Improvement in diet and the advance of science and sanitation have raised the mass of the citizens of the twentieth century’s First World to a level of health and life expectation previously unknown at any time or anywhere, but this is a very recent and fragile development.
Of special fascination to historians of European imperialism from the fifteenth to the nineteenth century is Cohen’s statement on page 141 that “a good case can be made that urban European populations of that period may have been among the nutritionally most impoverished, the most disease-ridden, and the shortest-lived populations in human history”.
Caucasian chauvinists will find it hard to accept Columbus and Captain John Smith as Typhoid Marys.

It appears that humans aren’t the only species afflicted with heart disease. Animals in captivity are too. In fact, heart disease is the number one killer of male Western lowland gorillas in North American zoos.

Brooks, a 21-year-old gorilla, died of heart failure at an American Zoo in 2005. Following the death of Brooks, researchers decided to take a closer look at the health and lifestyle of zoo gorillas in an attempt at preventing others from succumbing to heart disease.

Enter Mokolo and Bebac.
At roughly 460 pounds apiece, they were not exactly obese by gorilla standards, but they were definitely overweight. And Mokolo and Bebac had pretty healthy diets, didn’t smoke, didn’t drink, nor did they eat fast food. (At least not to the zoo keepers knowledge!).
But they had already developed heart disease (diagnosed on cardiac ultrasound scans) and were exhibiting typical captive-gorilla behaviour, which consisted of regurgitating and re-ingesting their food, and pulling out their hair and eating it.
Mokolo and Bebac were in fact standard middle-aged zoo gorillas. Both were being treated with human heart drugs, including beta-blockers and ACE inhibitors.

Yet in the wild, apes don’t develop obesity, diabetes or heart disease; nor do they regurgitate their food and pull out their hair. Chronic diseases such as heart disease and diabetes are nonexistent in gorillas living freely in the tropical forests of Sub-Saharan Africa.

So some researchers decided to change Mokolo and Bebac’s diet. What they did was put them back on the diet that they should have always been on – a diet resembling one that wild gorillas eat.

About the before and after gorilla diets:
Both the old and new diets were vegetarian.
What was different was that the new diet consisted of fruit and vegetables: a daily wheelbarrow of romaine lettuce, dandelion greens, endive, alfalfa hay, green beans, a handful of flax seeds, bananas, and young tree branches. An adult male gorilla eats up to 45 pounds of food daily.
And to get the gorillas moving more, the zookeepers scattered the food throughout their habitat to encourage them to forage for their food.
All this foraging and eating kept them occupied for more than half their day – twice as long as did their old diet. Which is as it should be – gorillas in the wild spend at least half their time foraging and eating.
(Although gorillas are primarily herbivorous, they also end up eating some of the protein-rich bugs, snails, and spiders found on leaves and fruit).
No more of the high-grain-and-sugar-filled biscuits that used to be gobbled up in minutes for Mokolo and Bebac.

The results of this experiment were astounding.
A year on, and these big boys shed 65 pounds each, despite doubling their calorie intake. (65 pounds is equivalent to roughly 15% of their body weight).
Tests showed that although their heart problems cannot be cured, the progression of the disease was slowed down.
And their behaviour improved too. The new diet ended their habits of pulling out their hair and regurgitating their food.

So there’s vegetarian, and there’s vegetarian.

In my mind, this story adds to the mounting evidence showing that all species, including humans, should be eating foods that they are evolutionarily adapted to, and to avoid those that weren’t part of their evolutionary menu.

A quote from one of the researchers (Lukas), “And, we’re just recognising that surviving on a diet and being healthy on a diet are different,”.

Until 10,000 years ago all humans ate wild and unprocessed food. These last 10,000 years represent roughly 500 generations of mankind – this recent blip in our long history is the era in which agriculture, farming and civilisations developed.
Even though modern Man may be civilised and intellectually superior to pre-historic Man, our genomes are remarkably similar. There is a fair bit of evidence to show that switching to a meat-based diet was one of the evolutionary factors which paved the way for humans to develop bigger brains. Adding calorie-dense meat to low-calorie plant foods meant Man spent less time looking for food, and subsequently had more time to pursue non-essential activities (such as painting).
Fire, standing upright and cooking are purported to be the other factors which led to the development of the human brain. Have a look here for a more detailed explanation of this theory.

How likely is it that millions of years of evolution shaped our diet incorrectly? Surely it makes sense to continue eating foods that accelerated the growth of the human intellect and to reject those that are associated with a decline in our physical health?

The premise of the Palaeolithic Diet is that abiding by the diet that we have evolved to eat will optimise our health. I am not saying that eating all modern foods are harmful; what I am saying is that the chances of being healthier are greater if we eat foods similar to the ones that pre-historic Man ate.

Caveman clearly didn’t dine on corn flakes for breakfast; nor did he snack on bagels and lattes, and then end his day with a pizza.
What Caveman most likely did eat was wild game if he managed to catch some; fruit if it happened to be in season; and insects or nuts if game and fruit weren’t around.

I’m not for a minute suggesting that we live like cavemen. So you don’t need to go foraging for wild foods and hunting for wild animals; my aim is to convert you to the Paleo way of eating with ‘normal’ foods from your local supermarket. Even though most modern fruits and vegetables have been engineered to be sweeter and less toxic than their wild equivalents, we can still aim to mimic the diet that pre-historic Man ate with what’s currently available.

Diets in pre-historic times varied considerably from Arctic regions to the Tropics because certain foods were more available than others in these diverse parts of the globe. What they all had access to was plants (fruit, vegetables, tubers); fish; meat; eggs and nuts.
Near rivers, seas and lakes Man ate more fish; in colder climes Man ate more meat; in the tropics Man ate more insects and plant matter.
So in Arctic regions Man lived well on 90 percent animal and 10 percent plant food; and in the tropics Man lived well on 90 percent plant and 10 percent animal foods. What all these different communities had in common was a total absence of grains, dairy products, refined fat, sugar and salt.

Across the globe pre-historic people ate similar foods – albeit in very different amounts.

The take home point is to not worry about the proportions of carbohydrate, fat or protein that you are eating; instead concern yourself more with the source of the carbohydrate, fat and protein that you are eating.

Man’s ancestral diet used to be rich and varied. We have evolved to eat wild animals, insects, nuts and plants; not bread, animal milk and sunflower oil. Pre-historically, the animal part consisted of termites, worms, caterpillars, chicks, eggs and (mostly small) mammals. And the vegetable portion consisted of fruits, roots, tubers, roots, bulbs, nuts, leaves, buds and flowers.

Our digestive system evolved with this diverse diet. In fact, this was a pivotal factor in Man being able to leave his original home in Africa and spread across the earth – he had the capacity to adapt to radically different environments because of this ability to eat such a varied diet. We have an excellent range of fallback foods; unlike koala bears, who would get wiped out if they didn’t have access to eucalyptus trees. Man could thrive and survive if a particular plant or animal became extinct.
We wouldn’t be where we are today if it weren’t for this remarkable feature of our digestive system being able to cope with diverse foods.
It has taken millions of years for our metabolisms to get to the stage where we currently are. 10,000 years is just not long enough to adapt to large amounts of grains, dairy, legumes, refined sugars and refined oils. Nowadays the majority of one’s calories come from foods that Man didn’t eat during human evolution.

We don’t know exactly how long pre-historic man lived; what we do know is that once he made it past early adulthood his chances of living a long life were good. The limitations to a long life were the environment and accidents – not the risk of a heart attack or stroke. And when pre-historic man died, he looks to have had strong osteoporosis-free bones, cavity-free teeth and no signs of cancer.
Whereas even slim, modern man who exercises regularly but eats a Western diet is at an increased risk of the above diseases compared to people who eat a Paleo diet.
Don’t we all know a fit young man who died after a run or on a squash court; or a woman who died of cancer at a young age?

Some people quote Egyptian Mummies or the ‘Ice Man’ having clogged coronary arteries as evidence of ancient people being prone to modern diseases. Yes, these ancient people did suffer from modern diseases, but neither of them fall into the pre-history category, i.e. they lived after the advent of farming and agriculture. (They are both within the last 5300 years).

Nearly all people want to live longer; but what seems to be equally important to most is to increase one’s chances of a disease-free life. There’s not much point in living to 100 if the last decades of one’s life are bed-bound with carers having to administer to one’s every need. Worse still, to be suffering the ravages of dementia and not recognising one’s nearest and dearest.

Evidence shows that our ancestors from Palaeolithic times were generally healthy and free of the degenerative diseases common in modern societies (and yes, some of them did live long – they didn’t all die young after being mauled by a tiger).

On the plus side one now usually knows where the next meal is coming from – Tesco, Waitrose, Lidl, Prêt or some such establishment.
Hunting through the supermarket aisles to gather items for your shopping basket is as close as most of us get to traditional hunting and gathering. And even less hunting and gathering involved if you sit at a desk to order online and then get your shopping delivered to your front door!

A brief look at the everyday lives of our prehistoric ancestors:
Physical exercise wouldn’t have been an option as it now is (should I go to the gym or not today?) – survival most likely depended on being able to run away from predators. And it’s unlikely that worries about heart attacks, stroke or cancer were high on prehistoric man’s list of priorities. Diabetes and obesity were almost certainly unheard of.

• The downsides: No local supermarket; having to scavenge for food; living in fear being attacked; not knowing where your next meal was coming from; dirt and grit in food; parasites in meat; surviving savage winters; no air-conditioners to cool down the hot summers.
• The upsides: Leisure time might have involved singing, dancing and storytelling around a night time fire. (Scraping the barrel here!).

I’m not for a minute proposing that we go back to the days of living in the wild just to reduce our risk of serious diseases – I would find it very hard indeed to live without a nice bathroom, electricity, and nicely packaged supermarket foods.

In its defence, the rise of agriculture paved the way for civilisation – agriculture and farming were in fact its catalysts. But that doesn’t mean that we are physiologically designed to eat grains, nor that we should continue eating foods which are associated with a deterioration of our general health. Grains and farming meant an elite few had more time on their hands for intellectual pursuits; albeit at the expense of the many who tilled the land.

Man had an almost complete lack of “modern” diseases, until agriculture started snowballing 10,000 years ago. There is good fossil evidence to show that pre-historic Man didn’t die of heart attacks, strokes or cancer; and there is also good evidence to show that he did live long enough to get these diseases.

1. Hey Caveman, isn’t the Paleo diet all about meat?
Not true. You can eat fruit and vegetables to your heart’s content on a Paleo diet.

2. I will be missing out on important nutrients because I’m cutting out whole food groups.
Not true. Replacing “grains, refined oils, refined sugar and dairy” with “fruit, vegetables, nuts, eggs, fish and meat” gives you more nutrients, not less.

3. Without dairy, I won’t get enough calcium.
Not true. It is eminently possible to have strong bones and cavity-free teeth without having to milk a cow every day. Read my post on dairy for more information on calcium and dairy.
Good Paleo sources of calcium include:
Green vegetables
Fish
Nuts

4. Without grains I won’t get enough fibre.
Not true. Fruit, vegetables and nuts have ample fibre.

5. The Paleo diet is expensive.
In the short run it is more expensive, but in the long run it will save you money.
Unfortunately, bread, pasta, and cakes are cheaper than fruit, vegetables, fish, meat and nuts.
So yes, in the short run the Paleo diet costs more.
But in the long run it will save you money from time off work due to illness, and from having to pay for medicines to treat your high blood pressure, diabetes, autoimmune disease, cancer etc…

6. Palaeolithic humans never ate grains and cereals.
There is evidence of grain granules on grinding tools from all over the world suggesting that Palaeolithic man (or more likely Palaeolithic Woman) turned grains into flour as long as 30,000 years ago. They most likely ate these grains in very small amounts.
As opposed to a modern scenario of cereal for breakfast, sandwich for lunch and pasta for dinner – i.e. grains, grains and more grains. Would you be eating this way if you had to pick wild grains, thresh and then grind them yourself everyday? Far easier to reach for some ripe fruit from a tree methinks.

7. All Paleo food is weird.
Not true. What’s weird about fruit, vegetables, fish, meat, eggs and nuts?
Doing a google search on ‘weird foods’ brought up some truly outlandish (to me) foods.
You can stick to whatever you consider to be normal meat and fish. Nobody is forcing you to eat any of these weird and wonderful foods.

8. The Paleo diet is just another low-carb or Atkins diet.
Not true. Sweet potatoes, pumpkins, carrots, mangoes, bananas – the list goes on and on – all high carb foods. And all allowed on the Paleo diet.

9. I can’t eat all those eggs without increasing my cholesterol!
Not True. Eating whole eggs doesn’t adversely affect your cholesterol. Click here for an explanation of why you don’t need to worry about eating eggs.

10. Proponents of the Paleo diet claim that the human genome is largely unchanged in the last million years whereas others say this is not the case.
Of course there are ongoing genetic changes all the time. But overall the human genome is much the same since the birth of Homo Sapiens 200,000 years ago.

It has taken millions of years for Man and our metabolisms to evolve. And we continue to evolve, just as all animals do, but 10,000 years is not long enough to adapt to large amounts of grains, dairy, legumes, refined sugars and refined oils in our diets. Our metabolisms have not yet adjusted to a diet where the majority of the foods consumed are evolutionarily new.

1. Isn’t the Paleo diet all about meat?
A resounding ‘NO’. You can eat fruit and vegetables to your heart’s content!

2. Are any grains allowed on the Paleo diet?
All grains are out.
What no wheat, rye, barley, buckwheat, rice or quinoa? Here’s an explanation of why all grains are verboten.

3. Won’t I be hungry and constipated without bread and bran?
No. The Paleo diet is particularly satisfying on the hunger front. And fruit and vegetables are higher in fibre/gram of food than grains are, so you certainly won’t be missing out on fibre.

4. Aren’t grains and dairy essential foods?
No. You can get all your essential nutrients from vegetables, fruit, fish, meat, eggs and nuts.

5. Will I be calcium deficient or have weak bones if I cut out dairy?
Not if you follow a Paleo diet for most of the time – you absorb more calcium when your diet has fewer anti-nutrients, which are normally present in high quantities in grains. Plus you lose less calcium in your urine because of the changes in the ‘acid-base’ balance that occur with a Paleo diet. This post explains the whole dairy and calcium conundrum.

6. Will the Paleo diet raise my blood cholesterol and thus increase my risk for having a heart attack?
No, it won’t increase your cardiovascular risk, if anything it will reduce it. It might raise your ‘good cholesterol’ (aka HDL), but it will lower your levels of small dense LDL, which is the type associated with cardiovascular disease.

7. Aren’t nuts and seeds high in phytic acid?
Yes, they are high in phytic acid, so ideally one should soak them in water overnight – this considerably reduces their phytic acid content. Or else limit their consumption to 30g (1 ounce) a day. (In small amounts, phytic acid is fine; plus it is less damaging than gluten and WGA lectin are).

8. What about legumes?
Strictly speaking legumes aren’t allowed – because they are high in lectins and anti-nutrients. (Although soaking them helps). So ideally, no pulses, peanuts or beans. (Peanuts belong to the legume family, and not the nut family).

9. And soy?
Soy too is out. Here’s a detailed look at the dangers of soy.

10. Do I eat this way all the time?
No – but I did for the whole of January, and my fasting insulin level fell from 5.9 in December 2014 to 2.6 at the end of January 2015. (Normal range is 2.6 to 24 mIU/L, and it’s better to have a level at the lower end of the range. Higher levels correlate with increasing ‘insulin resistance‘ which is associated with an increased risk of cardiovascular disease).
Will I continue this way?
My aim now is to eat this way on weekdays, and allow myself a few non-Paleo treats on weekends.
(I plan on having a melting chocolate pudding every weekend. Maybe my next study on myself will be to maximise the number of chocolate puddings I can consume whilst still keeping my fasting insulin level low?).

“Against the Grain: How Agriculture Has Hijacked Civilization” by Richard Manning
“Food and Western Disease” by Staffan Lindeberg
“A New Green History Of The World: The Environment and the Collapse of Great Civilizations” by Clive Ponting
“What Is Sustainable: Remembering Our Way Home” by Richard Adrian Reese
“Paleo Manifesto: Ancient Wisdom for Lifelong Health” by John Durant