Paleolithic diet
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Phenylalanine
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{{otheruses4|a modern dietary regimen|information on the dietary practices of Paleolithic humans|Paleolithic#Diet and Nutrition}}
[[Image:Brazilian bouillabaisse.jpg|thumb|250px|Paleolithic-style dish: A traditional seafood stew ([[Bouillabaisse]] served without bread).]]
The '''Paleolithic diet'''{{ref label|Macronutrient ratios|a|a}} (or '''Paleolithic nutrition'''), also popularly known as the '''paleo diet''' (var.: '''paleodiet'''), '''caveman diet''', '''Stone Age diet''' and '''hunter-gatherer diet''', is a [[diet (nutrition)|dietary]] regimen which seeks to mimic the [[Paleolithic#Diet and nutrition|diet]] of wild plants and animals that [[Homo (genus)|humans]]{{ref label|Macronutrient ratios|b|b}} habitually consumed during the [[Paleolithic]], a period of about 2.5 million years duration that ended around 10,000 years ago with the development of [[agriculture]].<ref name=doi:10.1080/11026480510032043>{{cite journal |author=Lindeberg S |title=Palaeolithic diet ("stone age" diet) |journal=Scandinavian Journal of Food & Nutrition |volume=49 |issue=2 |pages=75–7 |year=2005, June |doi=10.1080/11026480510032043 |url=http://journals.sfu.ca/coaction/index.php/fnr/article/viewFile/1526/1394}}</ref>
Based upon commonly available modern [[food]]s, the Paleolithic diet consists mainly of lean meat, fish, vegetables, fruit, roots and nuts, and excludes [[grains]], [[legumes]], dairy products, salt, refined sugar and processed oils.<ref name=doi:10.1080/11026480510032043/><ref name=JAmNeutraceutAssoc2002;5:15-24>{{cite journal |author=Cordain L |title=The nutritional characteristics of a contemporary diet based upon Paleolithic food groups |journal=J Am Nutraceut Assoc |issue=5 |pages=15–24 |year=2002, Summer |format=PDF |url=http://www.thepaleodiet.com/articles/JANA%20final.pdf}}</ref><ref name=JNutriEnvironMed2003;13(3):149-160>{{cite journal |author=Lindeberg S, Cordain L, Eaton SB |title=Biological and clinical potential of a Paleolithic diet |journal=J Nutri Environ Med |volume=13 |issue=3 |pages=149–60 |year=2003, September|format=PDF| url=http://www.thepaleodiet.com/articles/J%20Nutr%20Environ%20Med%202003.pdf |doi=10.1080/13590840310001619397}}</ref>
First popularized in the mid 1970s by a [[gastroenterologist]] named Walter L. Voegtlin,<ref name="isbn0533013143">{{cite book |last=Voegtlin |first=Walter L. |title=The stone age diet: Based on in-depth studies of human ecology and the diet of man |year=1975 |publisher=Vantage Press |isbn=0533013143}}</ref> this [[nutrition]]al concept has been expounded and adapted by a number of authors and researchers in several books<ref name="isbn0060158719">{{cite book |last=Eaton |first=S. Boyd |coauthors=Shostak, Marjorie; & Konner, Melvin |title=The Paleolithic Prescription: A Program of Diet & Exercise and a Design for Living |year=1988 |publisher=Harper & Row |location=New York |isbn=0060158719}}</ref><ref name="isbn0312975910">{{cite book |last=Audette |first=Ray V. |coauthors=Gilchrist, Troy; Audette, Raymond V.; & Eades, Michael R. |title=Neanderthin : Eat Like a Caveman to Achieve a Lean, Strong, Healthy Body |year=2000 |publisher=St. Martin's Paperbacks |location=New York |isbn=0312975910}}</ref><ref name="isbn0471267554">{{cite book |last=Cordain |first=Loren |title=The Paleo Diet: Lose Weight and Get Healthy by Eating the Food You Were Designed to Eat |year=2002 |publisher=Wiley |location=New York |isbn=0471267554}}</ref> and academic journals.<ref name="pmid2981409">{{cite journal |author=Eaton SB, Konner M |title=Paleolithic nutrition. A consideration of its nature and current implications |journal=N. Engl. J. Med. |volume=312 |issue=5 |pages=283–89 |year=1985 |pmid=2981409 |doi=}}</ref> Building upon the principles of [[evolutionary medicine]],<ref name="pmid11817903">{{cite journal |author=Eaton SB, Strassman BI, Nesse RM, Neel JV, Ewald PW, Williams GC, Weder AB, Eaton SB 3rd, Lindeberg S, Konner MJ, Mysterud I, Cordain L |title=Evolutionary health promotion |journal=Prev Med |volume=34 |issue=2 |pages=109–18 |year=2002, February |pmid=11817903 |doi=10.1006/pmed.2001.0876 |format=PDF |url=http://www.thepaleodiet.com/articles/Health%20Promotion%20Paper.pdf}}</ref> it is based on the premise that [[modern human]]s are genetically [[Adaptation|adapted]] to the diet of their Paleolithic ancestors and that human [[genetics]] have scarcely changed since the dawn of agriculture, and therefore that an ideal diet for human health and well-being is one that resembles this ancestral diet.<ref name=JNutriEnvironMed2003;13(3):149-160/><ref name="pmid15699220">{{cite journal |author=Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J |title=Origins and evolution of the Western diet: health implications for the 21st century |journal=Am. J. Clin. Nutr. |volume=81 |issue=2 |pages=341–54 |year=2005, February |pmid=15699220}}</ref>
This dietary approach is a controversial topic amongst [[nutritionist]]s<ref name="pmid10466159">{{cite journal |author=Nestle M |title=Animal v. plant foods in human diets and health: is the historical record unequivocal? |journal=Proc Nutr Soc. |volume=58 |issue=2 |pages=211–18 |year=1999, May |pmid=10466159 |doi=10.1017/S0029665199000300 |url= |doi_brokendate=2008-06-28}}</ref><ref name="doi10.1079/PHN2006959">{{cite journal |author=Cannon G |title=Sabre-tooth tigers and stud poker [Out of the Box] |journal=Public Health Nutrition |volume=9 |issue=4 |pages=411–14 |year=2006, June|doi=10.1079/PHN2006959}}</ref> and [[anthropologist]]s.<ref name="isbn0897897366">{{cite book |last=Milton |first=Katharine |editor=Ungar, Peter S. & Teaford, Mark F. |title=Human Diet: Its Origins and Evolution |year=2002 |publisher=Bergin and Garvey |location=Westport, CT |isbn=0897897366 |pages=111–22 |chapter=Hunter-gatherer diets: wild foods signal relief from diseases of affluence (PDF) |chapterurl=http://nature.berkeley.edu/miltonlab/pdfs/humandiet.pdf}}</ref><ref name="pmid12494313">{{cite journal |author=Richards MP |title=A brief review of the archaeological evidence for Palaeolithic and Neolithic subsistence |journal=Eur J Clin Nutr |volume=56 |issue=12 |pages=1270–78 |year=2002, December |pmid=12494313 |doi=10.1038/sj.ejcn.1601646 |url=}}</ref> Advocates argue that modern human populations subsisting on [[traditional diet]]s similar to those of Paleolithic [[hunter-gatherer]]s are largely free of [[diseases of affluence]],<ref name="isbn007140239X">{{cite book |author=Kligler, Benjamin & Lee, Roberta A. (eds.) |title=Integrative medicine |year=2004 |publisher=McGraw-Hill Professional |isbn=007140239X |pages=139–40 |chapter=Paleolithic diet |chapterurl=http://books.google.com/books?id=-JUcjUGBV6kC&pg=PA139&lpg=PA139&dq=environment+%22paleolithic+diet%22&source=web&ots=DtSWPqB2z6&sig=Zpbk072sJouGFh2ApjHafftTP4o#PPA139,M1}}</ref><ref name="pmid11817904">{{cite journal |author=Eaton SB, Cordain L, Lindeberg S |title=Evolutionary Health Promotion: A consideration of common counter-arguments |journal=Prev Med |volume=34 |issue=2 |pages=119–23 |year=2002, February |pmid=11817904 |doi=10.1006/pmed.2001.0966 |format=PDF |url=http://www.thepaleodiet.com/articles/Counter%20Arguments%20Paper.pdf}}</ref> and that such diets produce beneficial health outcomes in controlled [[Biomedical research|medical studies]].<ref name="pmid17583796">{{cite journal |author=Lindeberg S, Jönsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjöström K, Ahrén B |title=A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease |journal=Diabetologia |volume=50 |issue=9 |pages=1795–807 |year=2007, September |pmid=17583796 |doi=10.1007/s00125-007-0716-y |format=PDF| url=http://luur.lub.lu.se/luur?func=downloadFile&fileOId=626009}}</ref> Supporters point to several potentially [[therapeutic]] nutritional characteristics of preagricultural diets.<ref name="pmid15699220"/> Critics of this nutritional approach have taken issue with its underlying [[evolution]]ary logic,<ref name="pmid10702155">{{cite journal |author=Milton K |title=Hunter-gatherer diets-a different perspective |journal=Am J Clin Nutr |volume=71 |issue=3 |pages=665–67 |year=2000, March |pmid=10702155 |url=}}</ref><ref name="pmid16997359">{{cite journal |author=Ströhle A, Wolters M, Hahn A |title=Carbohydrates and the diet-atherosclerosis connection--more between earth and heaven. Comment on the article "The atherogenic potential of dietary carbohydrate" |journal=Prev Med. |volume=44 |issue=1 |pages=82–4 |year=2007, January |pmid=16997359 |doi=10.1016/j.ypmed.2006.08.014}}</ref> and have disputed certain dietary prescriptions on the grounds that they pose health risks<ref name="pmid10702155"/><ref name=medicinenet50760>{{cite web |last=Jeanie Lerche |first=Davis |title=The Caveman Diet – Eat Like a Caveman |publisher=[[MedicineNet]] |date=[[2002-03-15]] |url=http://www.medicinenet.com/script/main/art.asp?articlekey=50760 |accessdate=2008-01-19}}</ref> and may not reflect the features of ancient [[Paleolithic#Diet and nutrition|Paleolithic diets]].<ref name="pmid16997359"/><ref name="doi10.1046/j.1467-3010.2000.00019.x">{{cite journal |author=Nestle M |title=Paleolithic diets: a sceptical view |journal=Nutrition Bulletin |volume=25 |issue=1 |pages=43–7 |year=2000, March |doi=10.1046/j.1467-3010.2000.00019.x}}</ref> It has also been argued that such diets are not a realistic alternative for everyone,<ref name=MoffatBookReview>{{cite journal |author=Moffat T |title=Book Review – Evolutionary Aspects of Nutrition and Health: Diet, Exercise, Genetics and Chronic Disease |journal=Human Biology |year=2001 |volume=73 |issue=2 |pages=327–29 |url=http://muse.jhu.edu/demo/human_biology/v073/73.2moffat.html |doi=10.1353/hub.2001.0021}}</ref> and that meat-based diets are not [[sustainable eating|environmentally sustainable]].<ref name="pmid16236205">{{cite journal |author=McMichael AJ |title=Integrating nutrition with ecology: balancing the health of humans and biosphere |journal=Public Health Nutr. |volume=8 |issue=6A |pages=706–15 |year=2005, September |pmid=16236205 |doi=10.1079/PHN2005769}}</ref>
==History==
[[Gastroenterologist]] Walter L. Voegtlin was one of the first to suggest that following a diet similar to that of the [[Paleolithic]] era would improve a person's health. In 1975, he published a book<ref name="isbn0533013143"/> in which he argued that humans are carnivorous animals and that the ancestral [[Paleolithic#Diet_and_nutrition|Paleolithic diet]] was that of a carnivore—chiefly fats and protein, with only small amounts of carbohydrates.<ref name=westonaprice22>{{cite web |last=Fallon |first=Sally |coauthors=Enig, Mary G. |title=Caveman Cuisine |publisher=[[The Weston A. Price Foundation]] |date=[[2000-01-01]] |url=http://www.westonaprice.org/traditional_diets/caveman_cuisine.html |accessdate=2008-01-19}}</ref><ref>{{cite web |title=Functional and Structural Comparison of Man's Digestive Tract with that of a Dog and Sheep |url=http://www.paleodiet.com/comparison.html |accessdate=2008-01-19}}</ref> His dietary prescriptions were based on his own medical treatments of various digestive problems, namely [[colitis]], [[Crohn's disease]], [[irritable bowel syndrome]] and [[indigestion]].<ref>Audette, Ray. [http://www.scdiet.org/7archives/scdlutz.html Dr Voegtlin's "Stone Age Diet"], Paleolithic Eating Support List</ref>
In 1985, [[Melvin Konner]] and S. Boyd Eaton, an associate clinical professor of radiology and an adjunct associate professor of [[anthropology]] at [[Emory University]], published a key paper on Paleolithic nutrition in the ''[[New England Journal of Medicine]]''.<ref name="pmid2981409"/> Three years later, S. Boyd Eaton, [[Marjorie Shostak]] and Melvin Konner published a book about this nutritional approach,<ref name="isbn0060158719"/> which was based on achieving the same proportions of nutrients (fat, protein, and carbohydrates, as well as vitamins and minerals) as were present in the diets of late Paleolithic people, not on excluding foods that were not available before the development of agriculture. As such, this nutritional approach included skimmed milk, whole-grain bread, brown rice, and potatoes prepared without fat, on the premise that such foods have the same nutritional properties as Paleolithic foods.<ref name=westonaprice22/><ref name="doi10.1007/BF00999126">{{cite journal |author=Sirota LH, Greenberg G |title=Book reviews |journal=Applied Psychophysiology and Biofeedback |volume=14 |issue=4 |pages=347–54 |year=1989, December |doi=10.1007/BF00999126 |url=http://www.springerlink.com/content/t30247840382k168/?p=4deccdf06aa74f759e63e347e1fdc122&pi=12}}</ref> In 1989, these authors published a second book on Paleolithic nutrition.<ref name="isbn0207162646">{{cite book |last=Eaton |first=S. Boyd |coauthors=Shostak, Marjorie; & Konner, Melvin |title=Stone-Age Health Programme |year=1989 |publisher=Angus & Robertson Childrens |isbn=0207162646}}</ref><ref name=GailVines>{{cite web |last=Vines |first=Gail |title=Palaeolithic recipe for the clean life / Review of 'The Stone-Age Health Programme' by S. Boyd Eaton, Marjorie Shostak and Melvin Konner |publisher=New Scientist |date=1989-08-26 |url=http://www.newscientist.com/article/mg12316794.400-palaeolithic-recipe-for-the-clean-life--review-of-thestoneage-health-programme-by-s-boyd-eaton-marjorie-shostak-and-melvinkonner-.html |accessdate=2008-01-19}}</ref>
Since the end of the 1990s, a number of medical doctors and nutritionists<ref name="isbn0446608246">{{cite book |author=Eades, Michael R. & Eades, Mary Dan |title=The Protein Power Lifeplan |year=2000 |publisher=Warner Books |location=New York |isbn=0446608246}}</ref><ref name="isbn0091889480">{{cite book |last=Atkins |first=Robert C. |title=Dr Atkins' New Diet Revolution |year=1999 |publisher=Vermilion |isbn=0091889480}}</ref><ref name="isbn3927372234">{{cite book |last=Worm |first=Nicolai |title=Syndrom X oder ein Mammut auf den Teller. Mit Steinzeit-Diät aus det Wohl stands Falle |year=2002 |publisher=Systemed-Verlag |location=Lünen |language=German |isbn=3927372234}}</ref> have advocated a return to a so-called Paleolithic (preagricultural) diet.<ref name="pmid12494313"/> Proponents of this nutritional approach have published books<ref name="isbn0312975910"/><ref name="isbn0471267554"/><ref name="isbn1594860890">{{cite book |author=Cordain, Loren & Friel, Joe |title=The Paleo Diet for Athletes: A Nutritional Formula for Peak Athletic Performance |year=2005 |publisher=Rodale Books |isbn=1594860890}}</ref> and created websites<ref name=Lindeberg44>{{cite web |last=Lindeberg |first=Staffan |title=Home |work=Paleolithic Diet in Medical Nutrition |url=http://www.staffanlindeberg.com/Home.html |accessdate=2008-01-19}}</ref><ref name=CordainWebSite1>{{cite web |last=Cordain |first=Loren |title=The Science of Healthy Eating |work=The Paleo Diet |url=http://www.thepaleodiet.com/ |accessdate=2008-01-19}}</ref> to promote their dietary prescriptions.<ref>{{cite news |last=Burfoot |first=Amby |title=Should you be eating like a Caveman? |publisher=Runners World |date=[[2005-02-11]] |url=http://www.runnersworld.com/article/0,7120,s6-242-303-307-9048-0,00.html |accessdate=2008-01-19}}</ref><ref>{{cite news |last=Shreeve |first=Jimmy Lee |title=The Stone Age Diet: Why I Eat Like a Caveman |publisher=Independent UK |date=[[2007-08-16]] |url=http://www.alternet.org/healthwellness/59864/ |accessdate=2008-01-19}}</ref><ref>{{cite news |last=Taylor |first=Mike |title=Refined Food Bad! Caveman Diet Good! |publisher=TheStreet.com |date=[[2008-01-09]] |url=http://www.thestreet.com/funds/goodlife/10397540.html |accessdate=2008-01-19}}</ref><ref>{{cite news |last=Tuttle |first=Erica |title=Revolutionary Evolutionary Diets - Brief Article |publisher=FindArticles.com |date=[[2000-09-04]] |url=http://findarticles.com/p/articles/mi_m1571/is_33_16/ai_65091766 |accessdate=2008-01-19}}</ref><ref>{{cite news |last=Van Sant |first=Peter |title=The Caveman Diet |publisher=CBS News |date=[[2000-07-13]] |url=http://www.cbsnews.com/stories/2000/01/19/48hours/main151216.shtml |accessdate=2008-01-19}}</ref> They have synthesized diets from commonly available modern foods that would emulate the nutritional characteristics of the ancient Paleolithic diet, some allowing specific foods that would have been unavailable to preagricultural peoples, such as certain processed oils and beverages.<ref name="isbn0312975910"/><ref name="isbn0471267554"/><ref name=Lindeberg44/><ref name=CordainWebSiteRecipes>{{cite web |last=Cordain |first=Loren |title=A Sample of Paleo Recipes |work=The Paleo Diet |url=http://www.thepaleodiet.com/nutritional_tools/recipes.shtml |accessdate=2008-01-19}}</ref><ref name=LindebergWebSiteFood>{{citeweb |last=Lindeberg |first=Staffan |title=Frequently Asked Questions: What can I eat? |work=Paleolithic Diet in Medical Nutrition |url=http://www.staffanlindeberg.com/Food.html |accessdate=2008-01-19}}</ref>
==Practices==
[[Image:Rawtomatopasta1.jpg|thumb|Paleolithic-style dish: A raw tomato sauce with olives, celery, spinach and walnuts on courgette 'pasta' noodles.]]
The Paleolithic diet is a modern dietary regimen that seeks to mimic the diet of preagricultural hunter-gatherers, one that corresponds to what was available in any of the [[ecological niche]]s of Paleolithic humans.<ref name=doi:10.1080/11026480510032043/><ref name=JNutriEnvironMed2003;13(3):149-160/> Based upon commonly available modern foods, it includes [[Plant breeding|cultivated]] plants and domesticated animal meat as an alternative to the wild sources of the original preagricultural diet.<ref name=doi:10.1080/11026480510032043/><ref name=JAmNeutraceutAssoc2002;5:15-24/><ref name="pmid14708953">{{cite journal |author=O'Keefe JH, Cordain L |title=Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer |journal=Mayo Clin Proc |volume=79 |issue=1 |pages=101–08 |year=2004, January |pmid=14708953 |format=PDF |url=http://www.thepaleodiet.com/articles/Hunter-Gatherer%20Mayo.pdf}}</ref> The ancestral human diet is inferred from historical and [[Ethnography|ethnographic]] studies of modern-day [[hunter-gatherer]]s as well as archaeological finds and [[Biological anthropology|anthropological]] evidence.<ref name="pmid15699220"/><ref name="isbn0195183460">{{cite book |last=Lindeberg |first=Staffan |editor=Richards, Michael & Hublin, Jean-Jacques |title=The Evolution of Hominid Diets: integrating approaches to the study of Palaeolithic subsistence |year=2008 |publisher=Springer |location=New York |chapter=Modern human physiology with respect to evolutionary adaptations that relate to diet in the past |chapterurl=http://www.eva.mpg.de/evolution/conf2006/files/abstracts.htm}}</ref><ref name="isbn0195183479">{{cite book |last=Cordain |first=Loren |editor=Ungar, Peter S. |title=Early Hominin Diets: The Known, the Unknown, and the Unknowable |format= |year=2007 |publisher=Oxford University Press |location=Oxford, USA |isbn=0195183479 |pages=363–83 |chapter=Implications of Plio-Pleistocene Hominin Diets for Modern Humans (PDF) |chapterurl=http://www.thepaleodiet.com/articles/2006_Oxford.pdf}}</ref>
The Paleolithic diet consists of foods that can be hunted and fished, such as meat, [[offal]] and seafood, and that can be gathered, such as eggs, insects, fruit, nuts, seeds, vegetables, mushrooms, herbs and spices.<ref name=doi:10.1080/11026480510032043/><ref name=JAmNeutraceutAssoc2002;5:15-24/> Practitioners are advised to eat only the leanest cuts of meat, free of [[food additive]]s, preferably wild [[game (food)|game]] meats and [[grass-fed beef]] since they contain relatively high levels of [[omega-3]] fats compared with grain-produced domestic meats.<ref name=doi:10.1080/11026480510032043/><ref name=JAmNeutraceutAssoc2002;5:15-24/><ref name="pmid14708953"/><ref name="pmid11960292">{{cite journal |author=Cordain L, Watkins BA, Florant GL, Kelher M, Rogers L, Li Y |title=Fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease |journal=Eur J Clin Nutr. |volume=56 |issue=3 |pages=181–91 |year=2002, March |pmid=11960292 |doi=10.1038/sj/ejcn/1601307 |url=http://www.nature.com/ejcn/journal/v56/n3/full/1601307a.html}}</ref> Food groups that were rarely or never consumed by humans before the [[Neolithic revolution|Neolithic (agricultural) revolution]] are excluded from the diet, mainly [[grains]], [[legume]]s (e.g. [[peanut]]s), dairy products, salt, [[refined sugar]] and processed oils,<ref name=doi:10.1080/11026480510032043/><ref name=JAmNeutraceutAssoc2002;5:15-24/> although some advocates consider the use of [[Cooking oil|oil]]s with low [[omega-6]]/omega-3 ratios, such as [[olive oil]] and [[canola oil]], to be healthy and advisable.<ref name="pmid14708953"/> Practitioners are permitted to drink mainly water, and some advocates recommend tea as a healthful drink,<ref name="pmid14708953"/> but alcoholic and fermented beverages are restricted from the diet.<ref name=JAmNeutraceutAssoc2002;5:15-24/><ref name="pmid14708953"/> Furthermore, eating a wide variety of plant foods is recommended to avoid high intakes of potentially harmful [[bioactive]] substances, such as [[goitrogen]]s, which are present in certain roots, vegetables and seeds.<ref name=doi:10.1080/11026480510032043/><ref name="isbn0195183460"/><ref name=ReplytoCunnane>{{cite journal |author=Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J |title=Reply to SC Cunnane |journal=Am J Clin Nutr |volume=82 |issue=2 |pages=483–84 |year=2005 |pmid=16087997}}</ref> Unlike [[Raw foodism|raw food diet]]s, the Paleolithic diet does not limit the consumption of cooked foods.<ref name=doi:10.1080/11026480510032043/> Cooking is widely accepted to have been practised by at least 250,000 years ago, in the early [[Middle Paleolithic]].<ref>{{cite journal |author=Wrangham R, Conklin-Brittain N |title=Cooking as a biological trait |journal=Comp Biochem Physiol A Mol Integr Physiol |volume=136 |issue=1 |pages=35–46 |year=2003, September |pmid=14527628 |doi=10.1016/S1095-6433(03)00020-5 |format=PDF |url=http://anthropology.tamu.edu/faculty/alvard/anth630/reading/Week%208%20Diet%20tubers/Wrangham%20and%20Conklin-Brittain%202003.pdf}}</ref>
According to certain proponents of the Paleolithic diet, practitioners should derive about 56–65% of their [[food energy]] from [[Animal source foods|animal foods]] and 36–45% from plant foods. They recommend a diet [[high protein diet|high in protein]] (19–35% energy) and [[low-carbohydrate diet|relatively low in carbohydrates]] (22–40% energy), with a fat intake (28–58% energy) similar to or higher than that found in [[Western pattern diet|Western diet]]s.<ref name="pmid14708953"/><ref name="pmid10702160">{{cite journal |author=Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD |title=Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets |journal=Am J Clin Nutr. |volume=71 |issue=3 |pages=682–92 |year=2000 |pmid=10702160 |url=}}</ref><ref name="pmid11965522">{{cite journal |author=Cordain L, Eaton SB, Miller JB, Mann N, Hill K |title=The paradoxical nature of hunter-gatherer diets: meat based, yet non-atherogenic |journal=Eur J Clin Nutr |volume=56 |issue=Suppl 1 |pages=S42–52 |year=2002, March |pmid=11965522 |doi=10.1038/sj/ejcn/1601353 |url=}}</ref> Furthermore, some proponents exclude from the diet foods which exhibit high [[glycemic index|glycemic indices]], such as potatoes.<ref name=JAmNeutraceutAssoc2002;5:15-24/> Staffan Lindeberg, an associate professor in the Department of Medicine at the [[University of Lund]], advocates a Paleolithic diet, but does not recommend any particular proportions of plants versus meat or [[macronutrient]] ratios.<ref name=doi:10.1080/11026480510032043/><ref name="isbn0195183460"/> According to Lindeberg, [[calcium]] [[dietary supplement|supplementation]] may be considered when the intake of [[green leafy vegetables]] and other dietary sources of calcium is limited.<ref name=doi:10.1080/11026480510032043/>
==Basis==
===Rationale===
[[Image:USDA Food Pyramid.gif|thumb|305px|Over 70% of the total daily energy consumed by all people in the United States comes from foods, such as dairy products, cereals, refined sugars, refined vegetable oils and alcohol, that contributed little or none of the energy in the typical preagricultural [[hominin]] diet.<ref name="pmid15699220"/> ([[USDA]]'s [[Food Pyramid]])]]
According to S. Boyd Eaton, "we are the heirs of inherited characteristics accrued over millions of years; the vast majority of our biochemistry and physiology are tuned to life conditions that existed prior to the advent of agriculture some 10,000 years ago. Genetically our bodies are virtually the same as they were at the end of the Paleolithic Era some 20,000 years ago."<ref name="pmid9104571">{{cite journal |author=Eaton SB, Eaton SB 3rd, Konner MJ |title=Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications |journal=European journal of clinical nutrition |volume=51 |issue=4 |pages=207–16 |year=1997 |pmid=9104571 |format=PDF |url=http://www.direct-ms.org/pdf/EvolutionPaleolithic/Eaton%20Paleo%20Nutri%20Review%20EJCN.pdf |doi=10.1038/sj.ejcn.1600389}}</ref>
Paleolithic nutrition has its roots in [[evolutionary biology]] and rests on the principles of [[evolutionary medicine]].<ref name="pmid11817903"/><ref name="isbn0195103556">{{cite book |last=Trevathan |first=Wanda R. (ed.) |title=Evolutionary Medicine |url=http://books.google.com/books?id=grrA421tRNkC&printsec=frontcover |year=1999 |publisher=Oxford University Press |location=Oxford, US |isbn=0195103556}}</ref> The reasoning underlying this nutritional approach is that [[natural selection]] had sufficient time to genetically adapt the [[metabolism]] and [[physiology]] of Paleolithic humans to the varying [[Paleolithic#Diet_and_nutrition|dietary conditions]] of that era. But in the 10,000 years since the invention of agriculture and its consequent major change in the human diet, natural selection has had too little time to make the optimal genetic adaptations to the new diet.<ref name=doi:10.1080/11026480510032043/> Physiological and metabolic [[maladaptation]]s result from the suboptimal genetic adaptations to the contemporary human diet, which in turn contribute to many of the so-called [[Lifestyle diseases|diseases of civilization]].<ref name=JNutriEnvironMed2003;13(3):149-160/>
Loren Cordain, a professor in the Department of Health and Exercise Science at [[Colorado State University]], argues that "today more than 70% of our dietary calories come from foods that our Paleolithic (Stone Age) ancestors rarely, if ever, ate. The result is epidemic levels of cardiovascular disease, cancer, diabetes, osteoporosis, arthritis, gastrointestinal disease, acne, and more."<ref name=CordainWebSite1/> According to Staffan Lindeberg, the Paleolithic diet, basically meat, fish, vegetables, fruit and nuts, prevents heart disease, stroke and some forms of cancers and it has a beneficial effect on overweight, digestive problems and more;<ref name=Lindeberg44/> it may have benefits even compared with prudent diets based on [[whole-grain]] cereals and low-fat milk.<ref name=Lindeberg69>{{cite web |last=Lindeberg |first=Staffan |title=Our Research |work=Paleolithic Diet in Medical Nutrition |url=http://www.staffanlindeberg.com/OurResearch.html |accessdate=2008-01-19}}</ref>
===Medical research===
Based on the subsistence patterns and [[Biomarker (medicine)|biomarker]]s of hunter-gatherers studied in the last century, advocates argue that modern humans are well adapted to the [[Paleolithic#Diet and nutrition|diet]] of their Paleolithic ancestor.<ref name="isbn0521853761">{{cite book |last=Eaton |first=S. Boyd |coauthors=Cordain, Loren; & Sebastian, Anthony |editor=Aird, William C. |title=Endothelial Biomedicine |format= |year=2007 |publisher=Cambridge University Press |isbn=0521853761 |pages=129–34 |chapter=The Ancestral Biomedical Environment (PDF) |chapterurl=http://www.thepaleodiet.com/articles/Ancestral%20Biomedical%20Environment%20Final.pdf}}</ref> The diet of modern hunter-gatherer groups is believed to be representative of patterns for humans of 50 to 25 thousand years ago,<ref name="isbn0521853761"/> and individuals from these and other technologically primitive societies,<ref name="pmid3135745">{{cite journal |author=Eaton SB, Konner M, Shostak M |title=Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective |journal=Am J Med |volume=84 |issue=4 |pages=739–49 |year=1988, April |pmid=3135745 |doi=10.1016/0002-9343(88)90113-1 |format=PDF |url=http://www.direct-ms.org/pdf/EvolutionPaleolithic/EatonStone%20Agers%20Fast%20Lane.pdf}}</ref><ref name="isbn0198504454">{{cite book |author=Eaton, S. Boyd & Eaton, Stanley. B 3rd |editor=Stearns, Stephen C. |title=Evolution in health and disease |year=1999 |publisher=Oxford Univ Press |location=Oxford |isbn=0198504454 |pages=251–59 |chapter=The evolutionary context of chronic degenerative diseases |chapterurl=http://books.google.ca/books?id=B9bfKH42apQC&pg=PA251&lpg=PA251&dq=%22The+evolutionary+context+of+chronic+degenerative+diseases%22+Stearns&source=web&ots=Gi11VDCSWE&sig=2FtNXmA59NgK6p8vYMUb0coRgDc&hl=fr#PPP1,M1}}</ref> including those individuals who reach the age of 60 or beyond,<ref name="pmid8450295">{{cite journal |author=Lindeberg S, Lundh B |title=Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: a clinical study in Kitava |journal=J Intern Med |volume=233 |issue=3 |pages=269–75 |year=1993, March |pmid=8450295 |url=}}</ref><ref name="isbn0674950208">{{cite book |author=Trowell, Hugh C. & Burkett, Denis P. |title=Western diseases: their emergence and prevention |year=1981 |publisher=Harvard University Press |location=Cambridge, MA |isbn=0674950208 |pages=xiii–xvi}}</ref> seem to be largely free of the signs and symptoms of chronic disease (such as [[obesity]], [[hypertension|high blood pressure]], nonobstructive coronary [[atherosclerosis]], and [[insulin resistance]]){{ref label|Macronutrient ratios|c|c}} that universally afflict the elderly in western societies (with the exception of [[osteoarthritis]], which afflicts both populations).<ref name=JNutriEnvironMed2003;13(3):149-160/><ref name="pmid11817904"/><ref name="isbn0521853761"/> Moreover, when these people adopt [[western diet]]s, their health declines and they begin to exhibit signs and symptoms of "[[Lifestyle diseases|diseases of civilization]]".<ref name="isbn007140239X"/><ref name="isbn0521853761"/> In one [[clinical study]], [[stroke]] and [[ischaemic heart disease]] appeared to be absent in a population living on the island of [[Trobriand Islands|Kitava]], in [[Papua New Guinea]], where a subsistence lifestyle, uninfluenced by [[Western pattern diet|western dietary habits]], was still maintained.<ref name="pmid8450295"/><ref name="pmid10535381">{{cite journal |author=Lindeberg S, Eliasson M, Lindahl B, Ahrén B |title=Low serum insulin in traditional Pacific Islanders—The Kitava study |journal=Metabolism |volume=48 |issue=10 |pages=1216–19 |year=1999, October |pmid=10535381 |doi=10.1016/S0026-0495(99)90258-5 |url=}}</ref>
The results of controlled medical studies on the Paleolithic diet have also been interpreted as evidence of the health benefits of this diet.<ref>{{cite web |last=Lindeberg |first=Staffan |title=The original human diet is good for people with diabetes |work=Paleolithic Diet in Medical Nutrition |url=http://www.staffanlindeberg.com/DiabetesStudy.html |accessdate=2008-01-19}}</ref><ref>{{cite web |title=Random Samples |publisher=Science Magazine |date=[[2007-07-13]] |url=http://www.sciencemag.org/cgi/content/summary/317/5835/175c |accessdate=2008-01-19}}</ref><ref name="doi10.1186/1743-7075-3-39">{{cite journal |author=Jönsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson L, Lindeberg S |title=A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs |journal=Nutrition & Metabolism |volume=3 |issue=39 |year=2006 |doi=10.1186/1743-7075-3-39 |pages=39}}</ref> The first animal experiment on a Paleolithic diet suggested that this diet, as compared with a cereal-based diet, conferred higher [[Insulin resistance|insulin sensitivity]], lower [[C-reactive protein]] and lower [[blood pressure]] in domestic pigs.<ref name="doi10.1186/1743-7075-3-39"/> Subsequently, a short-term intervention with such a diet in healthy volunteers showed some favourable effects on [[cardiovascular]] risk factors.<ref name="pmid17522610">{{cite journal |author=Osterdahl M, Kocturk T, Koochek A, Wändell PE |title=Effects of a short-term intervention with a paleolithic diet in healthy volunteers |journal=Eur J Clin Nutr. |volume= 62|issue= |year=2007, May 16 |pmid=17522610 |doi=10.1038/sj.ejcn.1602790 |pages=682}}</ref> In the first controlled human [[clinical trial|trial]] on a Paleolithic diet, researchers found that the diet improved [[glucose tolerance]] more than a [[Mediterranean diet]] in individuals with ischaemic heart disease.<ref name="pmid17583796"/>
===Nutritional factors===
The novel foods introduced as staples during the [[Neolithic]] and [[Industrial Era]]s, namely dairy products, beans, cereals, [[refined grains|refined cereal]]s, [[refined sugar]]s, refined [[vegetable oil]]s, alcohol, salt and fatty domestic meats,{{ref label|Macronutrient ratios|d|d}} are believed to have fundamentally altered several key nutritional characteristics of the human diet since the [[Paleolithic]] period, and these dietary compositional changes have been implicated as [[risk factor]]s in the [[pathogenesis]] of many of the so-called "diseases of civilization",<ref name=JNutriEnvironMed2003;13(3):149-160/><ref name="pmid15699220"/><ref name="pmid16336696">{{cite journal |author=Jönsson T, Olsson S, Ahrén B, Bøg-Hansen TC, Dole A, Lindeberg S |title=Agrarian diet and diseases of affluence--do evolutionary novel dietary lectins cause leptin resistance? |journal=BMC Endocr Disord. |volume=5 |issue=10 |year=2005 |pmid=16336696 |doi=10.1186/1472-6823-5-10 |pages=10}}</ref><ref name=LeachMay25>{{cite journal |author=Leach JD |title=Prebiotics in Ancient Diet |journal=Food Science and Technology Bulletin |volume=4 |issue=1 |pages=1–8 |year=2007 |doi=10.1616/1476-2137.14801 |url=http://www.paleobioticslab.com/prebiotics_in_ancient_diet.htm}}</ref> including obesity, [[cardiovascular disease]],<ref name="pmid16540158">{{cite journal |author=Kopp W |title=The atherogenic potential of dietary carbohydrate |journal=Prev Med |volume=42 |issue=5 |pages=336–42 |year=2006, May |pmid=16540158 |doi=10.1016/j.ypmed.2006.02.003 |url=}}</ref> [[diabetes]], [[osteoporosis]],<ref name="pmid12450898">{{cite journal |author=Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr |title=Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors |journal=Am. J. Clin. Nutr. |volume=76 |issue=6 |pages=1308–16 |year=2002 |pmid=12450898 |url=}}</ref><ref name="pmid16772638">{{cite journal |author=Morris RC Jr, Schmidlin O, Frassetto LA, Sebastian A |title=Relationship and interaction between sodium and potassium |journal=J Am Coll Nutr. |issue=3 |pages=262S–70S |year=2006, June |pmid=16772638 |url= |volume=25}}</ref> [[Autoimmunity|autoimmune-related diseases]],<ref name="pmid10489816">{{cite journal |author=Cordain L |title=Cereal grains: humanity's double-edged sword |journal=World review of nutrition and dietetics |volume=84 |format=PDF| pages=19–73 |year=1999 |pmid=10489816 |url=http://www.thepaleodiet.com/articles/Cereal%20article.pdf |doi=10.1159/000059677}}</ref> certain [[cancer]]s,<ref name="pmid12714543">{{cite journal |author=Lawlor DA, Ness AR |title=Commentary: The rough world of nutritional epidemiology: Does dietary fibre prevent large bowel cancer? |journal=Int J Epidemiol |volume=32 |issue=2 |pages=239–43 |year=2003, April |pmid=12714543 |doi=10.1093/ije/dyg060}}</ref><ref name="pmid16855539">{{cite journal |author=Leach JD |title=Evolutionary perspective on dietary intake of fibre and colorectal cancer |journal=Eur J Clin Nutr |volume=61 |issue=1 |pages=140–42 |year=2007, January |pmid=16855539 |doi=10.1038/sj.ejcn.1602486 |url=http://www.paleobioticslab.com/evolution_fibre_colorectalcancer.htm}}</ref> and [[acne]],<ref name=DermatologyReviewIIAcne>{{cite book |last=Cordain |first=Loren |editor=Bedlow, J. |title=US Dermatology Review 2006 – Issue II |format= |year=2006 |publisher=Touch Briefings Publications |location=London |chapter=Dietary implications for the development of acne: a shifting paradigm (PDF) |chapterurl=http://www.thepaleodiet.com/articles/Cordain%20US%20Dermatology%20Reviews.pdf}}</ref><ref name="pmid17655968">{{cite journal |author=Kaymak Y, Adisen E, Ilter N, Bideci A, Gurler D, Celik B |title=Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne |journal=J Am Acad Dermatol. |volume=57 |issue=5 |pages=819–23 |year=2007, November |pmid=17655968 |doi=10.1016/j.jaad.2007.06.028}}</ref><ref name="pmid18158933">{{cite journal |author=Treloar V, Logan AC, Danby FW, Cordain L, Mann NJ |title=Comment on acne and glycemic index |journal=J Am Acad Dermatol |volume=58 |issue=1 |pages=175–77 |year=2008, January |pmid=18158933 |format=PDF| doi=10.1016/j.jaad.2007.10.017 |url=http://www.mdconsult.com/das/article/body/86574314-2/jorg=journal&source=MI&sp=&sid=/N/624090/s0190962207015976.pdf}}</ref> as well as many diseases related to [[vitamin]] and [[mineral]] [[deficiencies]].<ref name="pmid10489816"/><ref name="pmid15142639">{{cite journal |author=Kopp W |title=Nutrition, evolution and thyroid hormone levels – a link to iodine deficiency disorders? |journal=Med Hypotheses |volume=62 |issue=6 |pages=871–75 |year=2004 |pmid=15142639 |doi=10.1016/j.mehy.2004.02.033 |url=}}</ref><ref name="pmid16087997">{{cite journal |author=Cunnane SC |title=Origins and evolution of the Western diet: implications of iodine and seafood intakes for the human brain |journal=Am J Clin Nutr. |volume=82 |issue=2 |year=2005, August |pmid=16087997 |pages=483}}</ref>
According to Cordain et al., seven crucial nutritional characteristics of ancestral hominin diets that have been fundamentally altered by food staples and [[food-processing]] procedures introduced during the Neolithic and Industrial Periods serve to inhibit the development of [[diseases of affluence]] in modern-day hunter-gatherers:<ref name="pmid15699220"/>
[[Image:La Boqueria.JPG|thumb|Base-yielding fruits and vegetables, rich in vitamins, potassium and fiber, are staple foods of hunter-gatherer diets.<ref name="pmid15699220"/>]]
* [[Glycemic load]]: Unrefined wild plant foods like those available to contemporary hunter-gatherers typically exhibit low [[glycemic index|glycemic indices]].<ref name="pmid12081815">{{cite journal |author=Foster-Powell K, Holt SH, Brand-Miller J |title=International table of glycemic index and glycemic load values: 2002. |journal=Am J Clin Nutr |volume=76 |issue=1 |pages=5–56 |year=2002 |pmid=12081815 |url=}}</ref> Moreover, their diets are devoid of dairy products, such as milk, yoghurt, and cottage cheese, which have low glycemic indices, but are highly insulinotropic, with an [[insulin index]] similar to that of white bread.<ref name="pmid11641749">{{cite journal |author=Liljeberg Elmståhl H, Björck I |title=Milk as a supplement to mixed meals may elevate postprandial insulinaemia |journal=European journal of clinical nutrition |volume=55 |issue=11 |pages=994–99 |year=2001 |format=PDF| pmid=11641749 |doi=10.1038/sj.ejcn.1601259 |url=http://www.nature.com/ejcn/journal/v55/n11/pdf/1601259a.pdf}}</ref><ref name="pmid15788109">{{cite journal |author=Hoyt G, Hickey MS, Cordain L |title=Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk |journal=Br. J. Nutr. |volume=93 |issue=2 |pages=175–77 |year=2005 |pmid=15788109 |doi=10.1079/BJN20041304 |url=}}</ref> These dietary characteristics may lower risk of diabetes, obesity and other related [[syndrome X|syndrome X]] diseases by placing less stress on the [[pancreas]] to produce [[insulin]], and preventing [[insulin insensitivity]].<ref name="pmid14527633">{{cite journal |author=Cordain L, Eades MR, Eades MD |title=Hyperinsulinemic diseases of civilization: more than just Syndrome X |journal=Comp Biochem Physiol A Mol Integr Physiol. |volume=136 |issue=1 |pages=95–112 |year=2003 |pmid=14527633 |format=PDF| doi=10.1016/S1095-6433(03)00011-4 |url=http://www.thepaleodiet.com/articles/Hyperinsulinemic%20Diseases%20Final.pdf}}</ref>
* [[Fatty acid]] composition: Hunter-gatherer diets generally maintain relatively high levels of [[monounsaturated fatty acid|monounsaturated]] and [[polyunsaturated fatty acid|polyunsaturated]] fats, moderately low levels of [[saturated fat]]s (10–15% of total [[food energy]]<ref name="isbn0849341809">{{cite book |last=Cordain |first=Loren |editor=Meskin, Mark S.; Bidlack, Wayne R.; & Randolph, R. Keith |title=Phytochemicals: Nutrient-Gene Interactions |format= |year=2006 |publisher=CRC Press |isbn=0849341809 |pages=115–26 |chapter=Saturated fat consumption in ancestral human diets: implications for contemporary intakes (PDF) |chapterurl=http://www.thepaleodiet.com/articles/CRC%20Chapter%202006a.pdf}}</ref>) as well as a low [[Omega-6 fatty acid|omega-6]]:[[Omega-3 fatty acid|omega-3]] [[fatty acid]] ratio. Moreover, they are devoid of artificial [[trans fat]]. These nutritional factors may serve to inhibit the development of cardiovascular disease.<ref name="pmid15699220"/>
* [[Macronutrient]] composition: Dietary protein is characteristically elevated (19–35% of energy) at the expense of carbohydrate (22–40% of energy).<ref name="pmid10702160"/><ref name="pmid11965522"/> High protein diets may have a cardiovascular protective effect and may represent an effective weight loss strategy for the overweight or obese.<ref name="pmid15699220"/> Furthermore, [[carbohydrate restriction]] may help prevent obesity and [[type 2 diabetes|type 2 diabetes]],<ref name="pmid17684196">{{cite journal |author=Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, Yancy WS, Phinney SD |title=Low-carbohydrate nutrition and metabolism |journal=Am J Clin Nutr |volume=86 |issue=2 |pages=276–84 |year=2007, August |pmid=17684196 |url=}}</ref><ref name="pmid11965520">{{cite journal |author=Colagiuri S, Brand-Miller J |title=The 'carnivore connection'--evolutionary aspects of insulin resistance |journal=Eur J Clin Nutr. |volume=56 |issue=1 |pages=S30–5 |year=2002, March |pmid=11965520 |doi=10.1038/sj/ejcn/1601351}}</ref> as well as [[atherosclerosis]].<ref name="pmid16540158"/>
* [[Nutrient density|Micronutrient density]]: Fruits, vegetables, lean meats, and seafood, which are staples of the hunter-gatherer diet, are more nutrient-dense than refined sugars, grains, vegetable oils, and dairy products. Consequently, the vitamin and mineral content of the diet is very high compared with a standard diet, in many cases a multiple of the [[Recommended Dietary Allowance|RDA]].<ref name=JAmNeutraceutAssoc2002;5:15-24/>
* [[Acid-base homeostasis|Acid-base balance]]: Because of the absence of cereals and energy-dense, nutrient-poor foods, foods that displace base-yielding fruits and vegetables, the diet produces a net base load on the body, as opposed to a net acid load. Net acid producing diets may contribute to the development of osteoporosis and [[renal stone]]s, loss of [[muscle mass]], and age-related [[renal insufficiency]].<ref name="pmid12450898"/><ref name=L.A.Frassetto22>{{cite journal |author=Frassetto LA, Morris RC Jr, Sebastian A |title=A practical approach to the balance between acid production and renal acid excretion in humans |journal=J Nephrol |issue=19 |pages=33–40 |year=2006 |pmid=16736439 |url=http://www.jnephrol.com/index.asp?a=abstract&id=5CF81AF1-49CD-4C9D-B0CD-9358C0A}}</ref>
* [[Sodium]]-[[potassium]] ratio: Since no [[Food processing|processed foods]] or added salt are included the sodium intake (~726 mg) is lower than average U.S. values (3,271 mg) or recommended values (2,400 mg). Further, since potassium-rich fruits and vegetables comprise ~30% of the daily energy, the potassium content (~9,062 mg) is nearly 3.5 times greater than average values (2,620 mg) in the U.S. diet.<ref name=JAmNeutraceutAssoc2002;5:15-24/> Diets containing high amounts of salt induce and sustain increased acidity of body fluid, which may contribute to the development of osteoporosis and [[renal stone]]s, loss of muscle mass, and age-related renal insufficiency. Moreover, the inverted ratio of potassium to sodium in the U.S. diet compared with preagricultural diets adversely affects cardiovascular function and contributes to [[hypertension]] and [[stroke]].<ref name="pmid16772638"/><ref name="pmid18203914">{{cite journal |author=Frassetto LA, Morris RC Jr, Sellmeyer DE, Sebastian A |title=Adverse effects of sodium chloride on bone in the aging human population resulting from habitual consumption of typical American diets |journal=J Nutr |issue=2 |pages=419S–22S |year=2008, February |pmid=18203914 |url= |volume=138}}</ref>
* [[Fiber]] content: Contemporary diets devoid of cereal grains, dairy products, refined oils and sugars, and [[processed food]]s have been shown to contain significantly more fiber (~42.5 g/d) than either current or recommended values.<ref name=JAmNeutraceutAssoc2002;5:15-24/>
==Criticism of the Paleolithic diet==
===Comparative life expectancy===
One of the most frequent criticisms of the Paleolithic diet is that it is unlikely that preagricultural hunter-gatherers suffered from the [[Lifestyle diseases|diseases of modern civilization]] simply because they did not live long enough to develop these illnesses, which are typically associated with old age.<ref name="doi10.1079/PHN2006959"/><ref name="pmid11817904"/><ref name=BookReviewSolomons>{{cite journal |author=Solomons NW |title=Book Review – Evolutionary Aspects of Nutrition and Health: Diet, Exercise, Genetics and Chronic Disease |journal=American Journal of Clinical Nutrition |volume=71 |issue=3 |pages=854–55 |year=2000, March |url=http://www.ajcn.org/cgi/content/full/71/3/854}}</ref><ref>{{cite news |last=Vogin |first=Gary |title=Eating Like a Caveman – Flintstone Diet |publisher=[[MedicineNet]] |date=[[2001-12-19]] |url=http://www.medicinenet.com/script/main/art.asp?articlekey=50700 |accessdate=2008-01-19}}</ref><ref name="doi10.1017/S1368980007770568">{{cite journal |author=Cannon G |title=Drugs and bugs, and other stories [Out of the Box] |journal=Public Health Nutrition |volume=10 |issue=8 |pages=758–61 |year=2007, August |doi=10.1017/S1368980007770568}}</ref> In response to this argument, advocates of the paleodiet state that while Paleolithic hunter-gatherers did have a short average life expectancy, modern human populations with lifestyles resembling that of our preagricultural ancestors have no or little [[diseases of affluence]], despite sufficient numbers of elderly.<ref name="pmid11817904"/><ref name=10.1017/S1368980007815424>{{cite journal |author=Leach JD |title=Paleo Longevity Redux (Letters to the Editor) |journal=Public Health Nutrition |format=PDF |doi=10.1017/S1368980007815424 |url=http://www.paleobioticslab.com/PDFs/PHN_Leach_2007.pdf |doi_brokendate=2008-06-28}}</ref>
===Causes of the diseases of affluence===
Critics further contend that food energy excess, rather than the consumption of specific novel foods, such as grains and dairy products, underlies the diseases of affluence. According to Geoffrey Cannon,<ref name="doi10.1079/PHN2006959"/> science and health policy advisor to the [[World Cancer Research Fund]], humans are designed to work physically hard to produce food for subsistence and to survive periods of [[famine|acute food shortage]], and are not adapted to a diet rich in energy-dense foods.<ref name="pmid16277821">{{cite journal |author=Uauy R, Díaz E |title=Consequences of food energy excess and positive energy balance |journal=Public Health Nutr |volume=8 |issue=7A |pages=1077–99 |year=2005, October |pmid=16277821 |doi=10.1079/PHN2005797}}</ref> Similarly, William R. Leonard, a professor of anthropology at [[Northwestern University]], states that the health problems facing industrial societies stem not from deviations from a specific ancestral diet but from an imbalance between calories consumed and calories burned, a state of energy excess uncharacteristic of ancestral lifestyles.<ref>{{cite journal |author=Leonard WR |title=Food for thought. Dietary change was a driving force in human evolution |journal=Sci Am |volume=287 |issue=6 |pages=106–15 |year=2002, December |pmid=12469653 |doi= |format=PDF |url=http://www.anthropology.northwestern.edu/LHBR/sciamerican-2002.pdf}}</ref>
===Evolutionary logic===
The evolutionary assumptions underlying the Paleolithic diet have also been disputed.<ref name="isbn0897897366"/><ref name="pmid16997359"/><ref name="doi10.1007/BF00999126"/><ref name="Elton2008">{{cite book |last=Elton |first=S. |editor=O’Higgins, P. & Elton, S. |title=Medicine and Evolution: Current Applications, Future Prospects |year=2008 |publisher=Taylor and Francis |location=London |isbn=1420051342 |pages= |chapter=Environments, adaptations and evolutionary medicine: Should we be eating a ‘stone age’ diet? |chapterurl=}}</ref> According to Alexander Ströhle, Maike Wolters and Andreas Hahn,<ref name="pmid16997359"/> with the Department of Food Science at the [[University of Hannover]], the statement that the [[human genome]] evolved during the [[Pleistocene]] (a period from 1,808,000 to 11,550 years ago) is resting on an
inadequate, but popular [[gene-centered view of evolution]]. They argue that evolution of organisms cannot be reduced to the genetic level with reference to [[mutation]] and that there is no one to one relationship between [[genotype]] and [[phenotype]].<ref name="isbn0521620708">{{cite book |last=Gray |first=Russell D. |editor=Singh, Rama S.; Krimbas, Costas B.; Paul, Diane B.; & Beatty, John |title=Thinking about Evolution: Historical, Philosophical and Political Perspectives |year=2001 |publisher=Cambridge University Press |location=Cambridge |isbn=0521620708 |pages=184–207 |chapter=Selfish genes or developmental systems? |url=http://books.google.ca/books?id=HmVbYJ93d-AC&printsec=frontcover&hl=fr}}</ref>
[[Image:White bread 800.jpg|thumb|High-[[insulin]]ogenic foods, like refined grains, were introduced in the human diet only about 200 years ago.<ref name="doi:10.1016/j.ypmed.2006.09.003">{{cite journal |author=Kopp W |title=Reply to the comment of Ströhle et al. |journal=Prev Med. |volume=44 |issue=1 |pages=84–5 |year=2007, January |pmid=16997359 |doi=10.1016/j.ypmed.2006.09.003}}</ref>]]
They further question the notion that 10,000 years since the dawn of agriculture is a period not nearly sufficient to ensure an adequate [[adaptation]] to [[Agrarian society|agrarian]] diets.<ref name="pmid16997359"/> Referring to Wilson D.S. (1994),<ref name=WilsonDS>{{cite journal |author=Wilson DS |title=Adaptive genetic variation and human evolutionary psychology |journal=Ethol Sociobiol |volume=15 |issue= |pages=219–35 |year=1994|doi=10.1016/0162-3095(94)90015-9}}</ref> Ströhle et al. argue that "the number of [[generation]]s that a species existed in the old [[Natural environment|environment]] was irrelevant, and that the response to the change of the environment of a [[species]] would depend on the [[heredity|hereditability]] of the [[Trait (biology)|trait]]s, the intensity of [[selection]] and the number of generations that selection acts."<ref name="doi:10.1016/j.ypmed.2006.09.003"/> They state that if the diet of [[Neolithic]] [[agriculturalist]]s had been in discordance with their [[physiology]], then this would have created a [[selection pressure]] for evolutionary change and modern humans, such as [[Genetic history of Europe|European]]s, whose ancestors have subsisted on agrarian diets for 400–500 generations should be somehow adequately adapted to it. In response to this argument, Wolfgang Kopp states that "we have to take into account that death from atherosclerosis and cardiovascular disease (CVD) occurs later during life, as a rule after the reproduction phase. Even a high mortality from CVD after the reproduction phase will create little [[selection pressure]]. Thus, it seems that a diet can be functional (it keeps us going) and dysfunctional (it causes health problems) at the same time."<ref name="doi:10.1016/j.ypmed.2006.09.003"/> Moreover, S. Boyd Eaton and colleagues have indicated that "comparative genetic data provide compelling evidence against the contention that long exposure to agricultural and industrial circumstances has distanced us, genetically, from our Stone Age ancestors."<ref name="pmid11817904"/> According to Kopp, the implementation of high-[[glycemic]] and high-insulinogenic food, like refined cereals and sugars, into human nutrition only about 200 years, or 10 generations, ago, occurred too recently on an evolutionary time scale for the human genome to adjust.<ref name="doi:10.1016/j.ypmed.2006.09.003"/>
According to Ströhle et al.,<ref name="pmid16997359"/> "whatever is the fact, to think that a dietary factor is valuable (functional) to the organism only when there was ‘genetical adaptation’ and hence a new dietary factor is dysfunctional per se because there was no evolutionary adaptation to it, such a [[Molecular evolution|panselectionist]] misreading of biological evolution seems to be inspired by a naive [[Adaptationism|adaptationistic]] view of life."<ref name=>{{cite journal |author=Mahner M, Bunge M |title=Function and functionalism: a synthetic perspective |journal=Philos Sci |volume=68 |issue= |pages=75–94 |year=2001 |url=http://grupobunge.wordpress.com/2006/08/07/function-and-functionalism-a-synthetic-perspective-parte-1/ |doi=10.1086/392867}}</ref><ref name=Strohle768>{{cite journal |author=Ströhle A, Hahn A |title=Evolutionary nutrition science and dietary recommendations of the Stone Age—The ideal answer to present-day nutritional questions or reason for criticism? Part 1: Concept, arguments and paleoanthropological findings |journal=Ernährungs-Umschau |format=PDF| volume=53 |issue=1 |pages=10–6 |year=2006 |language=German |url=http://www.dr-moosburger.at/pub/pub058.pdf}} [http://www.ernaehrungs-umschau.de/archiv/summaries/?page=3&id=2398 Abstract (in English)]</ref>
Katharine Milton, a professor of [[physical anthropology]] at the [[University of California]], has also disputed the evolutionary logic upon which the Paleolithic diet is based. She questions the premise that the metabolism of [[modern humans]] must be genetically adapted to the [[Paleolithic#Diet and nutrition|dietary conditions]] of the Paleolithic.<ref name="isbn0897897366"/> According to Milton,<ref name="isbn0897897366"/> "there is little evidence to suggest that human nutritional requirements or human digestive physiology were significantly affected by such diets at ''any'' point in human evolution."<ref name="pmid2843616">{{cite journal |author=Milton K, Demment MW |title=Digestion and passage kinetics of chimpanzees fed high and low fiber diets and comparison with human data. |journal=J Nutr |volume=118 |issue=9 |pages=1082–88 |year=1988, September |pmid=2843616 |url=}}</ref><ref name="pmid10378206">{{cite journal |author=Milton K |title=Nutritional characteristics of wild primate foods: do the diets of our closest living relatives have lessons for us? |journal=Nutrition |volume=15 |issue=6 |format=PDF| pages=488–98 |year=1999, June |pmid=10378206 |doi=10.1016/S0899-9007(99)00078-7 |url=http://nature.berkeley.edu/miltonlab/pdfs/nutritionalchar.pdf}}</ref><ref name=meateating>{{cite journal |author=Milton K |title=A hypothesis to explain the role of meat-eating in human evolution |journal=Evolutionary Anthropology |volume=8 |issue=1 |format=PDF |pages=11–21 |year=1999 |doi=10.1002/(SICI)1520-6505(1999)8:1<11::AID-EVAN6>3.0.CO;2-M |url=http://nature.berkeley.edu/miltonlab/pdfs/meateating.pdf}}</ref><ref name="pmid10906529">{{cite journal |author=Milton K |title=Back to basics: why foods of wild primates have relevance for modern human health |journal=Nutrition |format=PDF| volume=16 |pages=481–83 |year=2000 |pmid=10906529 |doi=10.1016/S0899-9007(00)00293-8 |url=http://nature.berkeley.edu/miltonlab/pdfs/backbasics.pdf}}</ref>
==Criticism of low-carbohydrate and high-protein versions==
The [[high protein diet|high protein]] and [[low-carbohydrate diet]]{{ref label|Macronutrient ratios|e|e}} recommended by Loren Cordain and colleagues based on the dietary patterns of worldwide modern-day hunter-gatherers<ref name="isbn0195183479"/><ref name="pmid10702160"/><ref name="pmid11101497">{{cite journal |author=Cordain L, Miller JB, Eaton SB, Mann N |title=Macronutrient estimations in hunter-gatherer diets |journal=Am J Clin Nutr |volume=72 |issue=6 |pages=1589–92 |year=2000, December |pmid=11101497 |url=}}</ref> has attracted a number of criticisms,<ref name="doi10.1079/PHN2006959"/><ref name="pmid11101489">{{cite journal |author=Cunnane SC |title=Hunter-gatherer diets—a shore-based perspective |journal=Am J Clin Nutr |volume=72 |issue=6 |pages=1584–85 |year=2000, December |pmid=11101489 |url=}}</ref> including the following:
===Therapeutic merits===
It has been argued that relative freedom from degenerative diseases was, and still is, characteristic of all hunter-gatherer societies irrespective of the [[macronutrient]] characteristics of their diets.<ref name="pmid10702155"/><ref name="pmid11101497reply">{{cite journal |author=Milton K |title=Reply to L Cordain et al |journal=Am J Clin Nutr |volume=72 |issue=6 |pages=1590–92 |year=2000, December |pmid=11101497 |url=}}</ref><ref name="pmid11157335">{{cite journal |author=Walker AR |title=Are health and ill-health lessons from hunter-gatherers currently relevant? |journal=Am J Clin Nutr |volume=73 |issue=2 |pages=353–56 |year=2001, February |pmid=11157335 |url=}}</ref> Katharine Milton states that "hunter-gatherer societies, both recent and ancestral, displayed a wide variety of plant-animal subsistence ratios, illustrating the adaptability of human metabolism to a broad range of energy substrates. Because all hunter-gatherer societies are largely free of chronic degenerative disease, there seems little justification for advocating the therapeutic merits of one type of hunter-gatherer diet over another."<ref name="pmid11101497reply"/>
According to [[Marion Nestle]], a professor in the Department of Nutrition and Food Studies at [[New York University]], judging from research relating nutritional factors to [[chronic disease]] risks and to observations of exceptionally low chronic disease rates among people eating [[vegetarian]], [[Mediterranean diet|Mediterranean]] and [[Asian cuisine|Asian]] diets, it seems clear that plant-based diets are most associated with [[health]] and [[longevity]].<ref name="pmid10466159"/><ref name="doi10.1046/j.1467-3010.2000.00019.x"/>
Ströhle, Wolters and Hahn<ref name="pmid16997359"/> argue that hunters like the [[Inuit]], who traditionally obtain most of their dietary energy from [[Game (food)|wild animals]] and therefore eat a low-carbohydrate diet,<ref name="pmid5046723">{{cite journal |author=Ho KJ, Mikkelson B, Lewis LA, Feldman SA, Taylor CB |title=Alaskan arctic Eskimo: responses to a customary high fat diet |journal=Am J Clin Nutr |volume=25 |issue=8 |pages=737–45 |year=1972, August |pmid=5046723 |url=http://www.ajcn.org/cgi/content/citation/25/8/737}}</ref> seem to have a high [[Mortality rate|mortality]] from [[coronary heart disease]],<ref name="pmid12535749">{{cite journal |author=Bjerregaard P, Young TK, Hegele RA |title=Low incidence of cardiovascular disease among the Inuit--what is the evidence? |journal=Atherosclerosis |volume=166 |issue=2 |pages=351–57 |year=2003, February |pmid=12535749 |doi=10.1016/S0021-9150(02)00364-7 |url=}}</ref> and that many populations of [[horticulture|horticulturist]]s, [[Pastoralism|pastoralist]]s and simple agriculturists living today are ingesting a high-carbohydrate diet without having signs and symptoms of CHD.<ref name="pmid8450295"/><ref name="pmid10535381"/><ref name="pmid5547429">{{cite journal |author=Groom D |title=Cardiovascular observations on Tarahumara Indian runners—the modern Spartans |journal=Am Heart J |volume=81 |issue=3 |pages=304–14 |year=1971, March |pmid=5547429 |url= |doi=10.1016/0002-8703(71)90099-8}}</ref><ref name="pmid665563">{{cite journal |author=Connor WE, Cerqueira MT, Connor RW, Wallace RB, Malinow MR, Casdorph HR |title=The plasma lipids, lipoproteins, and diet of the Tarahumara indians of Mexico |journal=Am J Clin Nutr |volume=31 |issue=7 |pages=1131–42 |year=1978, July |pmid=665563 |url=http://www.ajcn.org/cgi/content/citation/31/7/1131}}</ref><ref name="pmid9059377">{{cite journal |author=Walker AR, Sareli P |title=Coronary heart disease: outlook for Africa |journal=J R Soc Med |volume=90 |issue=1 |pages=23–7 |year=1997, January |pmid=9059377 |url=}}</ref> In response to this criticism, Wolfgang Kopp states that "carbohydrate food, consumed by hunter-gatherers, is high in [[fiber]] and low-glycemic in effect,<ref name="pmid3541565">{{cite journal |author=Thorburn AW, Brand JC, Truswell AS |title=Slowly digested and absorbed carbohydrate in traditional bushfoods: a protective factor against diabetes? |journal=Am J Clin Nutr |volume=45 |issue=1 |pages=98–106 |year=1987, January |pmid=3541565 |url=http://www.ajcn.org/cgi/content/abstract/45/1/98}}</ref><ref name="pmid2178389">{{cite journal |author=Brand JC, Snow BJ, Nabhan GP, Truswell AS |title=Plasma glucose and insulin responses to traditional Pima Indian meals |journal=Am J Clin Nutr |volume=51 |issue=3 |pages=416–20 |year=1990, March |pmid=2178389 |url=http://www.ajcn.org/cgi/content/abstract/51/3/416)}}</ref> eliciting small amounts of insulin only. [...] Are high-carbohydrate diets [[Atherosclerosis|atherogenic]] per se? Not if they have a low glycemic load. In this point, Stroehle et al. are right. However, it is the question, whether diets high in low-glycemic plant food (which is relatively high in indigestible fiber and relatively low in [[carbohydrate]]) should be labeled as “high-carbohydrate” diets."<ref name="doi:10.1016/j.ypmed.2006.09.003"/> Kopp also says that it is very likely that diets with only a moderately increased glycemic load are atherogenic to some degree.<ref name="pmid16540158"/><ref name="pmid10333939">{{cite journal |author=Coutinho M, Gerstein HC, Wang Y, Yusuf S |title=The relationship between glucose and incident cardiovascular disease. A metaregression analysis of published data from 20 studies of 95.783 individuals followed for 12.4 years |journal=Diabetes Care |volume=22 |issue=2 |pages=233–40 |year=1999, February |pmid=10333939 |url= |doi=10.2337/diacare.22.2.233}}</ref>
According to [[Erica Frank]], professor of health care at the [[University of British Columbia]], eating an animal also involves absorbing the [[toxin]]s stored in its [[body fat]]. She quotes the [[EPA]]: "The average American intake is between 300 and 500 times the safe daily dose of [[dioxin]]."<ref name=medicinenet50760/> She argues that dioxin, which is stored in animal fat, is a [[carcinogen|cancer-causing substance]] and disrupts [[hormone]]s and the [[immune system]]. "People would be in error if they think they're doing themselves a service by eating [[bison]]."<ref name=medicinenet50760/>
===Anthropological evidence===
[[Image:Manihot esculenta dsc07325.jpg|thumb|Carbohydrate rich [[root vegetables]] may have been eaten in high amounts by Paleolithic humans.<ref name="pmid16085279">{{cite journal |author=Laden G, Wrangham R |title=The rise of the hominids as an adaptive shift in fallback foods: plant underground storage organs (USOs) and australopith origins |journal=J. Hum. Evol. |volume=49 |issue=4 |pages=482–98 |format=PDF |year=2005, October |pmid=16085279 |doi=10.1016/j.jhevol.2005.05.007 |url=http://www.tc.umn.edu/~laden002/Laden_Wrangham_Roots.pdf}}</ref>]]
Critics have argued that there are insufficient data to determine the average daily intake of animal and plant foods by Paleolithic humans.<ref name="isbn0897897366"/><ref name="pmid12494313"/><ref name="doi10.1046/j.1467-3010.2000.00019.x"/><ref name=Strohle768/><ref name="pmid2689923">{{cite journal |author=Garn SM, Leonard WR |title=What did our ancestors eat? |journal=Nutr Rev |volume=47 |issue=11 |pages=337–45 |year=1989, November |pmid=2689923 |url=http://naturalhygienesociety.org/articles/paleo1.html |format={{dead link|date=June 2008}} – <sup>[http://scholar.google.co.uk/scholar?hl=en&lr=&q=intitle%3AWhat+did+our+ancestors+eat%3F&as_publication=Nutr+Rev&as_ylo=1989, November&as_yhi=1989, November&btnG=Search Scholar search]</sup>}}</ref> Furthermore, according to Katharine Milton, "data from ethnographic studies of nineteenth and twentieth century hunter-gatherers, as well as historical accounts and the archeological record, suggest that ancestral hunter-gatherers enjoyed a rich variety of different diets. Thus estimates of nutrient proportions for "the Paleolithic diet" are hypothetical, at best."<ref name="isbn0897897366"/> Echoing Milton's criticism, Ströhle et al.<ref name="pmid16997359"/> argue that it is questionable if all hunter-gatherers living between 150,000 and 10,000 years ago in different geographical regions ate a low-carbohydrate diet.<ref name=doi:10.1080/11026480510032043/><ref name=isbn0521776724>{{cite book |last=Jenike |first=Mark R. |editor=Panter-Brick, Catherine; Layton, Robert H.; & Rowley-Conwy, Peter |title=Hunter–Gatherers: An Interdisciplinary Perspective |year=2001 |publisher=Cambridge University Press |location=Cambridge |isbn=0521776724 |pages=205–38 |chapter=Nutritional ecology: diet, physical activity and body size |chapterurl=http://books.google.ca/books?id=7yCpBRAY22UC&pg=PA205&lpg=PA205&dq=%22Nutritional+ecology:+diet,+physical+activity+and+body+size%22&source=web&ots=LGMaF0gq7Z&sig=WSR2rorWaFsWHIoGGOrb7hTlRgw&hl=fr#PPA205,M1}}</ref><ref name="isbn0897897366-p61-76">{{cite book |last=Conklin-Brittain |first=Nancy Lou |coauthors=Wrangham, Richard W.; & Smith, Catherine C. |editor=Ungar, Peter S. & Teaford, Mark F. |title=Human Diet. Its Origin and Evolution |year=2002 |publisher=Bergin and Garvey |location=London |isbn=0897897366 |pages=61–76 |chapter=A two-stage model of increased dietary quality in early hominid evolution: the role of fibre |chapterurl=http://www.questia.com/PM.qst?a=o&d=101313810#}}</ref> They indicate that, because the plant–animal subsistence ratios of contemporary hunter-gatherers vary in a remarkable manner (0–90% food from gathering; 10–100% food from [[hunting]] and [[fishing]]),<ref name=MarloweFW22>{{cite journal |author=Marlowe FW |title=Hunter-gatherers and human evolution |journal=Evolutionary Anthropology |volume=14 |issue=2 |pages=54–67 |year=2005 |format=PDF|url=http://www.anthro.fsu.edu/people/faculty/marlowe_pubs/hunter-gatherers%20and%20human%20evolution.pdf |doi=10.1002/evan.20046}}</ref><ref name=Ströhle22>{{cite journal |author=Ströhle A, Hahn A |title=Evolutionary nutrition science and dietary recommendations of the Stone Age—The ideal answer to present-day nutritional questions or reason for criticism? Part 2: Ethnographic results and scientific implications |journal=Ernahr.-Umsch. |volume=53 |issue= |pages=44–51 |year=2006|url=http://www.ernaehrungs-umschau.de/archiv/summaries/?page=3&id=2398}}</ref> it is likely that the macronutrient intake of preagricultural humans varied enormously.<ref name=isbn0521776724/>
They also refer to a hypothesis (the 'Plant underground [[storage organ]]s hypotheses') that suggests that carbohydrate [[tuber]]s were eaten in high amounts by our preagricultural ancestors.<ref name="pmid16085279"/><ref name="pmid10539941">{{cite journal |author=Wrangham RW, Jones JH, Laden G, Pilbeam D, Conklin-Brittain N |title=The Raw and the Stolen. Cooking and the Ecology of Human Origins. |journal=Curr Anthropol |volume=40 |issue=5 |pages=567–94 |year=1999, December |pmid=10539941 |url=http://www.scribd.com/doc/255939/The-raw-and-the-stolen-Cooking-and-the-ecology-of-human-origins |doi=10.1086/300083}}</ref><ref name="pmid17472915">{{cite journal|author=Yeakel JD, Bennett NC, Koch PL, Dominy NJ |title=The isotopic ecology of African mole rats informs hypotheses on the evolution of human diet.|journal=Proc Biol Sci. |volume=274|format=PDF| issue=1619 |pages=1723–30 |year=2007, July |pmid=17472915|doi=10.1098/rspb.2007.0330|url=http://people.ucsc.edu/~njdominy/publications/pdf/Proc_R_Soc_B.pdf}}</ref><ref name="pmid18032604">{{cite journal |author=Hernandez-Aguilar RA, Moore J, Pickering TR |title=Savanna chimpanzees use tools to harvest the underground storage organs of plants.|journal=Proc Natl Acad Sci U S A.|volume=105|issue=49|pages=19210–13|format=PDF| year=2007, December |pmid=18032604|doi=10.1073/pnas.0707929104|url=http://www.anthro.ucsd.edu/~jmoore/publications/HernandezEtAlPNAS07.pdf}}</ref> They add:<ref name="pmid16997359"/> "Provided that humans are incapable of metabolizing high amounts of dietary protein and given the fact that wild African mammals are relatively low in fat, a diet supplemented with carbohydrates from tubers seems to be more efficient in meeting the energy requirements of early hunters and gatherers than a diet based on lean meat."<ref name=SpethJD22>{{cite journal |author=Speth JD |title=Early hominid hunting and scavenging: the role of meat as an energy source |journal=J. Hum. Evol. |volume=18 |issue= |pages=329–43 |year=1983 |doi=10.1016/0047-2484(89)90035-3}}</ref><ref name=SpethJD33>{{cite journal |author=Speth JD, Spielmann KA |title=Energy source, protein metabolism, and hunter-gatherer subsistence strategies |journal=J. Anthropol. Archaeol. |volume=2 |issue= |pages=1–31 |year=1989 |doi=10.1016/0278-4165(83)90006-5}}</ref> Ströhle et al. further mention that Staffan Lindeberg, an advocate of the Paleolithic diet, has accounted for a plant-based diet rich in carbohydrates as being consistent with the [[human evolution|human evolutionary past]].<ref name=doi:10.1080/11026480510032043/><ref name=JNutriEnvironMed2003;13(3):149-160/>
==Sustainability concerns==
The Paleolithic diet has been criticized on the grounds that it cannot be implemented on a worldwide scale.<ref name=MoffatBookReview/> According to Loren Cordain, if such a diet was widely adopted, it would compromise the [[food security]] of populations dependent on cereal grains for their subsistence. However, he says that where cereals are not a necessity, as in most western countries, reverting to a grain-free diet can be highly practical in terms of cutting long-term healthcare costs.<ref name=faq>{{cite web |last=Cordain |first=Loren |title=Frequently Asked Questions |work=The Paleo Diet |url=http://www.thepaleodiet.com/faqs/ |accessdate=2008-01-19}}</ref> Barry Bogin, a professor of anthropology at the [[University of Michigan]], argues that less intensive farming techniques, such as pasture-grazed cattle, will not produce sufficient meat to feed the world’s population.<ref>{{cite news |last=Pearson |first=Helen |title=Wild meat healthier than farmed cattle |publisher=Nature News Service |date=[[2002-03-25]] |url=http://www.nature.com/news/2002/020325/full/news020325-2.html |accessdate=2008-01-19}}</ref>
Concerns have also been raised about the detrimental effects of meat-based diets on the environment.<ref name="pmid16236205"/> According to Anthony J. McMichael, director of the National Centre for Epidemiology and Population Health at the [[Australian National University]], "in order to achieve a world nutritional state that is health-supporting, [[food security|equitable]] and [[sustainable eating|ecologically sustainable]], we can learn much from consideration of the interplay between the evolutionary, environmental and ecological realms."<ref name="pmid16236205"/> He further indicates that the level of per-person meat consumption need only be moderate for dietary optimisation in accordance with human evolutionary biology.<ref name="pmid16236205"/>
==See also==
*[[Bushfood]]
*[[Gluten-free diet]] (related diet)
*[[Gluten-free, casein-free diet]] (related diet)
*[[Healthy diet]]
*[[Human evolution]]
*[[Hunter-gatherer fitness]]
*[[List of diets]]
==Notes==
{{refbegin}}
: {{note label|Macronutrient ratios|a|a}} The term "Paleolithic diet" and it's derivatives refer both to the ancient diet of Paleolithic humans (see [[Paleolithic#Diet and Nutrition]]) and the modern dietary regimen which is based on it.<ref name="pmid12494313"/> In the article, the term is used in this last sense.
: {{note label|Macronutrient ratios|b|b}} In this article, "human" refers to any member of the [[Homo genus]] (since ca. 2.5 million years).
: {{note label|Macronutrient ratios|c|c}} Stroke, coronary heart disease, diabetes, chronic obstructive pulmonary disease, lung cancer, female breast cancer, cervical cancer, colorectal cancer, and chronic liver disease/cirrhosis.<ref name="pmid11817904"/>
: {{note label|Macronutrient ratios|d|d}} During the Paleolithic, cereals and beans were rarely eaten and never in large amounts on a daily basis.<ref name=doi:10.1080/11026480510032043/>
: {{note label|Macronutrient ratios|e|e}} [[Paleolithic diet#Practices|See "Practices" section.]]
{{refend}}
==References==
{{reflist|2}}
==Further reading==
{{refbegin}}
*{{cite book |last=Bogin |first=Barry |editor=Romanucci-Ross, Lola; Moerman, Daniel E.; & Tancredi, Laurence R. |title=The Anthropology of Medicine: From Culture to Method |edition=3 |year=1997 |publisher=Bergen and Garvey |location=South Hadley, Mass. |isbn=0897895169 |pages=96–142 |chapter=The evolution of human nutrition |chapterurl=http://web.archive.org/web/20031203003838/http://citd.scar.utoronto.ca/ANTAO1/Projects/Bogin.html}}
*{{cite journal |author=Barnicot NA |title=Human nutrition: evolutionary perspectives |journal=Integr Physiol Behav Sci |volume=40 |issue=2 |pages=114–17 |year=2005, April/June |pmid=17393680 |url= |doi=10.1007/BF02734246}}
* {{cite journal |author=Eaton SB |title=The ancestral human diet: what was it and should it be a paradigm for contemporary nutrition? |journal=Proc Nutr Soc. |volume=65 |issue=1 |pages=1–6 |year=2006, February |pmid=16441938 |doi=10.1079/PNS2005471 |url=}}
*{{cite journal |author=Leonard WR, Snodgrass JJ, Robertson ML |title=Effects of brain evolution on human nutrition and metabolism |journal=Annu Rev Nutr. |volume=27 |pages=311–27 |year=2007 |pmid=17439362 |doi=10.1146/annurev.nutr.27.061406.093659 |url=http://www.pinniped.net/LeonardARN.pdf}}
*{{cite journal |author=Milton K |title=Micronutrient intakes of non-human primates: are humans different? |journal=Comparative Biochemistry and Physiology Part A |volume=136 |pages=47–59 |year=2003 |pmid=14527629 |doi=10.1016/S1095-6433(03)00084-9 |url=http://nature.berkeley.edu/miltonlab/pdfs/kmilton_micronutrient.pdf}}
{{refend}}
==External links==
*[http://www.direct-ms.org/pdf/evolutionpaleolithic.html Paleolithic nutrition (List of full-text articles)]
*[http://www.cavemanpower.com/food/caveman_power_diet.html Paleolithic Nutrition Community]
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