https://www.finedininglovers.com/blog/food-drinks/what-is-the-paleo-diet/
Shannon Johnson, R.D., L.D., C.L.T.
Paleo Objectives
• Explain Paleo eating and its origins.
• Describe foods that are included in the Paleo
plan and those that are excluded.
• Discuss how this type of eating style may or
may not benefit our patients.
Clip Art
Basic Principles of the Paleo Lifestyle
•
•
•
•
Eat whole foods.
Avoid processed, refined foods.
Eat for proper digestive functioning.
Eat for good blood sugar regulation.
Clip Art
– Individualize the plan to meet health needs/goals.
– This is not a “One size fits all” approach!
Clip Art
Paleolithic Diet Origins
• Prior to Agriculture ~10,000 years ago
– 333-400 generations ago
– No grains, legumes, farmed-raised/grain-fed animals
• We ate this way for 2.5 million years:
– Lean game meat/poultry/fish + vegetables/fruit
• Determined by
–
–
–
–
Fossil Records
Current Hunter-Gatherer Diets
Chimpanzee diets (We share ~98% of the same DNA.)
Nutrients in wild animals and plants
Cordain, Loren. The Paleo Diet, revised edition. Houghton Mifflin
Harcourt: Boston, NY; 2011.
Clip Art
Paleolithic Diet Origins
• Discordance or Mismatch Hypothesis:
The human genome evolved to adapt to conditions
that no longer exist. Dietary changes have occurred
faster than adequate genetic adaptation could
respond. This mismatch between genome and diet
has resulted in today’s chronic disease.
Clip Art
Konner M, Eaton SB. Paleolithic Nutrition: Twenty-Five Years Later. Nutrition in Clinical Practice. 2010;
25(6):594-602.
Paleolithic Evidence
– Hunter-gatherers of today do not suffer from
modern diseases (DM, obesity, HTN, CVD, OA,
high cholesterol).
– Pima Indians in America vs in Mexico
– Australian HGs with T2DM – improved health s/p
return to former lifestyle/diet .
Konner M, Eaton SB. Paleolithic Nutrition: Twenty-Five Years Later.
Nutrition in Clinical Practice. 2010; 25(6):594-602.
Diet Composition
Clip Art
DIET
PROTEIN
CARBOHYDRATE
FAT
Paleo
19-35%
22-40%
28-47%
30-35%
15-20%
(Meat glycogen)
50%
(↑ Omega-3)
15.5%
49%
34%
18-23%
4-26%
48-51%
(Cordain L)
Traditional
Alaskan (3000 Kcal)
Inuits/Eskimos
(Ho KJ)
US Diet
(Cordain L)
Low-Carb Fad Diets
(Cordain L)
!Kung in Africa
33% animal-based, 67% plant –based (1/2 wt = monongo nut)
(Lee)
Cordain, Loren. The Paleo Diet, revised edition. Houghton Mifflin Harcourt: Boston, NY; 2011.
Ho KJ, Mikkelson B, Lewis LA, Feldman SA, Taylor CB. Alaskan Arctic Eskimos: responses to a customary high fat diet. Am J Clin Nutr1972;25:737–
45.
Lee RB. What hunters do for a living, or how to make out on scarce resources. In: Lee RB, DeVore I, eds. Man the hunter. Chicago: Aldine
Publishing Co, 1968:30–48.
Small Clinical Studies
10-day Paleo Diet
9 non-obese, sedentary, healthy pts (uncontrolled)
– Typical Diet: 3 days
– 7 days of 3 “ramp-up” diets
• (gradual increase of fiber/K+)
– 10 days Paleo
Results:
*Modest, but significant decrease in BP
*Improved arterial distension
*↓ insulin secretion in 2-hr OGTT
*↓insulin/glucose ratio
*↓ 16% total cholesterol
*↓ 22% LDL
Frassetto LA, Schloetter M, Mietus-Synder M, et al. Metabolic and physiologic improvements from
consuming a Paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009;63:947-955.
Small Clinical Studies
Mediterranean vs Paleo
– Randomized controlled trial
– 29 people with IHD + glucose intol. or T2DM
– 12 weeks
Glucose (OGTT) Results:
↓7% in Mediterranean
Vs
↓ 26% in Paleo
Lindeberg S, Jonsson T, Granfeldt Y, et al. A Palaeolithic diet improves glucose tolerance more than
a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia.
2007;50:1795-1807.
Small Clinical Studies
Diabetes ADA diet vs Paleo
– Randomized, crossover pilot study
– 13 people with T2DM
– 3 months
Results:
Paleo diet group:
↓ HgA1c, TG, diastolic BP, wt, BMI, waist circ.
↑ HDL
Jonsson T, Granfeldt Y, Ahren B, et al. Beneficial effects of a Paleolithic diet on
cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.
Cardiovasc Diabetol. 2009;8:35.
The Paleo Plan Includes
•
•
•
•
•
Lean Animal-Based Protein
Vegetables
Fruit
Natural, healthy oils
Nuts
Clip Art
Cordain, Loren. The Paleo Diet, revised edition. Houghton
Mifflin Harcourt: Boston, NY; 2011.
http://blog.shadygrovefertility.com/wp-content/uploads/2013/11/paleo-for-pcos.jpg
Paleo Exclusions
• Processed Foods
–
–
–
–
Reasons We Tend to Include
High in sugar, fat (trans/saturated), and salt *Enjoyment, celebration
Low nutrient-density, High caloric-density *Easy/Quick
Oils when in high heat (deep fried) toxins *Cultural traditions
Sugar, Salt, Vinegar, Alcohol
• Grains
–
–
–
–
Easily become excessive in diet
If not used  wt
High in Lectins
High in Phytates
*Contributes to daily fiber
*Contributes to B9, B1, B2, B3
*Inexpensive staple food
*Cholesterol-lowering fiber
• Legumes
– High in Lectins
Clip Art
– High in Phytates
– If not appropriately cooked  toxins
*Contributes to daily fiber
*Cholesterol-lowering fiber
*Inexpensive Protein
• Dairy (including Butter)
– USA: A1 or A2 Beta Casein
– Lactose intolerance
– Allergies
*Major source of daily Ca & Vit D
*Probiotics
Lectins
• Lectins = Phytohemagglutinins = Phytagglutinins
– Glycoproteins that may serve in the following:
• Recognition and binding of nitrogen-fixing bacteria to
legume roots.
• Defense mechanism of plant’s seed
– Resistant to Proteolytic Digestion (wheatgerm,
tomatoes, and navy beans) Antibodies
• Known to agglutinate RBCs.
• > 400,000 kidney bean lectin binding sites on surface of each
RBC (phytohaemoglutinin).
– Do not eat raw kidney bean sprouts!
• Effects in Animals: Reduced growth rate, diarrhea,
interference with nutrient absorption, GI ulcers
http://www.ansci.cornell.edu/plants/toxicagents/lectins.html
Lectins, Phytates, Enzyme Inhibitors
in Legumes, Grains, & Nuts/Seeds
• Differing Lectin Levels /Toxicity
– Fungal infection/wounding of plant increases
lectins.
– Environment (weather, soil, location, season).
– High levels in grains (wheat in particular)
• Rinse/soak/rinse quinoa to help rid it of saponins
– High levels in legumes (beans, lentils, soybeans,
peanuts)
• Peas and green beans are considered safe
http://www.ansci.cornell.edu/plants/toxicagents/lectins.html
Lectins
• Certain seaweeds and mucilaginous vegetables have the ability to
bind lectins in a way that makes them unavailable to the cells of the
gut.
• Lectins are resistant to dry heat, so using raw legume flours in
baked goods should be done with caution.
• The “Blood Type Diet” is based on how our blood cells react with
lectins in foods.
• Some experts hypothesize that it’s no coincidence the top 8
allergens also contain some of the highest amounts of lectins
(including: dairy, egg, wheat, soy, peanuts, tree nuts, fish,
shellfish).
• Some experts theorize that lectins cause urinary tract infections.
• Some experts theorize that the reason anemia is higher in
developing countries is due to excessive levels of lectin consumption.
Beneficial Lectins?
Clip Art
“Mushroom lectins are endowed with mitogenic,
antiproliferative, antitumor, antiviral, and immune
stimulating potential.”
Singh RS, Bhari R, Kaur HP, et al. Mushroom lectins: current status and future
perspectives. Crit Rev Biotechnol. 2010 Jun;30(2):99-126.
------------------------------------------------------------------------------------------------------
Phytates decrease mineral bioavailability.
-bind Ca, Fe, Cu, Zn, Mg, blocking absorption
Soaking and cooking significantly decreased phytic acid in
10 different varieties of legumes.
Vadivel V, Biesalski HK. Effect of certain indigenous processing methods on
the bioactive compounds of ten different wild type legume grains. Journal of
Food Science and Technology. Dec 2012; 49.6:673-684.
Soaking and Sprouting
↓Lectins/Phytates/Enzyme Inhibitors:
Soaking, Sprouting, Fermenting, and Cooking
http://www.ansci.cornell.edu/plants/toxicagents/lectins.html
Who Does This?
Natives of Central America and India, Squirrels, Your Ancestors!
Soaking nuts, legumes, and grains in saltwater/acidic solution:
• Neutralizes enzyme inhibitors
• Decreases phytates
• Decreases lectins
Do not eat sprouted alfalfa seeds
-Canavanine (metab. during growth)
-inhibits immune system
Nourishing Traditions by Sally Fallon
http://apronstringz.wordpress.com/2012/04/13/mastering-sprouted-wheat-bread/
Soaking and Sprouting
Two varieties of wheat after sprouting/drying
significantly increased nutrient value.
Nutrient
Before Sprouting
After Sprouting
Alpha-Tocopherol
27 & 24 mg/kg
55 & 47 mg/kg
% Omega 3 FA in
Total FA
4.04 +/- 0.16
3.93 +/-0.12
16.08 +/-1.50
12.26 +/-1.36
Mg (mg/kg)
1792 +/- 101
1992 +/-188
3751 +/- 429
3271 +/-186
Ca (mg/kg)
313 +/- 18
277.8 +/- 26
756 +/- 49
602 +/- 60
Fe (mg/kg)
48 +/-3
41 +/-4
76 +/- 8
85 +/- 6
K+ (mg/kg)
8169 +/- 458
10,541 +/- 992
13,937 +/-1163
12,739 +/-1069
Ozturk K, Sagdic O, Hayta M, et al. Alteration in alpha-tocopherol, some minerals,
and fatty acid contents of wheat through sprouting. Chemistry of Natural
Compounds. Jan 2012;47(6): 876-879.
Dairy Issues?
• Lactose
Clip Art
– Intolerance……take lactaid or supplement with Ca + D
– Tolerance
• IgE-Based Allergy…….supplement with Ca + D
– Whey
– Casein
• Non-IgE Sensitivity ……..supplement with Ca + D
– Inflammatory mediators released from WBCs
• Casein Variant and Human Health?
– CVD/IHD, DM type 1
Dairy Issues?
http://a2milk.com.au/beta-casein/beta-casein-milk-protein/
http://a2milk.com.au/beta-casein/beta-casein-milk-protein/
A2-Beta-Casein
A2 beta casein = original beta casein gene.
*Milk from cattle thousands of years ago, before largescale domestication = A2 Milk.
A1 beta casein = from genetic mutation
*Digestion of A1 beta casein can result in the production
of bioactive beta casomorphin-7 (BCM-7).
BCM-7: oxidizes LDL
-Trials have shown A1 beta casein elicits
biological effects in animals which lead to heart disease.
Clip Art
A1 Beta Casein BCM-7
Epidemiological studies in several developed
countries show strong correlations between A1
beta casein and the following:
-incidence of type 1 diabetes mellitus
-heart disease mortality rates (oxidizes LDL)
-aggravation of neurological disorders
(autism and schizophrenia)
Clip Art
A1 Beta Casein/BCM-7
References
Bell SJ, Gronchoski GT, Clarke AJ. Health implication of milk contaiing beta-casein with the A2 genetic variant. Crit Rev Food Sci
Nutr. 2006;46(1):93-100.
Birgisdottir, B. E., Hill, J. P., Harris, D. P., Thorsdotter. 2002. Variation in consumption of cow milk proteins and lower incidence of
Type 1 diabetes in Iceland vs the other 4 Nordic countries. Diab.Nutr. Metab. 15:240-245.
Clemens RA. Milk A1 and A2 peptides and diabetes. Nestle Nutr Workshop Ser Pediatr Program. 2011;67:187-95.
Kaminski S, Cieslinska A, Kostyra E. Polymorphism of bovine beta-casein and its potential effect on human health. J Appl
Genet. 2007;48(3):189-98.
Laugessen, M. & Elliot, 2003. Ischaemic heart disease, Type 1 diabetes, and cow milk A1 β-casein. New Zealand Medical Journal
116(1168).
Monetini L, Cavallo MG, Manfrini S, et al; IMDIAB Group. 2002. Antibodies to bovine beta-casein in diabetes and other
autoimmune diseases. Horm Metab Res. 34(8):455-9.
PCT/WO 02/19832/A1; Milk containing beta casein with proline at position 67 does not aggravate neurological disorders;
Crawford RA, Boland MJ, Norris CS, Hill JP, Fenwick RM.
Sun Z, Cade JR, Fregly MJ, Privette RM (1999); Beta casomorphin induces Fos-like immunoreactivity in discrete brain regions
relevant to schizophrenia and autism; Autism 1999: vol. 3(1) 67-823.
Sun Z and Cade JR (1999); A peptide found in schizophrenia and autism causes behavioural changes in rats; Autism 1999: Vol 3(1)
85-95.
Tailford KA, Berry CL, Thomas AC, Campbell JH. 2003 A casein variant in cow's milk is atherogenic. Atherosclerosis. 170(1):13-9.
Paleo Calcium + Vitamin D Sources
• Sardines, Trout, Salmon, Perch
• Swiss Chard, Kale, Broccoli, Turnips/Collard Greens, Okra,
Bok Choy, Spinach, Seaweed, etc
• Mushrooms
• Egg Yolks
• Almonds, Sesame Seeds
• Beef liver
• Dried Figs, Oranges
• Sunshine!!!
http://www.webmd.com/food-recipes/guide/calcium-vitamin-d-foods
Clip Art
ACID/BASE BALANCE
- ↑ fruit/non-starchy veg  Basic  Maintenance of Stored Calcium
- ↑ grain/starch/sugar/salt  Acidic  Calcium Depletion
Clip Art
Application to Our Patients?
Clip Art
• GI Complaints: May serve as a place to start for
elimination diets.
• Epilepsy: Low-carb Ketogenic diets decrease
frequency of seizures.
• Obesity/Overweight: Weight loss
• Chronic Disease Improvement
• Compliance may be difficult even with most
motivated individuals.
Clip Art
– Not the most sustainable, ecological, or economical
diet.
Clip Art
Basic Paleo Principles are in
compliance with a healthy lifestyle
•
•
•
•
•
Eat whole foods.
Avoid processed, refined foods.
Eat for proper digestive functioning.
Eat for good blood sugar regulation.
Individualize to meet health needs and goals.
– Consider Probiotics and Vitamin D supplements
– Vegetarian: add back sprouted seeds
– Add back A2 beta casein Dairy
– Adjust Carbs to Meet Physical Activity Demands
Questions?
Clip Art
Shannon Johnson, RD, LD, CLT
sjohns80@fairview.org
612-273-4991
Thank You!