Popular Paleo Diet still has its skeptics

Dr. Jorge Rabaza, chief of surgery at South Miami Hospital, takes a lunch break and finds options, roast chicken and broccoli, that meet his Paleo Diet requirements in the hospital's cafeteria on Wednesday, Sept. 11, 2013. Rabaza has been on the Paleo diet for about three years and has lost about 40 pounds.
Dr. Jorge Rabaza, chief of surgery at South Miami Hospital, takes a lunch break and finds options, roast chicken and broccoli, that meet his Paleo Diet requirements in the hospital's cafeteria on Wednesday, Sept. 11, 2013. Rabaza has been on the Paleo diet for about three years and has lost about 40 pounds.
Allison Diaz / For the Miami Herald

Special to The Miami Herald

Just about everybody, including daytime talk show hosts and fitness bloggers, are touting The Paleo Diet as a way to address health issues, including digestive problems and asthma.

But some in the science and medical fields aren’t convinced.

A recent U.S. News and World Report ranking of 29 diets that are popular in the U.S. today placed The Paleo Diet at No. 28.

A renewed interest in the diet of cavemen resulted when gastroenterologist Walter Voegtlin wrote the Stone Age Diet in 1975. He based his book on his work with patients suffering colitis, Crohn’s disease, irritable bowel syndrome and indigestion.

In the early 2000s, Loren Cordain, a professor in the Department of Health and Exercise Science at Colorado State University, also was studying the human diet during the Stone Age. He discovered that the chronic diseases, which he says afflict 50 to 65 percent of the Westernized adult population, were rare or nonexistent in hunter-gatherer societies.

And he hypothesized that “when hunter/gatherer societies transitioned to an agricultural grain-based diet, their general health deteriorated.”

In 2001, he authored The Paleo Diet (John Wiley & Sons) that claims we can turn back the clock on disease and become more healthy by eating and exercising as they did 2 ½ million to 10,000 years ago; the time before crops and animals were domesticated.

The diet also postulates that genetically we are similar to our ancient ancestors. Therefore it makes sense to eat the foods that kept them healthy and that kept the species alive before modern medicine.

“That’s pretty much the basis of The Paleo Diet,” says Sheah Rarback, a registered dietitian at the University of Miami Miller School of Medicine and a nutrition columnist for the Miami Herald.

Much like the popular Atkins diet, The Paleo Diet is based on simply prepared lean grass-fed meats, chicken, wild-caught fish and free-range eggs prepared with healthy oils such as avocado, olive and coconut.

It encourages eating high-fiber, low-glycemic fresh vegetables and fruits while avoiding added sugar. It also prohibits eating potatoes and all grains. The theory goes that wild grains are usually small, difficult to harvest and virtually indigestible without grinding and cooking. Thus Paleolithic people wouldn’t have eaten many of them.

Raw nuts and seeds are fine on this diet, but legumes such as peanuts and soybeans are prohibited because they are domesticated crops. Also dairy foods including milk, cheese and yogurt aren’t allowed. After all, hunter/gatherers would not have had access to milk once they were weaned from the breast, as sheep, goats and cows weren’t domesticated until 6,000 years ago, according to research posted on The Paleo Diet website (

Dr. Jorge Rabaza is the chief of surgery at South Miami Hospital and a bariatric surgeon who helps obese people control their weight. But three years ago, when excess pounds had crept onto his 5-foot-9-inch frame, he turned to The Paleo Diet to control his own growing gut.

“I adopted The Paleo Diet because it made sense to me and now I find it works,” says Rabaza, 53, who lost 40 pounds and is back to the weight he was in high school.

Mark Bluh, 49, started following The Paleo Diet on June 13, 2012, when he weighed close to 330 pounds. He’d played football in college and had more than a half dozen knee surgeries. With the extra weight on his 6-foot-4-inch frame, his knee was hurting again and he realized he had to lose weight.

He learned about the program at a Crossfit gym, which promotes the diet. In one year he lost 200 pounds.

“It’s totally changed my life. That’s why I don’t mind following a diet like this because it lets me pay it forward,” says Bluh, an insurance agent who lives in Palmetto Bay.

Many people initially turn to The Paleo Diet to lose weight. And because it cuts out entire food groups while promoting lean proteins, fruits and veggies, it can offer results. And for those suffering digestive problems, it can have other benefits.

When Bluh turned to The Paleo Diet, he was not only overweight but, “I would eat antacids like candy, had heartburn all the time, suffered bloating and was just generally uncomfortable,” he says.

Now he’s symptom free. “I don’t have indigestion issues. I don’t have heartburn and I’m about as regular as they come,” he says.

For people with digestive issues such as wheat allergies, this diet may be beneficial. People with this allergy find that if they eat the protein in wheat called gluten, their bodies may react with a rash, hives, vomiting, diarrhea and even anaphylactic shock.

And those with the genetic autoimmune disorder called celiac disease also benefit from eschewing wheat and gluten. Their bodies produce antibodies that attack and destroy the small fluffy cells called villi that line their small intestines. These villi are responsible for nutrient absorption so if they malfunction, it’s easy to become malnourished.

The Paleo Diet may also be helpful for those who have dairy allergies or lactose intolerance. Because this diet eliminates all dairy-based foods, it can help them be free of symptoms such as nausea, cramps and bloating.

Of course fresh fruits and veggies are full of soluble fiber that can help promote digestive health. And their high omega-3 fat content can fight most inflammatory diseases, many of which are manifested in the digestive tract, says Rabaza.

But there are some concerns.

“I don’t understand why anyone who wants to eat a healthy diet would want to look back to a time when people lived very short life spans, had to work very hard to feed themselves and didn’t have many of the nutritious foods we have available today,” says registered dietitian Leslie Burman, who is “not a fan of this diet.”

Because it eliminates many foods and food groups, the diet can make it challenging to get all the nutrients your body needs.

For example, people with celiac disease who can’t eat wheat, barley or rye may be able to consume grains such as rice, millet and quinoa without having an autoimmune reaction. And they can reap the vitamins and minerals they contain.

But on The Paleo Diet, all grains are discouraged, says Burman who sees patients at the Zachariah Family Wellness Pavilion at Holy Cross Hospital in Fort Lauderdale.

And people who are lactose intolerant can often eat a small amount of dairy foods without discomfort. But with The Paleo Diet, all dairy products are taken off the table along with the beneficial bacteria, calcium and vitamin D they contain.

Although Bluh and Rabaza have found following this diet easy, Rarback, the dietitian at UM, is concerned that by eliminating whole food groups, most people will not be able to stick with the regimen for long.

“I don’t eat a lot of sugar or processed foods,” says Rarback, “But I enjoy the taste and health benefits of yogurt and would need a lot more evidence to persuade me to give it up.”

She adds that there aren’t any long-term scientific studies demonstrating the value, safety and efficacy of The Paleo Diet. “All the evidence we have is word of mouth, anecdotal and empirical,” she says.

That’s why she suggests that if you have any changes in your digestive system or develop chronic health problems, you should consult your doctor. You need to rule out causes that might require treatment other than eating like a caveman.

“Although The Paleo Diet may benefit some by taking processed foods out of the diet, it also removes nutrients that contribute to better health and wellness,” says Burman.

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