The Paleo/primal diet is a gut-healing diet that is used to heal symptoms of gastrointestinal, autoimmune, neurological, metabolic and mood disorders as well as most chronic health conditions.

The Paleo diet removes all processed foods, as wells as all grains, dairy, legumes and most starchy foods except for starchy vegetables. Most sweeteners except for honey and date paste are removed. Eliminating these foods allows the gut and the body to heal because these foods feed pathogenic bacteria, yeast and parasites that may live in the gut of an unhealthy person. Sweet potatoes and yams are allowed.

The point of the Paleo/primal diet is to mimic what our ancestors ate before agriculture and its follow-on foods of grains and dairy were introduced. Thus, it is often also called the “caveman” diet. The term “Paleo” refers to the Paleolithic era in which cavemen lived.

Paleo/primal foods have significantly higher amounts of vitamins, minerals, antioxidants, polyphenols and other phytonutrients than processed foods because these are foods that were raised/grown as they naturally do. There is a focus on organic, grass-fed and wild-caught foods, which means that foods are grown without pesticides, antibiotics or hormones.

History of the Paleo/Primal Diet

Loren Cordain, PhD, author of dozens of peer-reviewed medical papers that documented the harms of the Western, proccessed-foods diet and the benefits of removing processed foods from the diet, popularized the Paleo diet concept with his 1999 paper, Cereal grains: humanity’s double-edged sword. His paper furthered the concepts put forth in Walter Voegtlin’s 1975 book The Stone Age Diet: Based on In-depth Studies of Human Ecology and the Diet of Man as well as Boyd Eaton’s Paleolithic nutrition. A consideration of its nature and current implications 1985 article in the New England Journal of Medicine.

In 2002, Dr. Cordain published and then revised in 2010 The Paleo Diet Revised: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat. Mark Sisson, a tri-athlete and Ironman competitor, started the popular Paleo website Mark’s Daily Apple in 2006, then published his version of the Paleo diet, The Primal Blueprint, in 2009. In 2015, he co-founded the Paleo-food company, Primal Kitchen.

Beginning in 2007, peer-reviewed research articles began documenting the positive effects of the Paleo diet in reversing chronic health conditions such as diabetes, cardiovascular risk factors and gastrointestinal disorders.

In 2011, Terry Wahls MD enlarged the scope of chronic conditions helped by the Paleo diet by delivering a TEDx talk entitled Minding Your Mitochondria that detailed her inspiring story of how her nutrition-dense version of the Paleo diet combined with lifestyle changes reversed her symptoms of Multiple Sclerosis. Prior to her changes, she was resigned to using a reclining wheelchair for mobility; within 18 months afterwards, she was out of her wheelchair, riding a bike for miles at a time and riding horses.

Beginning in 2009, Dr. Wahls published over 20 peer-reviewed research studies that documented improvements in other patients with MS who followed her version of the Paleo diet, known as the Wahls protocol.

What’s Avoided in the Paleo/Primal Diet

This diet avoids:

    • Refined carbohydrates
    • Processed foods
    • Vegetable oils
    • Trans fats
    • Grains (including rice and corn)
    • Preservatives
    • Pseudo-grains (such as quinoa and buckwheat)
    • Dairy
    • Potatoes
    • Sugar except for raw honey and date paste
    • Artificial and natural colors and flavors
    • Chemical additives

    In the AutoImmune Paleo (AIP) version of Paleo, all of the above are eliminated as well as:

    • Eggs
    • Nightshades
    • Alcohol
    • Nuts and seeds

    These additional foods are banned from AIP because they can often cause hidden food sensitivities, which then create inflammation.

    What’s Allowed in the Paleo/Primal Diet

      • Animal fats
      • Coconut oil
      • Avocado oil
      • Olive oil
      • Palm oil
      • Sesame oil
      • Walnut oil
      • Grass-fed meats
      • Wild-caught seafood
      • Pasture-raised organic eggs and foul
      • Coconut milk
      • Fermented foods
      • All vegetables
      • All fruit
      • All nuts and seeds
      • Sweet potatoes and yams
      • Baked goods made with almond or coconut flours
      • Single-ingredient spices and herbs
      • Apple cider vinegar
      • Coconut vinegar

      To allow for better digestion and toleration, fruits and vegetables should be well cooked, but this isn’t a requirement. In addition, nuts and seeds are best digested if soaked and sprouted before consumption.

        Implementation Tips for the Paleo/Primal Diet

        The following tips can add to your success in switching to a Paleo/primal diet from a Standard American Diet (SAD):

        • Add in more protein, fat and fiber to each meal and snack to lessen cravings for sweets and carbohydrates
        • Add avocado slices to a dish to increase the fat content
        • Try substituting foods such as spiralized zucchini and cauliflower rice for grain-based noodles and rice
        • Serve sweet potatoes or starchy vegetables such as winter squash instead of typical grain-based foods
        • Find recipes for Paleo/primal “bready” things like pancakes, muffins, cakes and breads. Most of these recipes use a nut flour or coconut flour.
        • Try new Paleo/primal recipes on your family to find foods that they like and will eat before you completely pull the plug on the processed foods you’ve previously eaten

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        Sources & References

        Abbott, R.D., et al. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus. 2019 Apr 27;11(4):e4556.

        Bisht, B., et al. Multimodal intervention improves fatigue and quality of life in subjects with progressive multiple sclerosis: a pilot study. Degener Neurol Neuromuscul Dis. 2015;5:19-35.

        Bourre, J.M. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006 Sep-Oct;10(5):377-85.

        Bourre, J.M. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 2 : macronutrients. J Nutr Health Aging. 2006 Sep-Oct;10(5):386-99.

        Chenard, C.A., et al. Nutrient Composition Comparison between a Modified Paleolithic Diet for Multiple Sclerosis and the Recommended Healthy U.S.-Style Eating Pattern. Nutrients. 2019 Mar 1;11(3):537.

        Clemens, Z., et al. Childhood absence epilepsy successfully treated with the paleolithic ketogenic diet. Neurol Ther. 2013 Sep 21;2(1-2):71-6.

        Cordian, L. Cereal grains: humanity’s double-edged sword. World Rev Nutr Diet. 1999;84:19-73.

        Eaton, S.B., et al. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med. 1985 Jan 31;312(5):283-9.

        Haskey, N., et al. An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease. Nutrients. 2017 Mar 10;9(3):259.

        Hsieh, M., et al. Nutritional and dietary strategy in the clinical care of inflammatory bowel disease. J Formos Med Assoc. 2020 Dec;119(12):1742-1749.

        Irish, A.K., et al. Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study. Degener Neurol Neuromuscul Dis. 2017 Jan 4;7:1-18.

        Konijeti, G.G., et al. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017 Nov; 23(11): 2054–2060.

        Lavie, M., et al. Paleolithic diet during pregnancy-A potential beneficial effect on metabolic indices and birth weight. Eur J Obstet Gynecol Reprod Biol. 2019 Nov;242:7-11.

        Masharani, U., et al. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Eur J Clin Nutr. 2015 Aug;69(8):944-8.

        Ogle, K.A., et al. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up. Ann Allergy. 1980 May;44(5):273.

        Otten, J., et al. Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes. Diabetes Metab Res Rev. 2017 Jan;33(1):10.1002/dmrr.2828.

        Sohouli, M.H., et al. The effect of paleolithic diet on glucose metabolism and lipid profile among patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2022;62(17):4551-4562.

        Tóth, C., et al. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int J Case Rep Images. 2014;5(10):699–703.

        Wahls, T.L. Dietary Approaches to Treating Multiple Sclerosis-Related Symptoms. Phys Med Rehabil Clin N Am. 2022 Aug;33(3):605-620.

        Wahls, T.L., et al. Dietary approaches to treat MS-related fatigue: comparing the modified Paleolithic (Wahls Elimination) and low saturated fat (Swank) diets on perceived fatigue in persons with relapsing-remitting multiple sclerosis: study protocol for a randomized controlled trial.Trials. 2018 Jun 4;19(1):309.

        Whalen, K.A., et al. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with All-Cause and Cause-Specific Mortality in Adults. J Nutr. 2017 Apr;147(4):612-620.

        Resources
        Articles

        Thomas, Liji. Paleo Diet History. News Medical.

        Books

        Ballantyne, Sarah. Paleo Approach: Reverse Autoimmune Disease Heal Your Body. Victory Belt Publishing, 2014.

        Cordain, Loren. The Paleo Diet Revised: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat. Harvest, 2010.

        Long, R.W. Push the Rock: Second Chances on the Road to Kilimanjaro. First Summit Project, 2015.

        Sisson, Mark. The Primal Blueprint: Reprogram Your Genes for Effortless Weight Loss, Vibrant Health, and Boundless Energy. Primal Nutrition, Inc., 2019.

        Tam, Michelle, et al. Nom Nom Paleo: Food for Humans (Volume 1). Andrews McMeel Publishing, 2013.

        Voegtlin, Walter. The Stone Age Diet: Based on In-depth Studies of Human Ecology and the Diet of Man. Vantage Press, 1975.

        Wahls, Terry. The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles. Avery, 2020.

        Wahls, Terry. The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. Avery, 2017.

        Walker, Danielle. Danielle Walker’s Against All Grain: Meals Made Simple: Gluten-Free, Dairy-Free, and Paleo Recipes to Make Anytime. Victory Belt Publishing, 2014.

        Wolf, Robb. The Paleo Solution: The Original Human Diet. Victory Belt Publishing, 2010.

        Videos
        Websites

        Ancestral Health Society

        Mark’s Daily Apple

        Terry Wahls MD

        The Paleo Diet

        The Weston A. Price Foundation