A paleo diet emphasizes meat, fish, vegetables, fruit, and nuts and avoids processed foods, grains, and dairy. It may help with weight loss but is restrictive.
What it is
A paleo diet follows a hunter-gatherer pattern: meat, fish, eggs, vegetables, fruits, nuts. It excludes grains, dairy, legumes and processed foods.
Possible benefits
- Weight loss in short-term trials.
- Better blood sugar and blood pressure in small studies.
Downsides
- Low in calcium and fiber (whole grains).
- Costly.
- Hard to follow.
Ranking
US News ranks it in the middle among diets.
Check
Talk to a dietitian.
What the diet includes
The paleo diet emphasizes meat, fish, eggs, vegetables, fruits, nuts and seeds, and excludes grains, legumes, dairy, refined sugar and processed foods. It was popularized by Loren Cordain’s 2002 book The Paleo Diet.
- Small trials show improvements in weight, waist size, triglycerides and blood pressure. A 2015 meta-analysis in the European Journal of Clinical Nutrition of four randomized trials with 159 participants found improvements in waist circumference, blood pressure and HDL.
- A 2007 study in Cardiovascular Diabetology found paleo diet improved glucose tolerance more than a Mediterranean-style diet in people with heart disease.
- Evidence on long-term safety is limited.
Downsides
Cutting dairy and grains can reduce calcium, vitamin D and fiber intake unless replaced. Costs can be higher. U.S. News and World Report diet rankings have rated paleo lower than Mediterranean and DASH. People with kidney disease or high cholesterol should consult a clinician before high-meat diets. Sustainable long-term adherence is a challenge for many.
What the diet includes
The paleo diet centers on meat, fish, eggs, vegetables, fruit, nuts and seeds, and excludes grains, legumes, dairy, refined sugar and processed foods. Small trials report improved weight, waist size and triglycerides over a few months compared with some standard diets. A 2015 meta analysis in the European Journal of Clinical Nutrition found modest improvements in metabolic measures, but trials were small and short.
Downsides
Cutting out grains, legumes and dairy removes foods linked to lower heart disease and diabetes risk in large studies, and can reduce calcium and fiber intake. A 2023 US News ranking placed paleo lower than Mediterranean and DASH diets. The diet can be costly. People with kidney disease or high cholesterol should consult a clinician before adopting high meat diets.
Origins and research
The paleo diet was popularized by Loren Cordain in 2002, based on foods thought available before agriculture about 10,000 years ago. A 2014 randomized trial in the European Journal of Clinical Nutrition found a paleo diet improved glycemic control more than a standard diabetes diet in a small group of 13 people over 3 months. Larger trials are missing.
Nutrient gaps and cost
Eliminating dairy lowers calcium intake, which needs 1,000 mg per day for adults, so leafy greens, canned fish with bones and fortified foods become important. A paleo shopping basket costs about 10 percent more than standard diets in a 2017 study. Whole grain and legume intake is tied with lower mortality in large cohort studies.
Based on data from the European Journal of Clinical Nutrition and the Harvard T.H. Chan School of Public Health
