The Paleo Diet

Chapter 4

What this means is that protein boosts your metabolism and causes you to lose weight protein boosts your metabolism and causes you to lose weight more rapidly than the same caloric amounts of fat or carbohydrates. A study carried out at the Dunn Clinical Nutrition Center in Cambridge, England, by Dr. M. J. Dauncey and colleagues showed that during a twenty-four-hour period, a high-protein diet increased total energy expenditures by 12 percent (220 calories) compared to a calorically matched high-carbohydrate diet. more rapidly than the same caloric amounts of fat or carbohydrates. A study carried out at the Dunn Clinical Nutrition Center in Cambridge, England, by Dr. M. J. Dauncey and colleagues showed that during a twenty-four-hour period, a high-protein diet increased total energy expenditures by 12 percent (220 calories) compared to a calorically matched high-carbohydrate diet.

Over six months-with absolutely no increase in exercise or decrease in caloric intake-a high-protein diet could cause you to lose 10 10 to to 15 15 pounds. Over those same six months-with increased exercise and a somewhat decreased caloric intake-a high-protein diet could cause you to lose pounds. Over those same six months-with increased exercise and a somewhat decreased caloric intake-a high-protein diet could cause you to lose 30 30 to to 75 75 pounds! pounds!

Think about it. You don"t have to cut calories one bit. You can lose 20 to 30 pounds in a year with utterly no change in the quant.i.ty of food you eat or even any change in your exercise habits. Or a lot more than that if you exercise more or eat less. That"s just what happened with Dean.

Losing 75 Pounds in Six Months: Dean"s Story In April 1999, Dateline NBC Dateline NBC ran a feature story of my research into Paleo diets and interviewed Dean Stankovic, age thirty-two. Dean"s weight had fluctuated wildly on his 6-foot, 3-inch frame since his graduation from high school, at one point reaching a high of 280 pounds. Before he adopted the Paleo Diet, Dean had tried dozens of diets. Although Dean was very determined to lose weight, he just couldn"t seem to stick to traditional low-calorie diets like the one created by Weight Watchers. They made him feel hungry all the time. Worse, on all of these diets, his weight dropped at first-but the longer he stayed with them, the slower the weight loss became. This is because the body"s metabolic rate slows down to conserve body stores during periods of starvation-which is exactly what low-calorie diets are. Eventually, after a few months of starvation with these low-calorie diets, no matter how strong his willpower and resolve, Dean always went back to his normal way of eating-basically, the standard American diet. ran a feature story of my research into Paleo diets and interviewed Dean Stankovic, age thirty-two. Dean"s weight had fluctuated wildly on his 6-foot, 3-inch frame since his graduation from high school, at one point reaching a high of 280 pounds. Before he adopted the Paleo Diet, Dean had tried dozens of diets. Although Dean was very determined to lose weight, he just couldn"t seem to stick to traditional low-calorie diets like the one created by Weight Watchers. They made him feel hungry all the time. Worse, on all of these diets, his weight dropped at first-but the longer he stayed with them, the slower the weight loss became. This is because the body"s metabolic rate slows down to conserve body stores during periods of starvation-which is exactly what low-calorie diets are. Eventually, after a few months of starvation with these low-calorie diets, no matter how strong his willpower and resolve, Dean always went back to his normal way of eating-basically, the standard American diet.

Dean had tried the high-fat, low-carbohydrate diets advocated by Dr. Atkins and others. He lost weight with these diets but complained of a low energy level, lethargy, and constant fatigue. He also believed that all of those fatty, salty, bacon-and-egg breakfasts, greasy sausages and salami, and fatty cheeses just couldn"t be good for his body. And these diets became boring. It was fun at first to trade in one evil (sweets and starches) for another (fats). But after a while he craved apples, peaches, and strawberries-any fresh fruit. Dean just couldn"t imagine going through the rest of his life eating only tiny amounts of fruits and veggies. This was not a lifelong way of eating! Life was not worth living when all he had to look forward to was fatty meats and cheeses, cream, and b.u.t.ter. Dean"s mind and body rebelled, and he found himself once again down in the dumps-back to his old diet and back to his old weight.



In the fall of 1998, Dean met a young woman who had been eating in the Paleo manner for a number of years. She gave Dean some of my writings and dietary recommendations. After a few false starts, Dean began the Paleo Diet in earnest and started to lose weight steadily. By the spring of 1999, after six months on the Paleo Diet, he had lost 70 pounds and was down to a svelte 185 pounds. Dean"s opening remark on Dateline NBC Dateline NBC-"It is a very satisfying diet; I don"t feel hungry"-is a characteristic comment, echoed by almost everyone who gives this way of eating a try. Two years later, Dean has kept the weight off and sums up his feelings this way: "I consider it more than just a diet; it"s more of a lifestyle. I think it is one of the greatest diets ever created. I have no plans to go back to my old ways."

Protein Satisfies Your Appet.i.te Protein"s high DIT is not the only reason you lose weight when you start eating more lean animal protein. Protein also affects your appet.i.te. Protein satisfies hunger far more effectively than either carbohydrate or fat. Dr. Marisa Porrini"s research group at the University of Milan in Italy has found that high-protein meals are much more effective than high-fat meals in satisfying the appet.i.te.

High-protein meats also do a much better job of reducing hunger between meals between meals than do high-carbohydrate vegetarian meals. Dr. Britta Barkeling and colleagues at the Karolinska Hospital in Stockholm served twenty healthy women lunches of identical caloric value; the women ate either a high-protein meat ca.s.serole or a high-carbohydrate vegetarian ca.s.serole. The researchers then measured how much food the women ate at dinner. The women who had eaten the meat ca.s.serole ate 12 percent fewer calories during their evening meal. As this study ill.u.s.trates, protein"s powerful capacity to satisfy hunger not only influences how much you eat at the very next meal but also how much you"ll eat all day long. than do high-carbohydrate vegetarian meals. Dr. Britta Barkeling and colleagues at the Karolinska Hospital in Stockholm served twenty healthy women lunches of identical caloric value; the women ate either a high-protein meat ca.s.serole or a high-carbohydrate vegetarian ca.s.serole. The researchers then measured how much food the women ate at dinner. The women who had eaten the meat ca.s.serole ate 12 percent fewer calories during their evening meal. As this study ill.u.s.trates, protein"s powerful capacity to satisfy hunger not only influences how much you eat at the very next meal but also how much you"ll eat all day long.

At the Rowett Research Inst.i.tute in Great Britain, Dr. R. James Stubbs and colleagues fed six men a high-protein, high-fat, or high-carbohydrate meal at breakfast and then monitored their feeling of hunger for the next twenty-four hours. The high-protein breakfast suppressed hunger much more effectively than the other two breakfast meals did-even more than the high-fat breakfast. These experiments and many others have convincingly shown that if you want to feel less hungry and stay less hungry, lean animal protein is your best line of attack.

Theoretically, any leftover calories-whether they"re from protein, carbohydrates, or fats-would count as a calorie "surplus" and result in weight gain. In reality, the body doesn"t work that way. It is very difficult and inefficient for the body"s metabolic machinery to store excess protein calories as fat. The surplus almost always comes from extra fats or carbohydrates-and these are the foods that most frequently make you fat.

It is impossible to overeat pure protein. In fact, you couldn"t gain weight just on lean, low-fat protein if your life depended on it. The body has clear limits, determined by the liver"s inability to handle excess dietary nitrogen (released when the body breaks down protein). For most people, this limit is about 35 percent of your normal daily caloric intake. If you exceed this limit for a prolonged stretch of time, your body will protest-with nausea, diarrhea, abrupt weight loss, and other symptoms of protein toxicity.

But remember, protein is your best ally in waging the battle of the bulge-and when it is accompanied by plenty of fruits and veggies and good fats and oils, you will never have to worry about getting too much protein. Now let"s take a look at the next major reason why the Paleo Diet causes you to lose weight without nagging hunger.

Promoting Weight Loss by Improving Your Insulin Sensitivity The Paleo Diet promotes weight loss not only because of its high protein level that simultaneously revs up your metabolism and reduces appet.i.te, but also because it improves your insulin metabolism.

Insulin resistance is a serious problem, and most people who are overweight have it. In insulin resistance, the pancreas (the gland that makes insulin) must make extra insulin to clear blood sugar-glucose-from the bloodstream. There"s a bit of a "chicken and egg" argument as to which event happens first. Does being overweight cause insulin resistance or vice versa? Scientists aren"t entirely sure. However, once insulin resistance starts, it prompts a domino effect of metabolic changes that encourage weight gain. The body frequently stores more fat, for one thing. For another, excessive insulin in the bloodstream can cause low blood sugar (a condition called "hypoglycemia"). The body"s response to low blood sugar is: "Hey-we"re in trouble. We"d better eat something fast!" Low blood sugar stimulates the appet.i.te, and this can be deceptive: it causes you to feel hungry even if you"ve just eaten.

The good news is that what you choose to eat-protein, fats, or carbohydrates-can influence the progression of insulin resistance. Dr. Gerald Reaven"s research at Stanford University has shown that low-fat, high-carbohydrate foods hinder insulin metabolism. But high-protein diets are known to improve insulin metabolism. high-protein diets are known to improve insulin metabolism. Dr. P. M. Piatti and colleagues at the University of Milan put twenty-five overweight women on one of two diets. The first contained 45 percent protein, 35 percent carbohydrates, and 20 percent fat. The second contained 60 percent carbohydrates, 20 percent protein, and 20 percent fat. After twenty-one days the women on the high-protein diet had significantly improved insulin metabolism, but those on the high-carbohydrate diet actually got worse. Dr. P. M. Piatti and colleagues at the University of Milan put twenty-five overweight women on one of two diets. The first contained 45 percent protein, 35 percent carbohydrates, and 20 percent fat. The second contained 60 percent carbohydrates, 20 percent protein, and 20 percent fat. After twenty-one days the women on the high-protein diet had significantly improved insulin metabolism, but those on the high-carbohydrate diet actually got worse.

With all these benefits, it seems obvious that lean protein should be the starting point for all weight-loss diets. Prior to 2002, only three clinical trials of high-protein diets had been conducted. All three investigations found high-protein diets to be excellent-far better than low-fat, high-carbohydrate diets-at promoting weight loss.

Dr. Arne Astrup"s nutritional research group at the Royal Veterinary and Agricultural University in Copenhagen, Denmark, studied weight loss in sixty-five people placed on either high-protein or high-carbohydrate, reduced-calorie diets. After six months, those in the high-protein group had lost an average of 19.6 pounds-and 35 percent of the partic.i.p.ants in this group had lost more than 22 pounds. The people in the high-carbohydrate group, however, lost only an average of 11.2 pounds; only 9 percent of the people in this group lost 22 pounds.

Dr. Hwalla Baba and colleagues at the American University of Beirut demonstrated almost identical results when they put thirteen overweight men on high- and low-protein, reduced-calorie diets. After only a month the average weight loss for men on the high-protein diet was 18.3 pounds compared to only 13.2 pounds for the high-carbohydrate group.

Dr. Donald Layman, a professor of nutrition at the University of Illinois, studied twenty-four overweight women who for ten weeks were on 1,700-calorie-a-day diets. Half of the women followed the current USDA Food Pyramid guidelines recommending a diet of 55 percent carbohydrate, 15 percent protein (68 grams per day), and 30 percent fat. The other half had a diet of 40 percent carbohydrate, 30 percent protein (125 grams a day), and 30 percent fat. The average weight loss for both groups was about 16 pounds, but the high-protein group lost 12.3 pounds of body fat and just 1.7 pounds of muscle compared to 10.4 pounds of body fat and 3 pounds of muscle for the Food Pyramid group. Interestingly, the study also found that women on the higher-protein diet had higher levels of thyroid hormone, which indicates that they had a faster metabolic rate. The higher-protein diet also resulted in a noticeable drop in triglyceride levels and a slight increase in the good HDL cholesterol.

In the eight years since I wrote the first edition of this book, numerous human clinical trials have conclusively demonstrated the superiority of high-protein diets in producing weight loss and benefiting overall health.

What You Can Expect to Lose on the Paleo Diet When you start the Paleo Diet, you"ll probably realize-perhaps with a shock-just how much of your diet has been built around cereal grains, legumes, dairy products, and processed foods. Even most vegetarians must eat large amounts of grains and legumes to make their plant-based diets work, because it"s very difficult to get enough calories just from eating fruits and vegetables. Except for the 2,000 or fewer hunter-gatherers still remaining on the planet, none of the world"s people obtain their daily sustenance just from fruits, vegetables, lean meats, and seafood. When you start the Paleo Diet, you may choose to count yourself among the dietary elite-knowing that about 6 billion people on the planet aren"t eating this way. And yet just 10,000 years ago-a mere drop in the bucket of geological time-there wasn"t a single person who did not not follow the Paleo Diet. follow the Paleo Diet.

Everything I"m telling you about how the Paleo Diet will affect your body weight, health, and well-being is based on scientifically validated information that has been published in high-quality, peer-reviewed scientific and medical journals.

If you"re overweight, the Paleo Diet will normalize your weight. This means that you will steadily lose pounds, as long as you continue to follow the diet, until your weight approaches its ideal. Most people experience rapid weight loss within the first three to five days. This is mainly water loss, and it stabilizes fairly quickly. After that, how much weight you lose will depend on two things-how overweight you are to begin with and how many total "deficit" calories you acc.u.mulate. After the initial water loss, it takes a deficit of 3,500 calories to lose a pound of fat. It is not unusual for people who are obese (medically, this means people who have a body ma.s.s index (BMI) of greater than 30) to lose between 10 and 15 pounds each month.

Sharing Success Stories Many people, in many countries, have adopted Paleo Diets to improve their health and to lose weight. You can read about their stories and triumphs at my Web address: www.thepaleodiet.com/success_stories/. You may also want to visit my blog ( where Paleo dieters share experiences, offer support, and talk to one another about daily challenges, dietary issues, and health issues concerning the Paleo Diet lifestyle.

Losing 45 Pounds and Healing Crohn"s Disease: Sally"s Story Sally is a manager for a large telecommunications company in Illinois. Her reasons for adopting the diet were primarily health-related. However, she also benefited from the diet"s remarkable ability to normalize excess body weight.

In the fall of 1986, I became severely ill. It started with several months of unshakable diarrhea, followed by gut-wrenching pain. It became so bad that I could not keep any food down. I lost 70 pounds in three months, and I was only thirteen years old. I barely made it through my cla.s.ses at school, and then I"d go home and sleep. My best friends no longer came over, my mother was sick with worry, and my father thought I was anorexic. When my symptoms began, doctors could not find anything wrong except for "perhaps some allergies." And when my symptoms grew worse, I was shuffled back and forth between doctors and specialists, each speculating on tumors, liver disease, and other life-threatening conditions. I was subjected to every conceivable test: MRI [magnetic resonance imaging], ultrasounds, upper/lower GIs [gastrointestinal studies], blood tests, stool samples, urine tests, X-rays, throat scopes, and others. It took almost nine months to reach the diagnosis of Crohn"s disease.I was given large doses of prednisone [a steroid drug] and scheduled to have a portion of my bowels surgically removed if I didn"t respond to the medication. Within days of [taking] the steroids, I felt much better. Within weeks I was outside mowing the lawn and eating more in a day than I had eaten previously in a month. At the time, my medications were a miracle.For most of my life I have been cycling between steroids, anti-inflammatory drugs, and immune suppressors. All of these medications alleviated the symptoms, but none treated the underlying disease. My overall health slowly deteriorated. I was severely depressed and powerless to stop my life from slowly wasting away. When questioning doctors, I was given unhelpful speculations: "Crohn"s disease is genetic; it runs in families. It may be caused by a virus or bacterium, it is not contagious, and we do not know what causes this disease." Every specialist I saw agreed that Crohn"s is not diet-related.By the time I graduated from college, I became determined to do something. I enrolled in graduate school to learn more about scientific research so that one day I might help find a cure. While in graduate school, I discovered literature about diet-related treatments for a whole range of degenerative illnesses, including Crohn"s disease. All of the diets used to treat Crohn"s disease are very similar to a Paleolithic diet. It became my turn to become responsible for my own health, and I started eating a strict Paleolithic diet. The results were amazing. Within a month I was 90 percent symptom-free. I felt like I had been reborn.I have been on the diet for almost two years now. I"ve lost 45 pounds and am near my optimal weight. I am 100 percent symptom-free of Crohn"s disease and haven"t seen a doctor in over a year. I"ve started running 4 miles a day, something that I could never have achieved before. This diet is anything but a quick fix. It takes time to heal the wounds of disease and medication. However, to anyone looking for control over their disease or their weight, I urge them to give it a try. It might just save your life as it saved mine.

Vegetarian Isn"t Better: Ann"s Story After high school graduation, Ann Woods left her home for a summer waitressing job in Alaska. She had a great time living away from her parents and partying with her friends, but the continual stream of on-the-job glazed doughnuts, burgers, and fries, along with evening treats of M&Ms and Baskin-Robbins ice cream, eventually caused her waistline to balloon. When she came back home to start college in the fall, her weight had jumped from 110 to 135 pounds. She was still not fat but was much heavier than she had ever been. After a bit of friendly razzing from her boyfriend, she managed to lose all the weight by adopting a near-vegetarian diet that emphasized grains, potatoes, lots of starch, and very little fat or meat. At the time, this seemed a prudent thing to do. After all, this type of diet was supposed to be the healthiest.

Ann also began to jog, an activity that soon blossomed into a lifetime interest in running and fitness. Her weight stabilized, and she became lean and fit. Her blood pressure and cholesterol levels were low, but after almost seven years of running, she noticed that her energy began to wane. She was continually tired and wanted nothing more than to sleep after long runs. Ann recovered from one running-related injury only to find herself injured again within weeks. Dark circles formed underneath her eyes, and she caught colds more frequently than ever. She finally discovered that she had iron-deficiency anemia caused by her "healthful" staples of oatmeal, brown rice, beans, pasta, and low-fat yogurt.

Ann discovered the Paleo dietary principles in The Complete Book of Alternative Nutrition, The Complete Book of Alternative Nutrition, which featured my research. It made a lot of sense to her, and she gave it a try. She replaced her former vegetarian staples with lean meat, chicken, and seafood at almost every meal. Fruits and veggies were no problem-she had eaten a lot of these before her switch. Within a week, Ann noticed that her energy level was stable throughout the day. She no longer had late-afternoon slumps. Her stamina increased, and she was less tired after her runs. After three months on the diet she dropped 5 additional pounds to her present weight of 106, her stomach was now totally flat, and her muscle tone and strength were better than ever. On top of this, her iron-deficiency anemia disappeared, and the dark circles underneath her eyes vanished. which featured my research. It made a lot of sense to her, and she gave it a try. She replaced her former vegetarian staples with lean meat, chicken, and seafood at almost every meal. Fruits and veggies were no problem-she had eaten a lot of these before her switch. Within a week, Ann noticed that her energy level was stable throughout the day. She no longer had late-afternoon slumps. Her stamina increased, and she was less tired after her runs. After three months on the diet she dropped 5 additional pounds to her present weight of 106, her stomach was now totally flat, and her muscle tone and strength were better than ever. On top of this, her iron-deficiency anemia disappeared, and the dark circles underneath her eyes vanished.

A Nutritionist Loses 30 Pounds: Melissa"s Story Melissa Diane Smith, a nutritionist and a health journalist based in Tucson, Arizona, is the coauthor of Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance and is the author of and is the author of Going Against the Grain: How Reducing and Avoiding Grains Can Revitalize Your Health Going Against the Grain: How Reducing and Avoiding Grains Can Revitalize Your Health. This is her story: In 1986, I began a job at a health spa and naturally emphasized foods in my diet that I thought were healthy-bagels, m.u.f.fins, chicken-pasta dishes, chicken-rice dishes, and turkey sandwiches. This type of diet was disastrous for me. During the next year and a half, I gained 30 pounds and developed a whole host of health problems, including a very severe flulike illness that I could not shake, which was much later diagnosed as chronic fatigue syndrome.In an effort to regain my health, I tried several popular and recommended vegetarian, macrobiotic, and high-carbohydrate diets but grew weaker and sicker on each one. I continued to experiment and eventually stumbled upon the diet that turned my health around. It was based on lean animal protein and lots of nonstarchy vegetables and was entirely free of wheat or other gluten grains, dairy, legumes, processed fats, and sugar.When I ate this way, the difference in my health was dramatic. I quickly felt more energetic, mentally focused, and less sick. I also began to effortlessly lose the excess weight I had put on. Within about six months, I lost all the weight I had gained and was back to 115 pounds-size 6 for me. It was hard to turn against established nutritional wisdom, but I kept eating this way and totally recovered from chronic fatigue syndrome. The diet was the answer to regaining my health, and it"s kept me trim and healthy ever since.

Losing Weight the Right Way With the Paleo Diet, weight loss is a continuous, deliberate decline that occurs gradually, over a period of a few to many months. There are no quick fixes here-but then again, quick fixes don"t work. Most people who try such diets are unable to stick with them over the long haul.

You won"t feel hungry on this diet. Protein is a great satisfier. The low-carbohydrate content of the diet combined with its low glycemic load will normalize your insulin and blood sugar levels and will also help keep you from overeating. The weight that you will lose will stay off if you just stick to the diet-all the lean meats, fish, seafood, fresh fruits, and vegetables (except starchy vegetables) you can eat.

Isn"t it time to get started and give your body what it is genetically programmed to eat?

The Paleo Diet is a lifelong way of eating that will normalize weight in everyone

5.

Metabolic Syndrome: Diseases of Civilization It requires a very unusual mind to undertake the a.n.a.lysis of the obvious.

-Alfred North Whitehead

Metabolic syndrome diseases-the diseases of insulin resistance-are the main health problems of Western countries, affecting as many as half of all adults and children. There are four major metabolic syndrome diseases: * Type 2 diabetes* High blood pressure* Heart disease* Dyslipidemia (low HDL cholesterol, elevated triglycerides, and high small-dense LDL cholesterol) Gout and blood-clotting abnormalities are usually grouped with metabolic syndrome diseases, too, and so is obesity.

When people become insulin-resistant, the pancreas must secrete more insulin than normal to clear sugar (glucose) from the bloodstream. This creates a state in which the blood insulin level is elevated all the time.

Insulin is a major hormone that affects nearly every cell in the body. A chronically high blood-insulin level is thought to be the underlying culprit in all diseases of metabolic syndrome. But these are all complicated diseases, with many contributory factors.

Some scientists believe that high-saturated-fat diets make insulin metabolism less efficient. Others, including Dr. Gerald Reaven at Stanford University, believe that high-carbohydrate diets-both low- and high-glycemic foods-are to blame. Still others single out high-glycemic carbohydrates. However, the obvious has been ignored: Most people who develop obesity and diseases of insulin resistance do it with mixtures mixtures of high-fat and high-glycemic carbohydrates. Some examples of these bad food combinations: Baked potato and sour cream. Bread with b.u.t.ter. Eggs with toast and hash browns. Pizza with cheese. Ice cream, candies, cookies, chips. These and all of the other processed foods we eat contain both a high-fat component and high-glycemic carbohydrates. of high-fat and high-glycemic carbohydrates. Some examples of these bad food combinations: Baked potato and sour cream. Bread with b.u.t.ter. Eggs with toast and hash browns. Pizza with cheese. Ice cream, candies, cookies, chips. These and all of the other processed foods we eat contain both a high-fat component and high-glycemic carbohydrates.

With the Paleo Diet, it doesn"t matter which of these kinds of foods ultimately cause insulin resistance-because these unnatural food combinations aren"t part of the picture (except as Open Meal treats). Your meals won"t suffer-in fact, they"ll be richer, more varied, and more delicious than ever. Instead of fatty gourmet ice cream, treat yourself to a bowl of fresh blueberries or half a cantaloupe filled with diced strawberries and walnuts. Instead of fish sticks, how about peel-and-eat shrimp or a lean grilled steak? We"ll get to specific recipes and meal plans later in the book.

Healing Metabolic Syndrome: Jack"s Story Jack Challem, known worldwide as the "Nutrition Reporter," is a leading health journalist with more than twenty-five years of experience reporting on nutrition research. He is a contributing editor for Let"s Live Let"s Live and and Natural Health Natural Health magazines and the coauthor of a number of popular nutrition books. magazines and the coauthor of a number of popular nutrition books.

When I started writing my book Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance, Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance, I was in denial about having the early stages of Syndrome X. I was 48 years old, weighed 170 pounds, had a 38-inch waist, and a fasting glucose of 111 mg/dL. I should have known better. I made a point of getting back to the very diet I advocate in my book, I was in denial about having the early stages of Syndrome X. I was 48 years old, weighed 170 pounds, had a 38-inch waist, and a fasting glucose of 111 mg/dL. I should have known better. I made a point of getting back to the very diet I advocate in my book, Syndrome X. Syndrome X. I also stopped eating all pasta and virtually all bread. Basically, I was following a Paleo Diet with lean meats and a lot of veggies. I also stopped eating all pasta and virtually all bread. Basically, I was following a Paleo Diet with lean meats and a lot of veggies.In three months I lost 20 pounds and 4 inches from my waist. My fasting blood sugar was 85 mg/dL. My blood cholesterol and triglyceride values also improved. It has been extremely easy to maintain these improvements. Eating the Paleo Diet is simple and tasty.

How Insulin Resistance Increases Your Risk of Heart Disease High-glycemic carbohydrates cause an increase in your blood triglycerides and a decrease in your good HDL cholesterol. They also cause an increase in a special type of cholesterol in your bloodstream called "small-dense LDL cholesterol." All of these changes in blood chemistry severely increase your risk of death from heart disease.

Small-Dense LDL Cholesterol In recent years, small-dense LDL cholesterol has emerged as one of the most potent risks for atherosclerosis, the artery-clogging process. The study of atherosclerosis has become increasingly specific. First, we had cholesterol, then HDL and LDL (good and bad) cholesterol, and now a particularly bad kind of LDL cholesterol whose small, dense particles are ideal for artery blockage.

Even if you have normal total and LDL blood cholesterol levels, you still may be at risk for developing heart disease if your small-dense LDL cholesterol level is elevated.

Although low-fat, high-carbohydrate diets may reduce total and LDL cholesterol, they are useless in lowering small-dense LDL cholesterol. In fact, they make it worse. Dr. Darlene Dreon and colleagues at the University of California-Berkeley have shown repeatedly that high-carbohydrate diets increase small-dense LDL cholesterol particles in men, women, and children. High-glycemic foods increase our blood triglycerides, which make small-dense LDL cholesterol. When we lower triglycerides-by cutting out the starch and the high-glycemic carbohydrates-we automatically lower our small-dense LDL cholesterol.

The Keys to Greater Insulin Sensitivity The Paleo Diet improves insulin sensitivity in many ways. First, because it"s humanity"s original low-glycemic-carbohydrate, low-sugar diet, you won"t have to worry about triglycerides, HDL cholesterol, or small-dense LDL cholesterol. All of these blood values will rapidly normalize as your insulin level becomes reduced and stabilized.

The Paleo Diet"s high fiber, high protein, and omega 3 fat content all improve insulin sensitivity as well. Unlike starchy carbohydrates, protein causes only small changes in your blood levels of glucose and insulin. By itself, a single meal of pure fat doesn"t change these blood levels, either. The omega 3 fats that are integral to the Paleo Diet actually improve improve insulin metabolism and cause a rapid drop in blood triglycerides. The high fiber from nonstarchy vegetables and fruits found in the Paleo Diet slows the pa.s.sage of carbohydrates through your intestines; this slows blood sugar rises and ultimately also improves insulin sensitivity. insulin metabolism and cause a rapid drop in blood triglycerides. The high fiber from nonstarchy vegetables and fruits found in the Paleo Diet slows the pa.s.sage of carbohydrates through your intestines; this slows blood sugar rises and ultimately also improves insulin sensitivity.

Other Diseases Related to Insulin Resistance It"s only recently that scientists have begun expanding the scope of insulin resistance. In research worldwide, this condition is being linked to many other chronic diseases and health problems. Scientists are exploring the role of insulin resistance in certain types of cancer, nearsightedness, polycystic ovary syndrome, and even acne-although in all of these, as in heart disease, many causative factors are believed to be involved. It is premature to establish a direct cause-and-effect relationship. But if these diseases ultimately do turn out to have insulin resistance as their underlying cause, you"ll be protected-because the Paleo Diet contains all of the dietary elements known to stop insulin resistance.

Breast, Prostate, and Colon Cancers and Insulin Resistance Over the last five years, scientists have discovered through a chain reaction of metabolic events that elevated levels of insulin in the bloodstream increase blood levels of a hormone called "insulinlike growth factor one" (IGF-1) and decrease another hormone called "insulinlike growth factor binding protein three" (IGFBP-3). The decrease in IGFBP-3 causes tissues to be less sensitive to one of the body"s natural chemical signals (retinoic acid) that normally limits tissue growth. In addition, IGF-1, a potent hormone in all tissues, is a major regulator of growth: Increased levels of IGF-1 encourage growth, and reduced levels slow growth. Children who are below normal height have low levels of IGF-1. When IGF-1 is injected into these children, they immediately start to grow taller. As you might expect, tall children have higher levels of IGF-1. Studies of growing children by Dr. William Wong and colleagues at the Children"s Nutrition Research Center in Houston found that girls who were taller and heavier and who matured earlier had higher blood levels of both insulin and IGF-1 and lower levels of IGFBP-3. Diets that cause insulin resistance-particularly, high-glycemic-carbohydrate diets-increase IGF-1 levels, lower IGFBP-3 levels, and decrease tissue sensitivity to retinoic acid. These hormonal changes, in turn, accelerate growth in developing children.

What does this have to do with adult health? It"s been found that IGF-1 is a powerful stimulator of cell division-growth-in all all cells during cells during all all phases of life. In fact, scientists suspect that IGF-1 may be one of the primary promoters of all unregulated and tissue growth in the body. But IGFBP-3 prevents unregulated cell growth by causing cancer cells to die naturally through a process called "apoptosis." Over the last decade, numerous scientific papers have shown a strong a.s.sociation between elevated levels of IGF-1, lowered levels of IGFBP-3, and breast cancer in premenopausal women, prostate cancer in men, and colorectal cancer in all adults. In animal models of many types of cancer, scientists can promote cancer by adding a key ingredient-IGF-1; conversely, adding IGFBP-3 slows cancer. Synthetic derivatives of the body"s natural retinoic acid powerfully inhibit the cancer process in cell cultures. So, the whole chain of hormonal events initiated by elevated blood levels of insulin tends to promote the cancer process. phases of life. In fact, scientists suspect that IGF-1 may be one of the primary promoters of all unregulated and tissue growth in the body. But IGFBP-3 prevents unregulated cell growth by causing cancer cells to die naturally through a process called "apoptosis." Over the last decade, numerous scientific papers have shown a strong a.s.sociation between elevated levels of IGF-1, lowered levels of IGFBP-3, and breast cancer in premenopausal women, prostate cancer in men, and colorectal cancer in all adults. In animal models of many types of cancer, scientists can promote cancer by adding a key ingredient-IGF-1; conversely, adding IGFBP-3 slows cancer. Synthetic derivatives of the body"s natural retinoic acid powerfully inhibit the cancer process in cell cultures. So, the whole chain of hormonal events initiated by elevated blood levels of insulin tends to promote the cancer process.

Two risk factors for breast cancer are early onset of p.u.b.erty and above-average height. It is entirely possible that the same high insulin levels that elevate IGF-1 and lower IGFBP-3 (in other words, the levels that make children taller and make p.u.b.erty happen sooner during childhood) also increase susceptibility to cancer during adulthood.

Many women, worried about breast cancer, have adopted vegetarian diets in an attempt to reduce their risk. Unfortunately, it may be that these grain- and starch-based diets actually increase the risk of breast cancer, because they elevate insulin-which, in turn, increases IGF-1 and lowers IGFBP-3. A large epidemiological study of Italian women, led by Dr. Silvia Franceschi, has shown that eating large amounts of pasta and refined bread raises the risk of developing both breast and colorectal cancer.

Most vegetarian diets are based on starchy grains and legumes. Sadly-despite continuing perceptions of these as healthy foods-vegetarian diets don"t reduce the risk of cancer. In the largest-ever study comparing the causes of death in more than 76,000 people, it was decisively shown that there were no differences in death rates from breast, prostate, colorectal, stomach, or lung cancer between vegetarians and meat eaters.

Cancer is a complex process involving many genetic and environmental factors. It is almost certain that no single dietary element is responsible for all cancers. However, with the low-glycemic Paleo Diet, which is also high in lean protein and health-promoting fruits and vegetables, your risk of developing many types of cancer may be very much reduced.

Myopia and Insulin Resistance Because insulin resistance changes the hormonal profile of the blood to one that facilitates tissue growth, scientists have good reason to suspect that insulin resistance lies at the root of any disease in which abnormal tissue growth occurs. One extremely common such disease is myopia-nearsightedness-which affects an estimated one-third of all Americans. Myopia results from excessive growth of the eyeball. Although the eye looks normal from the outside, inside it"s too long for the eye to focus properly. Myopia typically develops during the childhood growth years and usually stabilizes by the time people reach their early twenties. New evidence that implicates insulin resistance in the childhood development of myopia may be useful in preventing nearsightedness in young children.

Eye doctors generally agree that nearsightedness results from an interaction between excessive reading and your genes. If you spent your youth with your nose in a book and if nearsightedness runs in your family, chances are good that you"re now wearing gla.s.ses or contact lenses. Myopia is thought to stem from a slightly blurred image on the back of your eye (the retina) that"s produced as you focus on the written page. This blurred image causes the retina to send out a hormonal signal telling the eyeball to grow longer. Experiments in laboratory animals suggest that the hormonal signal is produced by retinoic acid. Excessive reading slows the retina"s production of retinoic acid, a substance that normally checks or prevents the eyeball from growing too long. Additionally, recent research shows that elevated insulin also directly contributes to the excessive growth of the eyeball. This may mean that if your children"s diet prevents insulin resistance during growth and development, their risk of developing myopia may be lower.

Polycystic Ovary Syndrome Polycystic ovary syndrome (PCOS) affects 5 to 10 percent of all North American women. Women with PCOS ovulate irregularly or not at all, and their ovaries produce high levels of male hormones such as testosterone. Women with PCOS are p.r.o.ne to obesity, excessive body hair, acne, high blood pressure, and type 2 diabetes. They also have a seven times greater risk of heart disease and heart attack than other women do. Almost 60 percent of all women with PCOS are insulin resistant, and most of these women have elevated levels of IGF-1. Numerous clinical studies have shown that simply changing the diet-eating foods that improve insulin metabolism-can reduce many of the symptoms of PCOS. The Paleo Diet, which normalizes insulin metabolism, can greatly help women with this problem.

Acne For years, many dermatologists believed that diet had absolutely nothing to do with acne. But very new scientific evidence has linked insulin resistance to acne. Diets loaded with sugar, fructose, and high-glycemic carbohydrates may contribute to this problem, which can be devastating. Between 40 and 50 million American teens and adults have acne.

Some striking information to support the link between acne and diet comes from Dr. Otto Schaefer, who spent his entire professional career in the wilderness of the Canadian Far North, working with Inuit natives who literally were transferred from the Stone Age to the s.p.a.ce Age in a single generation during the 1950s and 1960s. Dr. Schaefer reported that in those Eskimos who ate their traditional foods, acne was absent. Only when they adopted Western foods laced with refined sugars and starches and dairy products did acne appear.

Four things happen when acne develops: First, there"s accelerated growth of the skin surrounding the hair follicle (called "follicular hyperkeratosis"). Second, oil (seb.u.m) production speeds up within the follicle. Third, the cells in the follicle abnormally stick together as they are being shed, thus plugging the follicle. And, finally, the plugged-up follicle gets infected. Until recently, dermatologists didn"t know why the accelerated growth occurred, why these cells became excessively cohesive, or what caused the boost in oil production. But growing evidence suggests that elevated insulin and IGF-1 are directly responsible for the increased follicular skin growth, along with reductions in circulating blood levels of IGFBP-3. Remember that high-glycemic foods raise your blood level of IGF-1 while lowering IGFBP-3. This is why low-glycemic-load, high-protein diets are so effective in eliminating acne. They put the brakes on excessive follicular skin growth.

Besides causing increases in IGF-1 and reductions in IGFBP-3, elevated insulin levels from eating high-glycemic carbohydrates cause a rise in the male hormone testosterone. It is these increases in IGF-1 and testosterone that promote the discharge of oil. This means that insulin resistance caused by high-glycemic diets may be directly responsible for the first three steps in acne development. In the last five years, dietary intervention studies and a series of epidemiological studies from the Harvard School of Public Health have conclusively demonstrated that high-protein, low-glycemic diets like the Paleo Diet improve insulin metabolism and can help prevent acne. It is now safe to say that the Paleo Diet will improve your insulin metabolism-and if you have acne, this lifetime program of healthy eating will help it disappear.

As you can see, the Paleo Diet can be a very effective tool in fighting virtually all the diseases of metabolic syndrome.

6.

Food as Medicine: How Paleo Diets Improve Health and Well-Being We never used to be so sick. The white man"s food is not good for us.

-Malaya Kulujuk, a Baffin Island Eskimo The Diet-Disease Connection Many of the chronic illnesses that plague the Western world-the "diseases of civilization"-can be attributed to dietary missteps. Diet and disease are obviously linked. And when we stray from the Seven Keys of the Paleo Diet, which stood firm for 2.5 million years, we not only develop metabolic syndrome diseases, but also increase our susceptibility to a host of other diseases.

How can we know whether a particular food, or the lack of it, in our diet is actually the factor responsible for a particular disease-or the absence of it? If you have a milk allergy or lactose intolerance, the cause and effect of your symptoms are probably painfully clear. But it"s much harder-if not impossible-to foresee whether the pat of margarine (containing trans-fatty acids) you put on your toast yesterday morning will have anything to do with causing a heart attack forty years later.

Scientists and physicians use a variety of research procedures to determine whether diet and disease are linked, including dietary interventions, epidemiological studies, animal experiments, and cultured tissue studies. When the results of all four procedures are in agreement, it is quite likely that a certain food may cause a certain disease. However, in most cases the link between diet and disease is usually not this clear-cut; often, genetic susceptibility to disease further clouds the issue. In many of the diseases that we will be examining, the diet-disease connection has only been partially unraveled. Nonetheless, by adhering to the dietary guidelines of your Paleolithic ancestors, you will reduce your risk of developing these illnesses, and if you are currently suffering from one of these illnesses, your symptoms may improve with the Paleo Diet.

Metabolic Syndrome Diseases I"ve already talked about the metabolic syndrome diseases (type 2 diabetes, heart disease, hypertension, dyslipidemia, obesity, PCOS, myopia, acne, and breast, prostate, and colon cancers) and how they are linked to elevated levels of insulin in the bloodstream. But all of these diseases also have other known contributing dietary factors. For example, salt is connected to high blood pressure-but so is a lack of fresh fruits and vegetables. Too much omega 6 fat in your diet at the expense of omega 3 fat can also cause your blood pressure to rise. Even a low protein intake has been linked to rising blood pressure.

Breast, prostate, and colon cancers are known to develop more often in people who don"t eat enough fresh fruits and vegetables. Fruits and veggies. .h.i.t cancer with a one-two punch: they"re excellent sources of antioxidant vitamins and minerals that may impede the cancer process, and they also contain a variety of special substances called "phytochemicals," nutrients found in foods that are lethal to cancer cells. The study of most phytochemicals is fairly new; scientists are only beginning to understand how they work. But here are a few examples: * Broccoli contains sulforaphanes, which chase cancer-causing elements out of cells.* Broccoli is also loaded with cancer-fighting folic acid, vitamin C, beta-carotene, and a substance called "indole-3-carbinol," which helps improve the body"s estrogens. * Strawberries, tomatoes, pineapples, and green peppers contain * Strawberries, tomatoes, pineapples, and green peppers contain p p-coumaric acid and chlorogenic acid, compounds known to be powerful anticancer agents.* Garlic and onions not only contain substances that will lower your cholesterol but are also rich sources of allylic sulfides, which seem to protect against stomach cancer.

As is the case with high blood pressure, eating too many omega 6 and too few omega 3 fats further increases your risk of developing breast, prostate, and colon cancers.

We may not know precisely how dietary factors cause each and every metabolic syndrome disease, but one thing"s certain: when you adopt the Paleo Diet, you will be putting all known dietary factors on your side to prevent these illnesses.

Cardiovascular Diseases The number one killer in the United States is cardiovascular disease. A staggering 35 percent of all deaths in this country result from heart attacks, stroke, high blood pressure, and other illnesses of the heart and blood vessels. Cardiovascular disease, like cancer, is a complex illness, and no single dietary element is solely responsible. However, once again, by following the nutritional principles of humanity"s original diet, you will put the odds in your favor of not developing this deadly disease.

Good Fats Help Prevent Cardiovascular Disease Good fats are what doctors call "cardioprotective." They protect the heart and the blood vessels from disease. With the Paleo Diet-unlike the average American diet-at least half of your fats are healthful monounsaturated fats. The other half is evenly split between saturated and polyunsaturated fats. There are no synthetic trans fats. And the crucial omega 6 to omega 3 fat ratio is about 2 to 1-which greatly reduces your risk of dying from heart disease.

Monounsaturated Fats Monounsaturated fats reduce your overall risk of heart disease by lowering your level of total cholesterol-but not your beneficial HDL cholesterol-in the blood. These healthful fats-found in abundance in the Paleo Diet-also help prevent LDL cholesterol from oxidizing (breaking down) and contributing to the artery-clogging process. Monounsaturated fats also may reduce your risk of breast cancer.

Omega 3 Fats I"ve already talked about the beneficial effects of omega 3 fats on insulin metabolism and how they lower blood triglycerides. Omega 3 fats are also exceptionally potent agents in preventing the irregular heartbeats that can make a heart attack fatal. They help prevent blood clotting and ease tension in clogged arteries as well.

In a landmark dietary intervention study, French physicians Serg Renaud and Michel de Lorgeril evaluated the effect of a diet rich in omega 3 fats in 600 patients who had previously survived a heart attack. In this investigation, known as the Lyon Diet Heart Study, half of the patients were a.s.signed to the American Heart a.s.sociation reduced-fat diet, in which 30 percent of calories come from fat. The rest followed a 35 percent fat traditional Mediterranean diet that was rich in omega 3 and monounsaturated fats and fruits and vegetables.

The results were striking: compared to the patients who followed the American Heart a.s.sociation Diet, those who were on the Mediterranean diet had a 76 percent lower risk of dying from another heart attack, a stroke, or another cardiovascular disease. This remarkable protection from heart disease can be yours, too. Like the Mediterranean diet, humankind"s original diet is also high in cardioprotective omega 3 fats, fiber, monounsaturated fats, and the beneficial phytochemicals and antioxidant vitamins that are found in fruits and vegetables.

Diseases of Acid-Base Balance and Excessive Sodium The average cereal-based, salt-laden, cheese-filled American diet-which is nearly devoid of fresh fruits and vegetables-tilts your body"s acid-base balance in favor of acid. As we discussed earlier, grains, cheeses, meats, and salty foods yield a net acid load to the kidneys, while fruits and vegetables always generate an alkaline load. An overload of acid foods-at the expense of alkaline foods-can cause numerous health problems, particularly as you age and your kidneys become less adept at handling dietary acid.

Of the four major acid-producing foods, three-grains, cheeses, and salt-were eaten rarely or never by our Paleolithic ancestors. Instead, they ate huge amounts (by modern standards) of alkaline fruits and vegetables, which buffered the acid from their meat-rich diets.

Many chronic diseases prevalent in Western countries develop because of a dietary acid-base imbalance. These include: * Osteoporosis* High blood pressure* Stroke* Kidney stones* Asthma* Exercise-induced asthma* Meniere"s syndrome* Stomach cancer* Insomnia* Air and motion sickness The realization that such diverse problems could be linked to acid-base imbalance is fairly recent. Not so long ago, scientists connected many of these illnesses to too much sodium, or salt. But the chemical recipe for salt has two ingredients-sodium and chloride. And as I discussed earlier, it"s the chloride part of salt that makes it acidic-not the sodium. Chloride may also be more to blame than sodium as a dietary cause of high blood pressure.

Osteoporosis Earlier, I talked about salt"s interplay with calcium in the body: people who eat a lot of salt excrete more calcium in their urine than do people who avoid salt. In turn, this calcium loss contributes to bone loss and osteoporosis, because the acidic chloride in salt must be buffered in the kidneys by alkaline base-and the body"s largest reservoir of alkaline base is the calcium in our bones. When we eat salty potato chips or a pepperoni pizza, we are leaching calcium from our bones. When we do it over the course of a lifetime, we may well develop osteoporosis.

Asthma and Exercise-Induced Asthma But salt is not just bad for the bones. Although it has not been shown to cause asthma or exercise-induced asthma, it can aggravate both conditions. Studies in humans and animals have shown that salt can constrict the muscles surrounding the small airways in the lung. My research team demonstrated that salt (both the sodium and the chloride components) increases the severity of exercise-induced asthma. We also showed that low-salt diets can reduce many symptoms of exercise-induced asthma.

Other Problems Caused by Salt Maybe you don"t salt your food. Good for you-but you should be aware that despite your good intentions, there"s probably more salt in your diet than you think. The average American eats 10 to 12 grams of salt every day. Almost 80 percent of this comes from processed foods-even those considered healthful. Two slices of whole-wheat bread, for instance, give you 1.5 grams of salt. So automatically there"s salt in any sandwich you make-even before you add salty meats like ham, salami, or bologna.

A high-salt diet increases your risk of kidney stones, stroke, and stomach cancer.

It also impairs sleep-this is one of the least-recognized benefits of low-salt diets. When you cut the salt out of your diet, you will sleep better almost immediately. Low-salt diets also have been shown to reduce motion and air sickness.

Many other foods are acidic and able to disrupt the body"s acid-base balance. Every time you eat cereals, peanuts, peanut b.u.t.ter, bread, m.u.f.fins, cheese, sandwiches, pizza, doughnuts, cookies-basically, any processed food-you are overloading your body with dietary acid. Unless you balance these foods with healthful alkaline fruits and vegetables, you will be out of acid-base balance-and at increased risk for many chronic diseases.

Pota.s.sium Another crucial chemical balance in the body is that of pota.s.sium and sodium. Paleo diets contained about ten times as much pota.s.sium as sodium. The average American eats about five times as much sodium as pota.s.sium every day. The beauty of the Paleo Diet is that it swiftly returns your body to humanity"s original high intake of pota.s.sium and low intake of sodium.

Digestive Diseases Fiber is absolutely essential to your health-and at least thirteen illnesses can result when you don"t get enough fiber in your diet. Some of the most common digestive diseases that develop when you eat the standard American diet with its overload of refined grains, sugars, dairy, and processed foods are: * Constipation* Varicose veins* Hemorrhoids* Heartburn* Indigestion* Appendicitis* Diverticular disease of the colon* Crohn"s disease* Ulcerative colitis* Irritable bowel syndrome* Duodenal ulcer* Hiatal hernia* Gallstones The Paleo Diet is naturally high in fiber because of its abundance of fruits and vegetables-about three to five times as much fiber each day as there is in the average American diet.

Some people worry that lean meat-based diets are constipating. This is not true. Meat, fish, and seafood are not constipating at all. The famous Arctic explorer Vilhjalmur Stefansson spent years mapping and exploring the Far North at the turn of the twentieth century. During his expeditions on dogsleds, he frequently lived off the land for more than a year at a time. He and his men were entirely dependent on the all-animal food diet that could be obtained from hunting and fishing. Amazingly, he reported in his journal that men who had suffered from constipation on their former rations of flour, corn biscuits, rice, and breads were almost completely cured of their problem within a week of adopting the all-meat (high in protein, but with enough fat to avoid the risk of protein toxicity) menu of the Eskimos.

Years later, when Stefansson returned to civilization, he and another explorer were put on an all-meat diet for an entire year, under controlled hospital conditions, by the most respected scientists and physicians of the day. The clinical evaluations at the end of the year showed bowel function to be normal. Just like Stefansson and the Eskimos, you will not suffer from constipation when lean meat, fish, and seafood dominate your diet. In fact, you will find that most of your digestive problems will disappear.

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