Dr. John Day, Cardiologist

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Is the Paleo Diet Good for Your Heart?

By the time Bob turned 40 he was overweight, had high blood pressure, high cholesterol, and had developed adult-onset diabetes.  He felt horrible. His doctor had a “heart-to-heart” talk with him and told him and told him he had to go on medications for high blood pressure, high cholesterol, and his diabetes.

Bob went online and studied the Paleo Diet.  At the age of 40 he said to himself, “I am too young to take all of these medications.”

Heart disease ran in his family and he did not want to travel the same health path his father had.  He decided to try “Paleo” first before going on all of the medications his doctor prescribed.

Bob faithfully followed the Paleo Diet.  It became a new way of life for him.  He started exercising every day without fail.  He gave up all sugar, grains, dairy, legumes, and processed foods.  He only ate wild meats, vegetables, fruit, nuts, and seeds.

Within 4 months he lost 60 pounds. His high blood pressure, high cholesterol, and diabetes were gone.  He was sure his doctor would be mad at him for not taking the pills he had prescribed.

Roaming the Savanna eating only wild meats, vegetables, and fruit has to be good for the heart, right?  After all, heart disease is just a recent phenomenon from our diets high in sugar, processed grains, and a sedentary lifestyle, correct?

The Paleo community tells us that this diet will solve most of our modern health problems.  On the other hand, U.S. News and World Reports ranks the Paleo Diet dead last each year in their annual review of popular diets.  Where is the truth?

In this article, we will answer the question, is the Paleo Diet good for your heart.  We will also look closely at whether heart disease existed among our paleo ancestors and what we can learn about this way of life and the risk of heart disease.

Heart Disease is Common Even in the Young

On the Standard American Diet, atherosclerosis or plaque build up in the arteries of the heart is very common and starts in childhood.  For example, even in physically active U.S. soldiers serving in the Korean War, autopsy studies of these young U.S. soldiers showed that 77% already had evidence of heart disease!

This study completely challenged our concept of “heart disease” from being something that only “old people” get.  Perhaps our diet improved between the Korean and Vietnam Wars as the same study of Vietnam War soldiers who died showed that only 45% of these young soldiers had heart disease at autopsy.

The take home message of these autospy studies is that, even in young soldiers who were physically fit, heart disease can start in childhood from a poor diet.  Would our hunter gatherer ancestors on a “pure diet” also have such high rates of heart disease?

Heart Disease in Our Hunter Gatherer Ancestors

In 2013, Dr. Randall C. Thompson from Saint Luke’s Hospital of Kansas City published the very provocative medical study, “Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations” in the prestigious Lancet medical journal.  In this study, Dr. Thompson and colleagues performed CT scans of the hearts and arteries of 137 mummies from four different ancient hunter gatherer cultures.

The four ancient hunter gatherer cultures studied were as follows:

1. Ancient Egyptians

2. Ancient Peruvians

3. Ancestral Puebloans (Southwest U.S.)

4. Unangan hunter gatherers (Inuit Eskimos of modern day Alaska)

All four ancient cultures were physically active outside every day.  Also, with the exception of the Unangans (Inuit Eskimos), all four ancient cultures primarily ate wild animal meat, vegetables, and fruits.  In contrast, the Unangans ate primarily an all meat diet with little or no plant based foods.

It should be pointed out that these four ancient hunter-gatherer cultures did not eat grains or much dairy with the exception of eggs in the Unangan diet.  Everything was organic and there certainly were no processed or GMO foods.

This sounds like the perfect lifestyle, right?  Heart disease should never occur, correct?

Even though many of these mummies were young at the time of their deaths, atherosclerosis or plaque build up in the arteries of the heart was seen in 34% of these mummies with the “perfect” Paleo lifestyle.  Among the Unangans, who ate an almost all meat diet, heart disease was seen in 60% of the mummies.

Is Heart Disease Inevitable?

How can our ancient ancestors who lived a “perfect lifestyle” still get heart disease?  Is heart disease inevitable?

While our ancestors thrived on a Paleo Diet, they did not escape heart disease.  Indeed, humans have thrived on all diets except the Standard American Diet (SAD).

There are, in fact, ancient cultures who have thrived without heart disease.  Three classic examples are the Kitavans from the tropical islands of Papua New Guinea, the Tarahumara Native Americans of Mexico, and rural Africans.

All three of these cultures (Kitavans, Tarahumara, and rural Africans) had a similar diet.  While it was also a hunter-gatherer type lifestyle, all three were low in meat.  These three diets were very high in plant based foods, including legumes and real whole grains, which are both shunned by modern-day Paleo followers.  Sugar and processed foods also did not exist in these three primitive cultures.

Benefits of the Paleo Diet

There are certainly tremendous health benefits of the Paleo Diet and lifestyle.  Unfortunately, these are largely ignored by US News and World Reports.  For example, eliminating all added sugars and processed foods can immediately reverse many chronic medical conditions, similar to Bob’s experience at the beginning of this article.

In addition, the Paleo community encourages daily physical activity similar to what our paleo ancestors would have done.  Physical activity, in combination with a diet free of any added sugars or processed foods, can be a very healthy lifestyle.

Weaknesses of the Paleo Diet

While many people thrive on the paleo lifestyle, it is by no means a perfect diet.  As we have covered in this article, ancient cultures living the paleo lifestyle still experienced heart disease.

From these studies, it is not clear if the heart disease came from campfire smoke inhalation, chronic inflammation from infectious diseases, or a meat heavy diet.  Certainly, the easiest way to create plaque build-up in the heart, or heart disease, is to feed animals a diet extremely high in meat.

From my perspective, arbitrarily shunning any foods created within the last 10,000 years, just because it doesn’t meet the definition of “paleo,”doesn’t make a whole lot of sense.  For example, among many different cultures legumes have been shown to be the most important dietary factor in longevity.

Legumes are avoided in the Paleo Diet because they are felt to contain two anti-nutrients, lectin and phytic acid.  Most lectins in beans are deactivated with cooking.  Additionally, many medical studies suggest that phytic acid may actually prevent cancer.

Even real whole grains are shunned in the Paleo Diet.  While processed grains have been one of the major drivers of our current health crisis in the U.S., study after study has shown that real whole grains can prevent heart disease and prolong life.  For example, a recent Harvard University study of more than 100,000 people showed that whole grains decreased heart disease by 20% and prolonged survival by 15%.

The key here is to avoid processing and to eat grains in moderation.  For most Americans, moderation means dramatically reducing how much grain you are currently eating.  Turning wheat into flour is really turning just turning wheat into sugar.  If you enjoy wheat, and do not have any gluten sensitivities, try buying bread without flour like Ezekiel Bread.

Lastly, if you tolerate dairy, dairy can be another healthy food.  For example, yogurt with no added sugar and live bacterial cultures can be part of any healthy diet.

The Modified Paleo Diet

If you want to eat more like our ancestors, may I suggest the “Modified Paleo Diet?”  This diet is similar to a diet eaten by Kitavans, Tarahumara, and rural Africans.

With the “Modified Paleo Diet,” added sugar and processed foods are still avoided.  Vegetables, fruits, nuts and seeds are still encouraged.  However, wild animal meat is eaten sparingly (wild fish is OK) and legumes as well as real whole grains are included in the diet.  Dairy is optional depending on how well you tolerate this food group.

Have you tried the Paleo Diet?  What was your experience?