Nutrition

Unsolicited advice for Paleo™ Peeps

Published 7.9.2017
The Paleo™ movement is facing hard times apparently, if this post is to be believed. Apparently there is angst in the Paleo world that some of their concepts are gaining mainstream attention, but the Paleo or Ancestral diet have not. Jimmy Moore thinks that Paleo’s mistake was not embracing the ketogenic or keto fad/scam.

I disagree. Checking the google trends shows that searches for paleo diets have been trending down for years, where searches for ketogenic diets are on the incline. The savvy marketer alters his business plan when the market shifts. Mark Sisson has now done so. Although keeping his meaningless except as a brand “Primal” tag, his latest book touts a keto diet to his followers.

However, if you are a true believer in the superiority of the “paleo” way of eating, then it’s worth considering why the fad has faded. Moore notes that paleo was never defined in any truly “faddish” way unlike the keto diet. A keto diet is based on eating gobs of high fat foods or fat itself— which may be a disaster healthwise for many, but certainly has a “naughty” aura of going against the grain that many people are attracted to.
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Paleo in its original incarnation was really a diet of high protein, low fat (Cordain touted lean meats because game is lean), and moderate carb consumption. Fruits and vegetables had a prominent place on paleo plates. In fact, Cordain’s paleo diet is not an unhealthy way to eat. His elimination of dairy, grains and legumes are arbitrary and anthropologically incorrect— at least in the case of grains and legumes, remnants of which have been found at paleo archeological sites— but a balanced, healthy, and nutritionally complete diet can be made without those food choice. The same cannot be said for the keto diet. By design, a ketogenic diet is not balanced, it is extreme.

It was the scientifically indefensible reasons for the elimination of grains and legumes (especially the legumes) from the diet that doomed Paleo. If you’re going to claim that your diet is based on science, then you need to accept all the scientific evidence, not just the bits that support you. The science behind the keto diet dooms it as well. Ketogenic diets are used to treat patients with drug resistant epilepsy— however, the diet is only undertaken with close medical supervision because dire deficiencies can develop if care is not taken. Humans did not evolve to eat only protein and fat.

Ketogenic are low carb diets, but not all low carb diets are ketogenic. Keto diets are having a moment currently as the Paleo fad fades, and bloggers are noticing. For instance, Mark Sission has tweaked his own fad diet, branded "Primal" to include keto. Sission is first and foremost a salesman, so whatever direction the market seems to be heading is where he'll go. There is no underlying reason other than profit, which is perfectly legitimate.
The Angry Chef (TAC), on the other hand, has a decidedly different take on the keto fad.

I spent a few years studying biochemistry, and most of that time was spent learning about human metabolism. In the main we would look at what happens when systems are not working in order to understand the many complex processes at play when they are functioning properly, and for this reason the metabolic changes that occur in starvation were always a topic of interest. Because of this I have always had a strange fascination with ketosis, a metabolic state that occurs during starvation, and a great example of the stunning adaptability and resourcefulness of the human body.

Eddy, the angry low carb diabetic blogger, has already ranted about this. Eddy is not keto however. He just dislikes anything that doesn’t exult low carb. The link between keto and starvation is important. TAC also notes that the brain runs on glucose, but low carb high fat (LCHF) followers are adamant that this is not the case.

One of the really interesting things about ketosis is that it has a definite switching mechanism. Unlike a lot of biological systems which operate by degrees, it is either on or off in the human body, and as it is a starvation response, it is not considered an ideal state to be in. Ketosis is very much an emergency strategy, turned on during severe food shortage. Our bodies are never that keen to go into it, and will rapidly switch back to normal glucose metabolism once adequate nutritional intake is resumed.

Keto is very easy to be knocked out of, because it is not the body's natural state. The body and brain prefer glucose as fuel.

There is however another way to push the body into ketosis without being subjected to the severe starvation that normally accompanies it. A diet that is extremely high in fat, very low in carbohydrates, and fairly low in protein can induce a state of ketosis without a huge restriction in calories. The reasons why ketosis can be induced in this way are not well understood, but it seems likely that it is little more than a strange anomaly in the way ketosis is triggered, and that the body is being tricked into thinking it is being starved due to a very low carbohydrate and protein intake. The extremes of the ketogenic diet are something that we would have been unlikely to have encountered in any natural environment during our evolutionary history, so this non-starvation ketosis state is most likely due to a tiny flaw in our metabolic programming.

The comments are as expected, as those who've lost weight eating less while skipping carbs descend to tout their success. This topic has taken on a special urgency because I now have a friend in real life (female) who seems to be trying the ketogenic diet to lose some weight. The only carbs she consumes regularly come from beer.

In his second entry, TAC mostly responds to those who didn't like his first foray. His view is that keto is a medical treatment and should be monitored as such.

In researching, I spoke to literally dozens of people, both researchers and clinicians, including world leading experts who have conducted some of the most important research into its effects (the very research that allowed its inclusion in the NICE guidelines as a treatment for epilepsy). I spoke to dietitians who have spent years working with the diet, putting hundreds of patients through it and dedicating their lives to its use. I also have Captain Science, who I would wager knows more about food, health and evidence based practice than all of the low carb commenters put together. Everyone I spoke to agreed, even fund raising organisations that are huge advocates of the ketogenic diet as a medical treatment. This is a medical intervention that pushes your body into an extreme state, and there are grave dangers associated with its unregulated use.

This can be applied to more than just keto touts and scammers:

Desperation is where the vultures of pseudoscience gather, quick to pour on shame and scorn, and then offer salvation with their universal cures. It is a deception as old as the hills, and a remind that although ancient bloodletting and Victorian potions are ancient history, their poisonous legacy lives on in a new breed of dietary quacks.

There’s a lot of rant and little evidence in this particular entry, beginning with a lengthy response to the critics of the first piece, which did include evidence and quotations from scholars in the field.