Why Paleo Is Not All Low Carb
If you’ve read our page on Paleo Purpose, Macronutrients and Weight Loss, you’ll know that we present a version of Paleo that is “Macronutrient Agnostic”… but why? Why isn’t Paleo Low Carb? Isn’t Low Carb the best? Doesn’t that diet beat all others? Aren’t we all about the high fat in the Paleo community?
Ah dear, well at the risk of wading into macronutrient wars we thought we’d write a little post to explain WHY we at Paleo In The UK do not promote a solely low-carb approach, and believe that the Paleo way of eating is much more to do with nourishment, micronutrients and what you DO actually eat than the restriction and limitation of certain macronutrients. This is not to say that in certain circumstances (i.e. certain metabolic states) the low carb approach isn’t the absolute best on… but this doesn’t make a low-carb dietary approach the healthiest for all…
Reason 1: Low Carb Is Not Anthropologically Accurate
We’re not going to dwell on this point, because if you have read any of our pages on this site then you will know that we at Paleo In The UK use a reflection on human evolution as only a starting point for evaluating what foods we are best nourished by, not as an attempt to create the ‘ideal diet’ solely from evaluating what hunter-gatherers specifically ate.
However, it is very true to state that the original figures utilised by Loren Cordain et al to estimate the macronutrient consumption of ancient hunter-gatherer tribes are thought to be largely inaccurate. For example, one of the tribes studied used weapons (i.e. guns) to hunt … not very palaeolithic. And as we’ve said many times, the Paleo Movement has moved largely beyond Cordain’s original work. (And yes, perhaps it is our flaw for still using the terminology that he has trademarked… but ultimately you cannot pull apart nutritional recommendations based on their language – as we, again, have said many times – and this is simply the term that has evolved alongside AIP etc. and is still used by all of us who promote genetically-appropriate, ancestrally-aware nutrition. Which is, quite frankly, a mouthful…)
In the early assessments of hunter-gatherer nutrition one ‘rule’ proved true: the macronutrient consumption varied enormously across ancient tribes. Macronutrient composition was literally based on food availability – and for ancient humans this was entirely based on geography. Transport, export and the concept of a global food chain was nowhere on the horizon for ancient hunter-gatherers. They ate what they could get their hands on. Preferably easily.
Ironically, this ends up being largely plant matter. Simply because it was the easiest and most effort-free of foods to obtain. And much of this plant matter was starchy – perhaps not potatoes and legumes (poisonous raw) but definitely root vegetables and other tubers (tiger-nuts, for example). By default, a foraged and gathered diet results in a dietary intake of quite a lot of carbohydrates. Nowhere near the carb counts of the modern diet, admittedly. But also nowhere near the carb quantities of the (currently all-the-rage) Ketogenic Diet. (The difference is on average about 25-30% carbs up to 60%+ for ancient tribes, versus roughly 10% for modern Keto).
As we repeat ad nauseum on this site, we’re not at all interested in recreating the ancient ways of eating to the letter. We’re interested in human evolution and how we evolved to thrive. This means that, irrespective of the diet of ancient man if we truly felt that low carb was currently proven to be the healthiest human diet for all, we would say so. And we don’t…
Which brings us onto reason two…
Reason 2: Low Carb Is Not Automatically Healthier
We know, many people have just reeled back in horror and thrust Gary Taubes’ entire back catalogue of work at us.
However, intriguingly, the undeniably brilliant Denise Minger has demonstrated quite conclusively that, in certain settings, diets literally based on sugar are therapeutic. Yes, that’s right. A high sugar diet is not just ‘healthy’ but utterly curative for some forms of metabolic derangement.
We asked our Functional Medicine Consultant/Nutritionist Founder to expand on all of this confusion – and tell us whether high carb or high fat really was better for health. Here is what she said:
“I keep my research spread across all of the debates in nutrition, a) because it interests me, b) because it’s relevant for my clients – but also, and importantly, c) because it is ever-changing. There are more questions than there are answers when it comes to human metabolism and the roles of various macronutrients. The reason for this seems, to me, to be largely due to the difficulty in the isolation of macronutrients or micronutrients from the overall dietary spread and/or quality and/or composition etc. Food and diets are single nutrients or calorie sources – and the categories that we discuss as ‘carbs’ or ‘fats’ are actually vast and varied. So… unsurprisingly, we have a handful of theories and facts about nutrition rather than ‘universal truths’.
Dietary extremes are clearly beneficial almost as ‘reset’ buttons for physiology. This helps when metabolism and biochemistry have become dysregulated or resistant. However, we know that this is true for extremes of high fat (epilepsy, certain cancers) AND extremes of high sugar (see Denise Minger’s YouTube talk).
Then there’s less acute health situations: the obesity and diabetes ‘epidemics’, for example. Gary Taubes’ brilliant work in this realm revolves around the hypothesis that nutritional deficiency occurs in a state of caloric sufficiency, thereby affecting hormones, behaviour, adiposity (fat storage and deposition) and blood sugar regulation. He explains how insulin resistance occurs in a hypercaloric, refined-carbohydrate-based diet – but how the eating behaviours to consume and store more calories as fat were hormonally driven (rather than just personal laziness). His presentation of the biochemistry of metabolic syndrome turned our nutritional worlds inside out and he really can be credited with overturning a lot of the propaganda against dietary fat.
His work also meant that we stopped talking food in terms of biology alone and we began to discuss food in light of biochemistry driving hormones, storage signals and then behaviour. We began to understand that weight balance wasn’t just reliant on a simple ‘calories in, calories out’ seesaw and the makeup of the nutrition itself alters what the body does with those calories.
However, this hypothesis neatly explains the biochemistry in those who are metabolically dysregulated… but it doesn’t actually map entirely onto healthy populations. Or indeed onto those with different dysregulations of metabolism (i.e. not insulin resistance). Whilst it promised to relegate the caloric quantity of diets to the realm of irrelevance… we actually find that calories are still important when it comes to obesity and diabetes. The model Taubes’ proposes seems, biochemically, to only occur when cells are living in a hyper caloric state. Which brings us back to quantity, rather than macronutrient type, which trumps the debates. And you can still lose weight on diets based entirely on sugars… then you have to factor in hunger and satiety cues, food environments, history, upbringing, eductaion etc. etc. Eating behaviour and health outcomes are not easy to discuss because this just isn’t a simple topic.
Then we have to evaluate that all the Taubes’ research and macronutrient enemy-making is looking at is obesity. And by extension the ill health that is known as metabolic syndrome It is NOT looking at overall health outcomes.
When you are looking at health through the lens of weight and metabolic syndrome you completely skew your perception of wellbeing. Ill health can occur in many different areas that have nothing whatsoever to do with weight. When you assess interventions or diets in the light of ‘all cause mortality’ versus ‘causes obesity’ or ‘causes heart disease’ or ‘causes cancer’ you get different results each time. Each of these outcomes is an entirely different physiological situation – and only ‘all cause mortality’ can really help us assess the truth of the impact of any intervention.
This is because ‘all cause mortality’ is so damn general. As such, it’s pretty useless because it’s non-specific. Whilst we’re all about personalised nutrition and unique iterations of dietary style it might seem a bit lame to resort to ‘all cause mortality’ figures…
But actually, when you do, you realise that human health – what provides for it and what detracts from it – is not, generally speaking, about the extremes. The extremes really work as an intervention when there is extreme compromise and acute ill health. Reversing the body out of utter malfunction seems to require quite alarming practices…
And yet when it comes to attaining, maintaining and enjoying ‘optimal’ health: moderation – and more importantly variation – seems to be fundamental.
This means that when we construct a Paleo-based diet, we recommend a tonne of plant matter. Why? Because plants contain a whole load of micronutrients, polyphenols, natural antioxidants and all the ‘stuff’ our body needs to run. We recommend really good quality proteins. Why? Because the amino acids (i.e. a variety of them from all sorts of sources) will literally form our own building blocks. That means that if you want to build a good you, choose great bricks. And we recommend really nourishing varieties of fats. Why? Because the fats you eat are the raw materials for your cell membranes and every hormone you make – which means that if you want to send good messages and regulate all your systems you NEED fats.
When looked at in terms of ‘what do I need to thrive?’ this diet ends up quite vegetable and even fruit heavy. This means that, by default (and akin to hunter-gatherers) to get all the nutrients you need you probably don’t end up very-low-carb (i.e. sub-10%).
But there is another element that must be discussed… because whatever you end up at in terms of macronutrient ratios – no-one is suggesting that you pick a macro composition and religiously stay at that each day.
The one compelling thing that I am convinced by (and do think that there is more and more evidence for) is that our bodies thrive when being asked to adapt. This means that VARIATION is useful, swapping and changing our dietary intake according to… well, anything really. Varying protein intake, having a vegan week, doing a low fat or extremely low carb day, fasting occasionally – possibly even doing all of this to match the seasons – all of these ‘strategies’ can be used to allow our bodies to fluctuate (or ‘undulate’) through having to use different macronutrients and micronutrients – excelling based on facing change.
I read the work of sceptics and of nutritional experts, all of whom are scientists and know better than me. Many of the people I absorb the understandings from come down at one of the extremes of macronutrient consumption. As such, in the last few years I have been convinced of the benefits of fasting, of ketosis, of lower fat diets – and I have personally tried lots of different approaches.
The thing I come back to every time, however, is that our bodies are ridiculously malleable. They can adjust to, and do OK with, many eventualities. When there is an acute health condition which we are trying to affect with diet I do think that manipulating the metabolism by skewing (quite dramatically) macro intake is appropriate. And yet, in my clinic I don’t tend to see the cancers or epilepsy patients who would be scientifically proven to benefit from the permanent ketosis, low carb style-approach.
Instead I see people whose bodies are dysregulated and dealing with epic amounts of stress, hormonal disarray, biological confusion, energy and ATP suppression and immune chaos. In clients like this, the fundamental bedrock of my work is helping their bodies to feel nourished, calmer and safe. In my experience, withholding carbohydrates as a macronutrient (or, having said that, withholding fats as a macronutrient) is categorically NOT a way to shift the biochemistry from a state of alarm, stress and dysregulation to a place of safety. Starvation and/or forcing the body into different ways of creating energy (based on a narrowed set of macronutrients) is inherently stressful. In my clients, this is precisely the opposite of the effect I am trying to create.
For that reason, anyone who approaches Paleo as a means to restore balance to their biochemistry is probably not best served by going very, very low carb. Having a sweet potato is not like having a candy bar – and it must be remembered that ‘carbohydrates’ is an enormously broad category. Eliminating all carbohydrates from the human diet has NOT been studied over the long term. As such, it might be perfectly healthy… but in truth, we just don’t know the longterm effects yet.
What I can say clinically is that I see, more often than not, the ADDITION of carbohydrates into the lives of those who have gone very-low-carb is amazingly therapeutic and restorative. It can re-regulate the thyroid, metabolism, sex hormones, hunger signals, sleep and the nervous system. Quickly.
So there is zero evidence to suggest that low-carb is actually the ‘healthiest’ human diet – and much depends on the biochemistry of each individual as to the benefit (or detriment) they will experience from this approach. However, I always prefer to emphasise nutrients – as in MICROnutrients not MACROnutrients. In this instance, it really is wise to focus on the small stuff – and let the balance of the big stuff take care of itself.”
Reason 3: Low Carb Is Restrictive
So, the science for the healthiest human diet doesn’t support low carb, even though the data on the benefit of lower carb interventions for certain health conditions is compelling.
And yet, the danger within the Paleosphere is that we are actually taking into an echo-chamber. If you are here then it is highly likely you’ve already eliminated refined sugars, fizzy drinks (even sugar-free versions) and the majority of processed foods. Your focus is also, more than likely, on ‘health’. To add onto this ‘health’ aspiration a ‘low carb’ mantra leads us into the one main, and legitimate, criticism of the Paleo approach to nutrition.
We are actually going to talk about this much more specifically next week – but the biggest problem with any dietary approach is that it promotes rules, restriction and parameters of success/failure based on nutritional behaviours. Adding ‘low carb’ on top of the Paleo approach actually makes what is supposed to be a health-focused nutritional style a ‘diet and weight-loss’ focused nutritional style.
At the beginnings of the so-called Paleo Movement there was a real problem: Paleo was anal, specific, restrictive, obsessive and (for want of better words) Orthorexic.
Prescribing ‘eliminations’ and ‘macronutrient restrictions’ endorses the idea that people cannot be trusted around food and that we must be told what to eat in order to be healthy. In a way, building a site based on Paleo endorses this notion (and this is what we will dig deep into next week).
But adding onto this the notion that ultimate health is built upon a certain macronutrient ratio is completely unfounded: every shred of evidence – from modern science to an examination of ancient hunter-gatherers – suggests that this is untrue. Humans can thrive on many macronutrient ratios so adding this ‘rule’ into the Paleo recommendations is completely unnecessary.
Originally, within Paleo, it was naughty to eat a banana or an apple (oh my god – the sugar!!!). This isn’t based on nutrition, it’s based on a phobia of carbohydrates due to the concept that they create weight gain. All of these notions breed disordered relationships with food. Remember what Victoria said above – Taubes’ insulin hypothesis is proven to occur in a state of hyper caloric excess… A banana in a balanced diet does… well… nothing at all (except give you a touch of sugar (i.e. energy), fibre and potassium).
Paleo – at least in the way we believe it should be presented – is not about endorsing disordered or prescriptive food relationships. The way we eat should feel amazing, not like a straight jacket – and we will discuss this more next week…
…but for now, this is our third and final reason Why Paleo Is Not Low Carb: because it just doesn’t NEED to be.
Insisting that it must be creates distorted food perceptions and dysregulated food relationships. Ultimately, if you have a disordered relationship with (and perception of) food, then this cannot in any way promote health.
Health is not about macronutrient control or restriction. Macronutrients do not define your wellbeing. You are also not a better person for being a ‘sugar-burner’ or a ‘fat-burner’… there is no morality here. This is food, this is about nutrition – and this is about your health. You may need to manipulate macros to alter body composition – but you do not need to be low carb or keto to be healthy – far from it.
So Paleo, as it is based on health NOT weight loss or body composition is NOT Low Carb…
Do come back next week when we will talk more about when recommendations become rules and create unhealthy food behaviours – and how we ourselves aren’t even sure about where to draw the line when it comes to Paleo vs. Orthorexia… because, much as it’s hard to admit, sometimes the two really do converge.