Does the Paleo Diet Support Long-term Weight Loss ?

paleo diet weight loss

Can the Paleo Diet help you lose weight?

While the Paleo diet is becoming increasingly popular, the movement has not been without controversy.

In a recent December 2013 US News report, the Paleo diet was ranked dead last on a list of the ‘best diets’.

Other critics respectively report that diets were likely more regionally diverse than we give credit. Others may also critique that a true Paleo diet may look something like an episode from Man vs. Wild where we might find ourselves chewing creepy crawlies and diving into some raw meat.

Most legitimately, critics report the lack of solid evidence from clinical trials that the Paleo diet is actually achieving results long-term – particularly with long-term weight loss.

While there are numerous anecdotal reports of positive outcomes with the Paleo diet for a wide range of health challenges,  long-term studies have been lacking.

So is it time to throw out the Paleo diet and go back to the drawing board?

Not so fast.

The Paleo diet consists mainly of fish, grass-fed pasture-raised meats, eggs, vegetables, fruit, fungi, roots, and nuts.  It also excludes grains, legumes, dairy products, potatoes, refined salt, refined sugar, and processed oils – and that gets stakeholders up in arms.

Because Americans do not eat ample nutrient-dense foods, they are often deficient in nutrients only found in fortified grains and dairy products. A misdirected criticism of the Paleo diet is that you lose access to these fortified products and therefore put yourself at risk for further nutrient deficiency. They fail to consider that you are replacing them with highly nutrient-dense foods that do not require fortification, and that our bodies functioned well for thousands of years without regular access to grains or dairy.

The excluded foods often line the inner aisles of our grocery stores, account for many jobs, and even cultural traditions. They taste good, they can be subsidized by our tax money, and are often fortified with extra nutrients that are lost with processing. They keep food cheap, tasty and convenient – but that does not always equate to “healthy”.

Another legitimate criticism of the diet is cost, with unsubsidized quality meat and vegetables costing consumers more at the grocery store, and brings up questions on environmental sustainability on a large scale. Those are legitimate questions, but the bigger question is likely the Farm Bill, and the true hidden costs of our food subsidies and health costs associated with the Standard American Diet.

We could discuss all of those ad nauseum and their are still some legitimate questions to be answered,  but it is becoming difficult to debate the basic tenets of a Paleo diet. For instance, one of the main criticisms cited by the US News “best diets” report was that the Paleo diet lacked research proving a benefit for weight loss.

A recent study published in January 2014 in the European Journal of Clinical Nutrition found that a Paleo diet was more beneficial than a diet within the Nordic Nutrition Recommendations (NNR) in terms of fat mass, abdominal obesity and triglyceride levels in obese postmenopausal women.  The two-year randomized controlled trial studied 70 obese postmenopausal women (average age of 60) who were given either a Paleo diet or the traditional Nordic diet.

While both groups had a significant reduction in total fat mass after 6 months and 24 months, more fat loss was experienced in the Paleo group at the 6 month mark.  Both groups also experienced decreases in waist circumference, with the highest decrease being in the Paleo group after 6 months.  In addition, the Paleo group had a more pronounced decrease in triglyceride levels at both the 6-month and 24-month marks than the NNR group.

This study shows that a Paleo diet is better than an NNR diet when it comes to fat mass, abdominal obesity, and triglyceride levels in obese postmenopausal women after 6 months.

While this study was published just one month after the  US News report was released, I wonder if the US News would have altered its ranking if equipped with this report?

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By | 2017-05-21T18:28:13+00:00 February 17th, 2014|Health Topics, Lifestyle Benefits|6 Comments


  1. Marguerite Tennier February 18, 2014 at 5:31 am - Reply

    Isn’t it true however that our ancestors on that diet died at 40 or so, not at 80, 90 or even 100 like many people today?

  2. Alexander Rinehart, DC, MS, CCN, CNS February 18, 2014 at 8:52 am - Reply

    Not a fair comparison. Much of the gains in life expectancy have been due to improved sanitation, water supply, education, housing, workplace safety etc….not to mention vaccines, antibiotics and medical advances but they actually account for less than the former elements. Life expectancy in 1800s was still in the 40s.

  3. Miriam February 18, 2014 at 5:06 pm - Reply

    And your take on Paleo vs. Mediterranean?

    • Alexander Rinehart, DC, MS, CCN, CNS February 18, 2014 at 5:16 pm - Reply

      The study was basically a look at Paleo vs. Mediterranean when you actually look at what comprises the Nordic recommendations. Mediterranean is wonderful when compared to standard american fare and still leads to healthy outcomes. I like that the paleo diet does pay more formal attention to hidden food sensitivities/allergies that are often overlooked sources of inflammation, difficulty gaining./losing weight, gut dysfunction, etc. (corn, dairy, soy, wheat, tree nuts, eggs, etc) . Both focus on nutrient-rich foods, healthy oils, and real non-processed foods. I like Chris Kresser, L.Ac’s take on the Paleo diet the best because he’s the first to personalize it based on your personal profile, and he’s not a hardliner like some of the other personalities in the Paleo community.

  4. Melissa February 18, 2014 at 7:25 pm - Reply

    Promoting a Paleo diet, while it may lead to some weight loss, can also lead to increased risk of heart disease and cancer, since it relies heavily on meat consumption. For health, weight-loss, and life longevity, the Eat to Live guidelines are optimal – fresh fruit, fresh vegetables, non-processed grains and beans/legumes. When the Paleo diet says it’s “safe” to eat bacon for breakfast, but not to consume legumes, I wonder how people are not more skeptical to research the overall health benefits of this plan. Plus, it is important to look at the link to CrossFit, since most avid Paleo dieters are also Crossfit enthusiasts that continuously train and/or compete at intense physical levels each week.

    • Alexander Rinehart, DC, MS, CCN, CNS February 18, 2014 at 8:09 pm - Reply

      Hi Melissa thanks for your comment as it brings up significant questions that many have regarding the diet. They are well beyond the scope of a comment, but I’ll try to touch base on some of your points.

      The diet is more flexible than what is believed. While there are general rules of thumb that yes bacon can be okay and general assertions that grains, dairy and legumes are bad. There’s a lot of grey areas in the science that Paleo advocates are mindful of…

      Yes, there are some hard-line personalities that have books to sell that cut a black and white picture of what paleo should be, but it’s not the case for everyone.

      There are also a number of individuals (and crossfit enthusiasts included) who think they are doing paleo, but just eat bacon and hamburgers and binge drinking on the weekend…but are still not getting the diversity of vegetables etc promoted in a “true” paleo diet.

      As for athletes and crossfitters, the exception is that they need more carbohydrates, and can get them in a paleo diet by eating starchier root vegetables and fruits. The more strenuous the individual or the workout, the more starch you require and can handle healthily (even white potatoes). Dr. Cordain’s Paleo Diet for Athlete’s covers this well, particularly when it comes to meal timing which can be just as important as meal composition. An active lifestyle and healthy diet go hand in hand and are hard to separate. There’s personalization that needs to be accounted for though based on individual context.

      I invite you to check out Chris Kresser L.Ac’s book Your Personal Paleo Code, and the resources connected to it on the companion website. He does the best job of sorting through the noise on these issues. So the “Paleo Diet” is a template to then personalize from, it is not hard and fast rules that create so much controversy. The principles are sound.

      As a general rule, many do not do well on grains and dairy. But if they do tolerate them, I agree non-processed grains are ideal, and would assert that full-fat dairy is preferred over the skim and low-fat versions.

      The science of saturated fats and red meat has shifted and there is a lot of information pointing to refined carbohydrates, processed oils, and added sugars as bigger issues to content with. Other factors are also important such as how food is cooked (ex. charring, high temperature cooking, frying with unstable oils) and how much processed meat one consumes (hot dogs, sandwich meat, etc). As always, the story goes deeper. There are also spiritual and cultural beliefs regarding consumption of meat, as well as humane treatment of animals, environmental conservation and more…again beyond the scope of this discussion and those are personal beliefs that I by no means would ever attack.

      I have covered the saturated fats, red meat, and heart disease concept pretty thoroughly in past articles, with the most comprehensive being here:

      Vegetarian, vegan, mediterranean diet all have their benefits (and each has their disadvantages too), especially when compared to the standard American diet.

      But this does not assume that a high protein (a lot more than just bacon), high veggie, no processed food and a personalized selective tolerance of starch, grains, dairy, and legumes is automatically unhealthy.

      The common thread for both approaches is the processed foods, processed oils, high heat cooking with the wrong oils, as well as unnecessary added sugars are extremely common in our food supply – and sedentary living is the norm, not the exception. I believe them to be at greater contributors to heart disease and cancer than red meat and bacon, and the research supports this when you sift through and account for confounders like charring meat, eating processed meats, cooking with the wrong oils, eating hamburgers with ketchup and white buns, etc.

      I’d be interested in your thoughts on my discussion here:

      Thanks again.

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