In addition to my three months alcohol free I am further customising our diet to really focus on maximising health. We follow what is a largely Paleo Diet inspired way of eating with tweaks for autoimmunity. The basic diet guidelines leaves some room for self interpretation and that is where we have made a few missteps and have some room for optimisation over the coming three months.
I figure with alcohol removed this is a perfect time for me to tweak the basic Paleo template to include more of the good stuff. I guess it also does not hurt to add that we have been a little naughty over the Christmas break. A few takeaways and too much alcohol. We always eat well but I want to eat as clean as possible for the next few months and really maximise nutrition.
The diet I am looking to develop is ultimately fine tuned as a starting point for those of us in our fortieth year and beyond to keep us happy, fit and functional for many more years to come.
Basic Paleo
Robb Wolf is pretty much the standard bearer for what is or is what is not Paleo and I tend to look at Robb’s site first. Few reasons for this but the Paleo theory has led to a pretty dynamic diet which has, much like our good selves, evolved over time. Low carb, high carb, high protein – all can be catered for within a Paleo template. However, for absolute beginners there are a few basic guidelines that helps you get 90% of the way there. Beyond that, you must experiment, tweak and customise the diet to your own specific situation and goals.
I pinched the following cute little table from Robb’s site but it sums things up quite nicely:
So we have fruits, vegetables, lean meats, seafood, nuts and seeds and healthy fats in the okay to eat column. We then have dairy, grains, processed food of all types, sugars, legumes (beans), starches and alcohol in the avoid column.
For many people following these basic guidelines provides the simplest route to improved health, weight and sporting performance. This is somewhat of an umbrella approach and sure some folks are okay with a few grains or dairy and grass fed butter is okay for most but this approach provides a simple jump in point (which is important). Certainly, if you have digestive issues or health maladies of any kind rearing their ugly head (as many of us do as we enter our forties) then this basic template offers huge improvements without too much tinkering or experimentation.
For a more detailed overview of each of these categories head over to Robb’s site and read the overview of the basic Paleo diet tenets there.
Improvements to Paleo
There are a few people out there that have tried to tweak or refine the basic Paleo guidelines. The idea being that they are improving the core guidelines in some way. As with Robb Wolf most of these ancestral diet strategies have been founded by people who have fought their way back from complex health conditions that where traditional medicine offered little in the way of results.
Before we can look at ways to improve and simplify implementation of the overall Paleo prescription for those of us 40 and beyond we should look at the others diets that have tried this usually with a very specific goal.
Dr. Mark Hyman – The Pegan Diet
The Pegan diet is interesting if somewhat strangely named. My initial feeling was that this would be a Vegan take on Paleo so include no animal products all. Rather the diet is inspired by the fact that Vegan seems to work for some folks as does Paleo. What the diet really does is focus more on vegetables, reducing the amount of meat, removing dairy for most and further promoting fish, grass fed meats etc in a lower quantity and to ensure you get some good omega 3 sources like sardines in the diet.
My take really is that this is just a sensible spin on Paleo which often gets regarded as a kind of low carb “eat as much bacon as you like” diet like Atkins rather than the sensible take promoted by Robb Wolf, Chris Kresser etc. To get around this the diet outlines key foods that should be included like oily fish and limits too much (cheap and nasty) meat products.
Dr. Jack Kruse – Epi Paleo
Jake Kruse comes off as a bit of a loon. This is a shame as he does have some good ideas so it is worth looking past the veneer of crazy.
His take on Paleo though I have a lot of time for. Jack has several tiers where he believes we should focus our food intake. These almost sit above standard Paleo and provide clearer guidelines on what should be eaten to maximise nutritional input.
Ideally the diet should include the following in order of priority (if not volume):
- Shellfish
- Crustaceans
- General Fish
- Organ meat of grass fed pastured animals
- Muscle meat of grass fed pastured animals (Paleo starts here in Jack’s opinion)
The diet also strongly suggests the inclusion of:
- bone broths
- sea vegetables
The diet also considers meditation, circadian rhythms and exercise as part of the core prescription. Jack also asks that any nightshade vegetables are removed ideally and certainly where there is proven illness or inflammation (potatoes, peppers, tomatoes, aubergines/eggplants etc).
The practical takeaway here is to maximise fish input and ensure small omega three fish like sardines, prawns, highly nutritious food like mussels etc are a regular part of the diet as they are just so packed with goodness and less problematic than traditional meat products.
There is a good overview of the Epi Paleo diet here: https://www.jackkruse.com/brain-gut-6-epi-paleo-rx/
The Paleo Autoimmune Protocol (AIP)
The autoimmune protocol is close to my heart as my wife has multiple sclerosis that we keep largely under control and have done for five years or so with our own take on Paleo which we talk about at our other site: www.primod.co.uk.
The autoimmune protocol builds on the basic Paleo guidelines and recommends the removal of other food types with a goal to test if they are problematic:
- Nuts & Seeds
- Nightshades (potatoes, tomatoes, peppers, aubergines / eggplants etc)
- Eggs
- Alcohol
- Sweeteners
- NSAIDS
Much like the Epi Paleo and Pegan there is a focus on maximising nutrient intake and healing the gut so adding in bone broth and ensuring no grains, no dairy, no legumes etc are key components here.
I first heard of the autoimmune tweaks to Paleo from the original Paleo Diet book by Lauren Cordain and then this was expanded by Robb Wolf on his podcast (which largely launched Paleo out of the gyms and into the public eye).
The Autoimmune research has really been spearheaded by Sarah Ballantyne AKA The Paleo Mom in recent years who I have had the pleasure of working with in helping her manage her website. Sarah herself battles autoimmune conditions and as such has in the trenches experience which I think is essential when wading through the sea of often contradictory information.
The Perfect Health Diet
The Perfect Health Diet is not quite Paleo but it is certainly inspired by ancestral thinking and evolution and has reached many of the same conclusions. The Perfect Health Diet has helped to remove the scaremongering around carbohydrates and starches which has fed back into modern Paleo carbohydrate and starch recommendations (some good, lots can be bad, non is also hugely problematic over time). The whole carbohydrates picture is complex primarily due to the starting point of the individual yet it’s clear some whole food carbohydrates are essential and this needs to be adjusted around goals.
The diet also provides simplified instructions regards the exact types and ratios of foods available and has dared to question some Paleo stalwarts like the safety of pork.
I think that the perfect health diet represents the best overall diet for most people looking to maximise health and longevity. It is of note that it is not finely tuned to specific autoimmune conditions and needs a few small tweaks such as the removal of potatoes and other nightshades should you have autoimmune issues yet for most it is practical and achievable.
The Paleo Cure / Personal Paleo Code
Chris Kresser is a Paleo practitioner who has been involved in the scene since the early days. Chris has a strong research background and a clinic where he has helped thousands of people who have tried many different approaches to deal with and recover from chronic health issues.
This research and practical experience has led to a strong understanding of how various dietary strategies like GAPS, SCD and low carb can be used as tools to tackle specific issues. Additionally how the diet must be customised for an individual based on their current situation. That is the diet to fix a problem may not be the same as the diet to maintain health once it has been achieved.
Chris has a diet that he has called Your Personal Paleo Protocol and which has seemingly rebranded to the Paleo Cure (confusing). The approach though is to customise a diet based on the basic Paleo premise and all these many twists and turns to suit your specific needs at a given time.
More than anyone else on the Paleo scene Chris understands the need to identify an individuals situation and customise a diet accordingly so this is a great jump in point for those with complex health problems or issues not resolved by basic Paleo.
Terry Wahls – The Wahls Protocol
Terry Wahls is a medical doctor who used Paleo principles and functional medicine to reverse the ravaging effects of Multiple Sclerosis (an issue close to my heart). Terry declined rapidly after diagnosis and spent four years in a tilt recline wheel chair and was almost completely confined to a bed. During this time she researched brain health and the autoimmune disease process and devised a diet that was designed to A) halt the autoimmune process and B) provide optimal nourishment for the brain.
Terry’s story is truly amazing and a testament to the power of the human spirit and how diet and lifestyle changes can impact ones individual health. I recommend everyone watch her TED Health video to get the full story.
The Wahls diet tackles things primarily from these two directions to halt and heal but really focuses on covering all of the nutritional bases to ensure healthy brain and central nervous system functioning. As such there are some great takeaways with regards to keeping our brains functional as we age – something I certainly care about.
The problem with Paleo
The main problem with Paleo is that it is predominantly a loose set of a high level guidelines with a hell of a lot of scope for personalisation. Much as you could follow a vegetarian diet and just eat toast and pasta every day you can craft a far from perfect diet under the basic Paleo guidelines. I think there may be a bit too much entrenched ‘meat is good’ mentality which eclipses the fact that fish is also good and that most folks are simply not going to source high quality, organic and grass fed meat (certainly in the UK / busy families etc).
We also have a lot of people that think that Paleo is basically a low carb or Atkins style diet which is far from the truth and leads to some frustrating opinions online.
If we dig in we see that there are several diets that are suggested as being optimal for health:
- Conventional dietary guidelines
- The Mediterranean Diet
- Paleo / Ancestral Diets
- Low Fat Diets
- Low Carb Diets
- Vegetarian Diets
- Vegan Diets
That is just the tip of the iceberg and each diet has it’s own detractors and fans. The big conflict I see at the moment is between the pro fat and anti fat crowds. We have those like Dr. Dean Ornish and Dr. Roger McDougal which firmly believe in the power of a low fat diet for everything from MS to Cardiovascular disease. Then the pro (good) fat crowd which includes Paleo and the likes of Dr. William Davis and Dr. David Perlmutter who argue for the inclusion of more dietary fat. We even have folks like the Bulletproof Executive telling us to drink butter and refined coconut oil products in our (bulletproof) coffee every morning.
The main takeaway here is that it is super confusing out there and many people have success with many different dietary strategies. Even the BBC has picked up on this and has articles on the low fat, high fat conundrum.
If we look at the diets of traditional people we see populations eating high fat and protein diets, high fat and dairy diets, low fat carbohydrate heavy diets and all without the modern diseases of civilisation. Therefore it would seem that there is no perfect combination of macronutrients and those arguing for such a case are likely incorrect or trying to push an overly simplified generalisation.
In fact, if we think from an evolutionary perspective. Humans would likely have eaten high carb some times, low carb some times and somewhere in between at other times. It is crazy to think that ancestral diets would have had a perfect split of carbohydrates, proteins and fats on a daily basis. You kill a huge beast – you are going to eat that huge beast for a few days so protein and fat. Berries are in season – you may eat super high carb for a while. Factor some seasonality into this and it is likely we would have swung between periods of lower and higher carbohydrate and other macronutrients. The human body is very flexible and some variation in the foods and macronutrients we eat throughout the seasons is natural – there likely is no single perfect prescription for every single day of our life despite dietary guidelines to this effect being everywhere.
The issue of food quality and in particular organic and pasture raised naturally fed meat makes things difficult further still. In many cases Paleo makes the assumption we are eating food that is naturally grown be that meat, fruit or vegetables and for most real people we are eating what we can find (and afford) in the supermarkets or local shops which does not always live up to these lofty standards. Certainly supermarket chicken is a nasty old affair.
From a diet prescription perspective having this many natural variables is troubling – we want simplicity. Do this and see this result. Maybe this is why so many diets work for a while and then plateau. There are actually diets like the Paleo inspired AltShift diet that recommends shifting between high and low carb days and this is not miles away from the treat day approach often used (and taken to the extreme by Carb Nite).
There are a few variables here so how do we improve Paleo? How do we create some practical and easy to follow guidelines? How do we make it more suitable for your average 40 something? Is it tweaks to the recommendations to keep our body and brains healthy? Is it a more practical approach to the implementation? Improved guidance with regards to customisation? All the above? The following is my attempt at a prescription so you can take all that Paleo has to offer and ensure you are maximising to keep yourself physically and mentally healthy to a ripe old age.
Improving Paleo for the Average Joe (and Jane)
A lot of diets start with what you can’t have. That sucks a bit as it starts you off on a negative footing so lets look at the wondrous world of food that you can enjoy.
Vegetables
Vegetables should form the base of your diet and be the thing you eat in abundance. That is they should be at the bottom of your food pyramid. Lots of colourful, seasonal, vegetables. Cooked and raw. Fermented. Just eat lots and lots of vegetables of all shapes and sizes and you are going in the right direction.
- vegetables of all shapes and sizes
- don’t go crazy with the starches (potatoes etc) *
- try and include vegetables with prebiotic fiber
- eat cooked and raw vegetables
- avoid nightshades if you have autoimmune issues
Starch
I am a big believer that starch should be tailored to personal situation and matched to activity levels. I am not against carbs and the science shows that they are essential but everything from no carb, low carb, high carb has it’s place – I think of these approaches as tools and they must be tweaked for the individuals tolerance / situation.
As some general guidelines I think the following works:
- 20% to 30% of calories – for general population who are not athletes – this level of carbs would tend to promote longevity and limit the ravaging effects sugar can have on our brains as we age so for those of us 40 plus looking to extend our lives you will want to sit about here
- 30% to 40% of calories – active people or athletes *
Athletes can also take additional carbs after activity or on training days if required
To keep this simple I just tend to have some carbs with dinner and keep breakfast and lunch low carb. A sweet potato or some roots. If I have been inactive (working at my desk and little else) I will keep it lower carb on the evenings as well. My wife who walks 10k a day on average and runs tends to need a bit more so she fills the gap with dark chocolate bounties – not ideal but the exercise certainly allows her some flexibility that I don’t really have.
There is a really comprehensive (and totally sane) look at carbohydrates on the perfect health diet site.
Fruit
I find the ancestral mindset really useful here – consider where you live and what fruit would have been available? Three bananas a day? I don’t think so. The availability of fruit would have been seasonal and there would have been a lot of berries with apples and pears likely available at certain points.
Most modern fruit has been modified to be sweeter than it would have been – I still remember the crab apples that just grew in my garden as a kid and they were edible but not pleasant.
Fruit is okay and high sugar fruits can be good after exercise but don’t go crazy. Fructose (fruit sugar) does us no good in large amounts so that morning glass of healthy fruit juice needs to go.
Some basic rules for fruit:
- berries are low sugar and ideal
- ideally aim for seasonal fruit so you are not scoffing bananas every day
- give yourself a bit more breathing room for fruit in summer
- use fruit for a post exercise sugar boost if needed
Fish
If Paleo gets one thing wrong it is that it points people towards meat over fish. Generally fish is a safer choice and white fish hits the lean protein guideline perfectly. However, it is the shellfish and crustaceans that really provide benefits as we age and we try to have mussels at least once a week. Also smaller oily fish like Mackerel and Sardines provide a cheap, convenient and healthy way to get our Omega 3’s in.
Fish is not without it’s problems though and farmed fish fed unnatural diets (pretty much all Salmon) should be avoided where possible. As a tip the fish in the freezer section generally tends to be wild and from the sea so start there.
- Shellfish – not a lot but try to include once a week
- crustaceans – prawns are lovely
- small oily fish – three to four times a week
- avoid large fish – this tends to have the worst issues with polution
- lean fish protein – better than most lean meats
I know not everyone is super keen on fish but if you can work some sardines into a big ass salad a couple of times a week at work (or just eat them out the tin as a snack as I do) then have shellfish, prawns and cod one night you are really moving in the right direction.
Meat
There is nothing wrong with eating meat. Meat provides a comprehensive range of nutrients and protein and lets be honest, is very tasty. Meat in the UK is not quite the horror story it is in the US but there is still an order of preference.
As a general rule of thumb: wild or traditionally reared (grass fed) animals are better. Limit animal fats – saturated fat is not the demon it was once portrayed as however the fat is where the nasties build up (if your meat is organic and grass fed then don’t worry about this).
The following is from the Perfect Health Diet site:
If we were to rank popular meats by their healthfulness, the order would be (1) fish and shellfish, (2) ruminants (beef, lamb, goat), and (3) birds (duck, chicken, turkey). In last place would be pork.
We avoid pork pretty much. We will eat good bacon now and again but the correlation between pork and various diseases along with our own experiences means that joints of pork are off the table for good. There is an interesting study on pork and inflammation on the Weston A Price site that that I recommend anyone struggling with inflammatory conditions read: http://www.westonaprice.org/health-topics/how-does-pork-prepared-in-various-ways-affect-the-blood/
Meat that can be worked into the weekly diet
- Chicken breasts
- Grass fed and pastured ruminants (beef & lamb)
- offal – tough gig for some but very good for you if from healthy animals
- birds (duck, chicken & turkey – ideally organic)
We avoid pork as much as possible which is not to say we never eat good quality bacon.
Summary
My mission here is to simplify and frame the Paleo recommendations in particular for those of us 40 or older. I want to provide a clear guideline for what you should eat to really maximise nutrition and health.
I would however welcome any feedback – what are you guys eating? What are you not eating? What is working for you? And most importantly of all – why?
References