Paleo Diet

•RCT evidence— Improves cardiometabolic markers; no longevity data

Evidence

A 2015 meta-analysis of small RCTs showed paleo-style diets improved weight, waist circumference, blood pressure, triglycerides, and HbA1c more than control diets over 3–24 months. Effects largely attributable to reduced ultra-processed food intake and increased vegetable / protein intake — not anything uniquely paleo.

What survives criticism

• Removing ultra-processed foods is high-value.
• Adequate protein and vegetable intake is good practice.
• Whole-food framing is sound.

What doesn’t survive

• The historical claim that "Paleolithic humans ate this way" is poorly supported — ancestral diets varied dramatically by climate and available food.
• Legume avoidance has no good rationale; legumes are cardio-protective.
• Whole-grain avoidance is unnecessary for most.
• Dairy exclusion is fine for the lactose-intolerant; otherwise the evidence supports moderate dairy.

Practical translation

A paleo template with re-included legumes and whole grains is essentially the Mediterranean diet with a different brand.

Related entries

Mediterranean diet, Ultra-processed foods, Fiber and the microbiome.