Friday, October 25, 2013

Half-assing paleo... Could it kill you?

If you have been hanging around here for a while, you may recall that, about 18 months ago or so, I did a post about "half-assing" paleo -- and the conclusion was that, yeah, you can do that, if it is all part of a planned steady march toward ultimately dialing it all in and doing it right. In other words, you can start slowly and work your way up to awesome. But, what about a whole different kind of "half-assing" paleo? Let me describe someone and you see if you know that person.

He (or she, but I will pick on a guy today) did a paleo challenge, and liked the results -- a lot. He found that 30 days of grain-free, dairy-free, legume-free, beer-free living with an emphasis on lots of animal proteins, vegetables of many types and colors, and good fats, and, really, he never felt better.

But then a few months removed from the challenge, things aren't going so well for our man. He is still eating a lot of animal protein. "Dude, bacon is delicious. So are eggs. And steak? Oh hells, yes!" But veggies? He loves his sweet potatoes, but the rest of the veggie world hasn't been making an appearance on his plate nearly as often, certainly not at every meal like it did during the challenge. And fat? He digs his bulletproof coffee, but there's a whole 'nother world of gross vegetable oils that our boy is horsing down on a regular basis. See, unlike that month of paleo perfection, now he is eating out a lot. He goes to the bar post-work, or post-softball-game, and eats french fries or sweet-potato fries*** cooked at high temps in vegetable oils, and he drinks beer with his buddies. Because... beer, dude! And fries! And then there are the burgers. Nothing wrong with burgers, but those lettuce wraps he was ordering during the challenge? Yeah... not so much now that the challenge is over. "Plus, dude, they have these *amazing* pretzel buns for burgers at the bar...." Oh, and cheese and ice cream are delicious too. And he digs cookies, and chips sometimes too. in fact, all dessert is pretty awesome. After all, he works hard and "deserves" it.

Our man is (at best) half-assing paleo, and it's not as part of any "plan." He has just morphed from someone who was "eating paleo" to a guy whose dietary choices amount to "meat and eggs plus crap."

Do you know that guy?

I am not a medical professional, and I certainly have made it clear pretty often around here that I don't care what you do. You are an adult and can make your own choices, but our man in the example seems to me like he is headed for a heart attack, or some heavy atherosclerosis that could lead to all sorts of things.

Like a heart attack. Or a stroke.

Here's why....

There is a wonderful new book out by Jimmy Moore, who enlisted a boatload of medical professionals to help him. It's called Cholesterol Clarity, and, along with The Paleo Coach and The Paleo Solution, is required reading if you want to do this paleo thing right.

See, a whole lot of us experience an interesting series of effects from full-on (i.e., non-half-assed) paleo living. First, we feel fantastic with low-inflammatory living. Second, proper blood-sugar management means that for the first time in our lives, we aren't hungry every three hours We control our food instead of food controlling us. Third, our LDL goes up and our standard-issue non-paleo doc has a cow about it.

Jimmy Moore's book, and a load of other paleo resources -- like Chris Kresser and Chris Masterjohn among others -- will lead you to a simple conclusion: "LDL" as run as part of a standard lipid panel is a nearly meaningless number. I don't want to go too far down the rabbit hole of science here. Kresser and Masterjohn are the authorities in that regard, but let's descend briefly, but carefully....

"LDL" as expressed on your standard blood panel is what is called "LDL-C" by the smart guys. The smart guys also don't care much about it. Instead, in recent years, if you get NMR blood testing done --  which *can* be ordered by any doc (but rarely is) but *will* be ordered by a paleo doc on this list or this one -- you will see what D. Boon called in another context "a mile of numbers and a ton of stats" that your regular doc will never see.

Those "extra" stats measure things like LDL particle size,  LDL particle number ("LDL-P" and "Apo-B") and, most importantly, inflammation of the whole-body variety ("C-reactive protein," among others) and, more particularly, of the myocardial-stress type ("NT-proBNP" and "Galectin-3"). The NMR blood panel will also tell you, just like the standard panel, what your HDL and triglyceride numbers are and other juicy items like fasting glucose, Vitamin D levels, etc.

What you will find, from Moore's book, and elsewhere, is that, in general, fairly strict paleo eating decreases all the bad inflammation numbers (that's good) , increases HDL (that's good too), decreases triglycerides to rock-bottom (also good), and makes the great majority of your LDL particles light and fluffy (whoo!). It also sometimes *increases* your LDL-C, and you might also find that your LDL-P (particle number/count) is not in the optimal range. Your standard doc will go bananas over the increased LDL-C, and even a paleo doc will tell you that there *may* be a bit of a concern with non-optimal LDL-P. But those same paleo docs will also tell you that the most serious threats are inflammation, followed by high triglycerides and low HDL. See, if inflammation is low, atherosclerosis does not happen easily. The LDL particles, even if present in higher numbers, float right on by -- unless you are inflamed.

If you are getting the idea that inflammation, not LDL, is the issue, you are right on the money.

And generally speaking, as I noted, if you are pretty strict about your paleo eating, your inflammation, triglyceride and HDL numbers will be spectacular. But what about our man, the half-asser?

Chances are that all the gluten from the wheat and the beer in his life  (you *do* know that almost all beer has gluten, right?), crappy vegetable oils, legumes, etc. are inflaming the hell out of this guy. Chances also are that his HDL has plunged (bad) and his triglycerides have soared (also bad). Combine that inflammation -- whole-body and cardiovascular -- with the often-increased LDL figures that paleo causes, and, suddenlly what look like relatively benign LDL issues unto themselves become pretty freaking scary when coupled with an inflamed system, high triglycerides and low HDL. 

If what this all appears to mean is that half-assing paleo -- or, more specifically, making your food choices amount to "meat and eggs plus crap" -- could be a ticket to *very* poor health, yeah that is exactly what it seems like to me. In fact, I will go so far as to say that if most of what someone retained from his paleo challenge days was high animal-protein consumption, but he has lapsed into downing gluten, legumes, vegetable oils and dairy on a regular basis, that person is on the road to potentially very serious inflammation-related problems. My bet is that almost anyone would be better off on a Mediterranean diet than a half-assed version of paleo that seems to be combining the worst aspects of the Standard American Diet with heavy meat consumption.

Yes, a guy who bills himself as the Paleo Drummer just told you that paleo can lead to problems. Not strict paleo, mind you, or even something close to it. But you you can really mess yourself up by eating a version of paleo that isn't really "paleo" at all. "Meat and eggs plus crap" is a bad formula to reach good health.

Don't be a half-asser when it comes to paleo. It could kill you.

***Sweet potato fries, a.k.a. "the biggest scam ever." Yes, sweet potatoes can be good for you. Sweet potatoes deep fried in boiling hot vegetable oil? No. Those aren't any better for you than regular french fries, a.k.a. The Worst Food In the World.


  1. I agree that 'meat plus crap' is pretty bad, but I think that for certain foods, including them in the diet is beneficial regardless of what the rest of the diet is composed of.

    Eggs are definitely one of those foods. Egg yolks are ridiculously nutritious, and every egg study I've ever seen has shown improved lipid profiles, so I think eating plenty of eggs is healthy regardless of what the rest of your diet looks like. I think the same goes for other nutrient-dense animal foods, like liver (and even butter).

    I agree that for most people, a "Mediterranean diet" would be better than what you described, if only for the reason that most of the veggie oils would be replaced with olive oil. But I'm not sure a meatless crap diet is better than a meatful crap diet. They both could definitely end up killing you, but depending on the foods that the meat is replacing, your example guy could still be much better off than someone who drinks a coffee with creamer in the morning (instead of bulletproof coffee) and has a soy burger (instead of a real burger) for lunch.

  2. While I'm eating my lunch of bursting-with-vegetables quiche + large side salad, I couldn't agree more that the vegetables with every meal thing is the number one aspect of paleo that I would bring up to explain why I eat this way. Sadly, it also seems to be the aspect that's most overlooked in articles "debunking" it. What gets "debunked" almost always amounts to "eating tons of meat". :(

  3. I worry about this too, having gotten my family on the Whole30. Now they've gone back to eating bread, cheese, etc but retain their love for the macadamia nut habit they acquired and are gaining back all the weight plus. Sigh.

  4. I pretty much eat Vegan with the exception of adding a little meat. No processed foods. I may have a couple of eggs in morning, maybe a little beef at lunch and dinner. I guess that makes me a half ass Vegan. (Just a little sarcasm to add to the mix).