When people are passionate about things, they tend to get very defensive. Question someone’s child, and they are bound to get upset in a hurry. I certainly do! So why is it people get so defensive when you start explaining the Paleo diet to them?
Today I saw a lady at my office. Fairly typical middle-aged, over weight female with poorly controlled diabetes. She recently started on an insulin pump but her glucose control is no better at all. I had a suspicion why, and again started to question the details of what she eats. Of course, she eats carb after carb after carb. Whole wheat this, and low fat that. She has tried to cut the carbs in the past, and actually had pretty decent success, but quickly falls back into your carbilicious ways. Why? Why go back when a change in diet shows clear improvement in her sugars?
Another gentleman today saw me for his second visit with me. He changed from another physician because he heard I was good at treating diabetes, and felt his prior physician was not doing a good job. During his first visit he explained what he was looking for; excellent sugars with minimal medications, and to be able to eat what he wants. No problem right?! Over around 20 minutes I proceeded to deflate his balloon to the point it may have actually been a black hole by the end of the visit. He was very frustrated because his sugars were regularly bottoming out, yet his Hemoglobin A1C (90 day sugar average we use to direct care of diabetics) was still too high. He was essentially convinced that the labs were repeatedly wrong. He swore his sugars were always “around 100.” So, luckily for me, and unluckily for him, I did a 72 Hour Glucose monitor on him. This is a device that is connected to your belly via a microscopic fiber, and it checks your glucose every 5 minutes for 72 hours. What did we find? For three days in a row the pattern was clear… Every evening his sugar shot up around 7:30 like one of the Blue Angels during an air show. It would hover around 400 a few hours, then slowly drop overnight. In the morning, as he would typically skip breakfast it would plummet. By noon he would eat a “sandwich and chips” and it would shoot up to around 300 for a few hours before things started again before dinner. So, clearly his prior physician was doing a terrible job (insert sarcasm here) and all I had to do was change a few things up and it would be ok!
On todays visit we reviewed the 72 hour glucose monitor, and I broke it down for him that if HE wanted to control his sugars we could do it, but HE would have to make some significant changes. What kind of changes? Changes of OMISSION. I started to tell him the typical Paleo diet rules…and he became, you guessed it, very defensive. “But how do I eat a sandwich???….”
I would love someone to please answer this question for me; What is so terribly crazy about the Paleo Diet? You hear it talked about on the news and they make it sound so revolutionary or “different.”. Simply stated, Paleo is not about what you eat, it’s about what you DON’T eat. The Paleo diet does not ADD anything to your diet that is out of the ordinary, extremely controversial, or generally crazy. Even the devil that is an egg is getting off the hot seat lately. All it truly does is OMIT certain things from your diet. But not all diets of omission are so highly scrutinized. Remove meat and become a Vegan and it’s “chic and trendy,” cut out carbs and it’s reckless and dangerous! Give me a break! So why is it so crazy? Why are people so, and I mean this literally, offended by the notion of changing to a Paleo lifestyle? It’s because they are passionate about their carbs…
People are addicted to carbs. Tell a heroin addict you are going to take away their heroin, and they get very defensive. Tell a carb addict you are going to take away their pasta Primavera and it’s time to break it down Bruce Lee style. Let’s look at this simply, eating Paleo allows you to eat meat, vegetables, fruit, eggs, and nuts. All these are 100% natural, nothing fancy here. Please, how is this dangerous or controversial? The extra meat you eat to replace the pasta is dangerous? “But there is no data that so much meat is good for you…” Well guess what, there is plenty of data that too much pasta is BAD for you. Want data? Talk to my two patients above. They both love pasta, and they are both diabetics in their 50’s who keep eating pasta and can’t control their blood sugars.
Can meat hurt you? Can vegetables hurt you? Can fruit hurt you? Can eggs hurt you? Can nuts hurt you? Barring actual allergies, I say the answers are no.
Ok, let’s look at the other side. Can dairy hurt you? Can grains hurt you? Can sugar hurt you? Can artificial crap hurt you? I’m going to go with yes on these, and there is science to prove it. (See rising rates of diabetes, lactose intolerance, fatty liver, cancer, auto-immune disease etc, etc)
So, what is Paleo truly guilty of? In my opinion, it is guilty of exposing people for what they are…carbohydrate addicts. It can’t possibly be guilty of making people eat un-natural foods, or unrecognizable concoctions companies sells as “food.” It’s not a fad diet, as fads make you eat things that come in and out of style. What is a fad anyway? It is defined as: an intense and widely shared enthusiasm for something, especially one that is short-lived and without basis in the object’s qualities; a craze. Last I checked meat, vegetables, fruit, eggs, and nuts have been around a long time. Probably a little longer than a tortilla chip or fat-free cheese. A rice cake…now that was a fad!
What do addicts do? They generally know what they do is bad for them, and they have periods of clarity where they do better. Eventually though, the pull of their drug of choice draws them back in. Or, they slip up and use just a little and BAM…right back to square one. They feel shame for their addiction, people look down upon them for it, and they wish so badly they could make a permanent change, but they always fall back into old habits. Now, imagine a heroin addict who is advised to control the addiction by sticking with “moderation” because of course, everything is good in moderation right?
Sadly, if you insert carbs as the addiction in this scenario, you might as well see pictures of my two patients above. They literally can’t imagine life without eating their daily carbohydrates. There is real fear and confusion when I try to take away what makes them feel best. Heroin is clearly bad for you, but a loaf of french bread or rice and gravy certainly can’t fit in the same category can they? Well they certainly are not as ACUTELY dangerous for you, but a long-standing addiction to carbs lead to the same result as any other addiction. Without the same pattern of addiction is there regardless of the “drug” of choice.
What’s worst than that? Diabetics are told to control their sugars by using the very carbs they are addicted to in “moderation”…and somehow we are surprised that they can’t stop over eating carbs. As the Hartwig’s in their book It Starts With Food label it, OVER-carbsumption. Paleo simply OMITs the drug…and somehow it is a bad thing… The current food pyramid does the same thing with obesity! Lose weight by eating the things that make you gain weight in moderation. It’s a lose-lose situation.
Oh, and one more thing Paleo is guilty of. It makes the sugar people, and the wheat people, and the dairy people, and the soybean people, and the corn people….you guessed it, defensive 🙂 Their “bottom line” is very defensive about their products potentially being a major cause for obesity and chronic disease. They rely on the government to make sure that nothing about their industry gets labeled as a potential problem. Can I blame the government? Yes and No. But, that’s a whole other blog post entirely…
Meat, vegetables, fruit, eggs, nuts…these actual foods, 100% natural FOODS can’t hurt you. Instead Paleo is guilty of simply exposing people, industry, pundits etc for who they are. They are either addicted to carbs, their livelihoods depend on your carb addiction, or their election depends on your carb addition. It’s sad, it’s true, and I’m afraid it’s here to stay.
-Ernie
By the way, do you agree with this post? Do you know people who could stand to hear it? Do me a favor, share it everywhere you can. Post on Facebook, tweet it to followers, reblog it, pin it on pinterest to your heart’s content. In many ways I preach to the choir. Most who follow my blog agree with these concepts because you already follow a Paleo Lifestyle. But, many do not. The only way to bring about change is to spread the word! So, if you want to help, share away! Thanks for reading, and thanks for your support. Please comment all you want, conversation is a good thing!
PaleoHikerMD 
Steve Parker, M.D.
February 17, 2015 at 8:39 am
Amen, brother.
Another issue that type 2 diabetics have is that they’ve been eating copious carbohydrates for over 40 years. It’s hard to break any habit with that type of longevity. It doesn’t help that they’re immersed in a carb-centric culture.
-Steve
PaleoHikerMD
February 19, 2015 at 11:48 am
No Steve, it’s all genetics 🙂 It’s not the rice and gravy, biscuits, cakes, cookies…etc. Keep up the good work on your site!
K
February 17, 2015 at 9:50 am
I would love to hear your take on how eating more eggs and meat does not necessarily create a cholesterol problem. I think it’s addressed well in The Paleo Solution, but some people need to hear a doctor’s perspective. We have all heard that eating more whole grains and low-fat products can benefit our health, and that we should reduce our animal protein.
PaleoHikerMD
February 19, 2015 at 11:47 am
Thanks for commenting. I’m thinking maybe this would be a good blog post! Stay tuned and I’ll address these questions 🙂
hfsg
February 19, 2015 at 8:51 am
Reblogged this on Health Food Store Girl and commented:
Interesting thoughts on Paleo diet and why we resist quitting our carbs. I followed strict Paleo for a few months last year and I have to say I felt wonderful. I still do feel wonderful, now including occasional complex carbs and not saying no to a fresh french sourdough baguette once in a while!
PaleoHikerMD
February 19, 2015 at 11:36 am
I don’t believe that 100% Paleo is necessary, and many agree. 85% Paleo is adequate IMO, but there of course are certain things I’ll never eat! A fresh sourdough baguette….like REAL Fresh! Yes, I may indulge at times. A stale Twinkie…not for me (or you I am sure). Reality is many people do not have will power to “dabble” so they have to stay more strict. Also, some people are more truly addicted and a little carb hit takes them back down the hill. None the less, thanks for reading and sharing!
Hannu
February 19, 2015 at 11:19 am
My thoughts exactly!!
PaleoHikerMD
February 19, 2015 at 11:33 am
Thanks for reading!
Sofia
February 21, 2015 at 12:52 am
This is one of the best blogs/posts I’ve read on the subject. I thought l couldn’t survive by cutting out certain foods. That was until l realized how much better l felt not only physically but emotionally! I’m so much more levelheaded and calmer on Paleo. I don’t feel bloated, sluggish or tired. I’ve followed Paleo for about a year; very strict for the past month. I feel really sick when l stray. Not worth it!! If l have dairy or grains, my stomach lets me know within the first 15 min. The “pleasure” resulted in pain.
SimpleLivingOver50
February 21, 2015 at 10:19 am
I agree with you 100%. I am reposting this article. I am kicking ass with the paleo lifestyle and Type II Diabetes has nothing on me.
PaleoHikerMD
February 21, 2015 at 10:51 am
Keep it up:). Ignore the haters…
SimpleLivingOver50
February 21, 2015 at 10:19 am
Reblogged this on Simple Living Over 50.
elizabeth2560
February 21, 2015 at 5:42 pm
Hello. New here – exploring the medical perspective of various diets. I cannot seem to find easy link on your pages to a summary of what a paleo diet actually is. Does it contain any grains? Is it completely carbohydrate free? Surely the hunter-gatherers would have eaten some whole-grains from grasses and carbohydrate root vegetables? I am curious to the concepts behind the diet.
I would also like to read about your take on the high consumption of meat and eggs (as in the comment above) and evidence of any long-term health effects, either detrimental or beneficial.
By my research, it seems to me that cultures with the lowest incidence of heart disease typically consume a high carbohydrate, low-fat (not always), low-meat, almost-zero-sugar diet, yet all begin experiencing higher levels of the diseases of affluence when they take on a western – style lifestyle. The defining changes appear to me to be lower activity, higher time-stress, smoking; and diets lower in fibre, lower in fruit and vegetables, higher in fat, higher in kilojoules, higher in meat, higher refined carbohydrate and sugar. While the exact components that lead to the diseases of affluence are highly contested (and it may be a combination of several), I do not believe It is the carbohydrate per se. Whole-grains and legumes can and – dare I say it – should be consumed as part of a healthy diet. I think where you may be coming from is: what is the best diet to follow once diseases of affluence appear. That is, when one has over-consumed for forty years, what is the best way to reverse the problems that have occurred? However, is that also the key to prevention? Is this the same diet?
PaleoHikerMD
February 21, 2015 at 7:58 pm
Hi there and thanks for reading! The Paleo diet consists of what I call a real food diet. No processed foods, no grains, no dairy, no legumes, no sugar. All carbs you take in are from fruits and vegetables, and they have plenty to go around. Would the hunter-gatherers have had some whole grains? Well, maybe a very scant few IMO (I am no paleontologist!). The inclusion of appreciable amounts of grains did not occur until the agricultural revolution. The diet you discuss, a “high carbohydrate, low-fat (not always), low meat, almost-zero-sugar-diet” is similar to the diet many American’s eat today. This is the type of diet many physicians and cardiologists recommend for their patients. One problem though, it simply does not work! Look around. The amount of carbohydrates humans eat has steadily gone up in the last 30 years, and the amount of fat humans eat has in turn gone down. Yet, cardiovascular disease, cerebrovascular disease, diabetes, cancer, auto-immune disease etc are all steadily on the rise. If the diet you say is best actually is, then people who follow it should do better long term. Fact is they do not. I could not disagree with you more as I feel the carbohydrate is THE major cause of chronic disease; not fat or protein. Whole grains and legumes are not required for a healthy diet because your body was simply not designed to digest them, and they can cause inflammation which may lead to chronic disease as well.
Take for example fatty liver disease. Fatty liver disease is a relatively new disease first described in the medical literature in the 60’s-70’s in Japan I believe. What is the cause? Carbohydrates! Patients preparing for a bariatric weight loss surgery are placed on essentially a Paleo diet, and surgeons routinely see a 50% decrease in the size of patient livers for surgery due to a dramatic drop in the fat stored in the liver. When you eat a diet high in carbohydrates your body never is required to manufacture glucose in the liver via gluconeogenesis, and in fact actually stores excess carbs as fat in the liver. That is precisely how fatty liver disease occurs. There is absolutely no such thing as an essential carbohydrate. It’s simple biochemistry.
Lastly, look at animals. If you look into the population of apes that are kept in zoos across the world, over 80% of them have DIABETES. Why? Due to budgetary problems zoos have been forced to feed them “cube” foods made of fillers such as corn and wheat. In a zoo in California they actually converted apes back to their natural diet and their diabetes resolved in almost every case. Again, simple facts easily researched.
If you search the fossil records, the majority of chronic disease began after the agricultural revolution and the beginning of our dependence on grains. Our brains steadily grew during humanity’s high meat eating hunter stage. Our brains have statistically gotten smaller in the last 100 years.
These are of course my opinions that I have drawn from my research and personal experience with patients. Some will agree, some will not, but I see things this way. As always, this does not substitute for sound advice from your personal physician. I simply share my frustrations with the SAD diet and where I see it getting my patients. Thanks again for reading, and good luck!0
elizabeth2560
February 22, 2015 at 5:12 pm
Thanks for your reply.
I have a few more questions.
Are these foods allowed on paleo diet: bacon, salt, herbs, spices, coffee, alcohol?
Where is data re: brains getting smaller?
Where is the evidence that individuals who eat whole grains and legumes (and not fat, refined CHO and sugar) have a high incidence of CVD, diabetes, cancer and fatty liver disease?
A couple of comments.
I agree with you about the SAD diet.
I am also appalled at the growing statistics on certain diseases.
I admire you as a doctor that you have taken a stance of offering dietary solutions to your patients.
What I am trying to say is there maybe not only ONE healthy diet solution.
I repeat my previous comment that someone who has ‘over-consumed’ for forty years may need drastic dietary measures to reverse the damage.
Where you are coming from (seeing those people and recommending diet to reverse these effects) is different from where I am coming from in preventing those diseases in the first place.
There is strong evidence that cultures who have diets high in (low-glycaemic) CHO, low fat, low meat, low sugar have a very low incidence of the diseases of affluence and also have longevity (sardinia, Italy; Okinawa, Japan; Costa Rica, Greece*, Seventh day Adventists in USA; cultures throughout south-east asia). Yet these cultures develop these diseases if a western-style lifestyle is taken on.
PS. Apes are vegetarian.
elizabeth2560
February 22, 2015 at 5:16 pm
* Re: my last comment; Greece being the exception and consuming a diet higher in fat than the others listed.