Is the Paleo Diet Healthy? What the Science Actually Says
Is the Paleo diet actually healthy? Should you eliminate grains, legumes, and dairy to "eat like your ancestors"? A 2019 study found that long-term Paleo dieters had lower beneficial gut bacteria, reduced microbial diversity, and higher levels of TMAO, a compound linked to cardiovascular disease. The ancestral wisdom might be more modern anxiety than evolutionary truth.
This episode traces the Paleo diet from its actual origins—not CrossFit boxes in 2010, but 1890s "wilderness cults," Gilded Age masculinity panic, and upper-class men doing caveman cosplay to feel less soft. We cover the founders (one was a eugenicist who advocated for the mass slaughter of dolphins), the rules, and why the whole framework is based on foods that didn't exist in the Paleolithic era.
The Paleo diet isn't just about eating like a caveman—it's an ideological package that reveals contemporary anxieties about gender, modernity, and identity. In this episode, Zoë and Kylee trace Paleo's roots from 19th-century "wilderness cults" where middle-class white men played at manual labor to reassert their masculinity, through the eugenicist origins of its founder, to its modern incarnation as a $500 million industry complete with paleo cruises, paleo protein powders, and paleo meal delivery services.
The central promise—that we can buy our way back to an imagined ancestral authenticity—turns out to be masculinity, politics, pseudoscience, and consumer capitalism wrapped in an anti-modern rhetorical burrito. When someone says they're paleo, you're learning about their politics and what they're anxious about way more than their dietary preferences.
The anxieties driving the Paleo diet today are remarkably similar to fears from 150 years ago. During the Gilded Age, rapid industrialization, the women's rights movement, and immigration sparked panic that white men were becoming "too soft, too civilized, and too feminine." The response was wilderness cults and physical culture movements—theatrical trials of strength that ultimately led to the founding of the Boy Scouts.
The diet component emerged in 1952 with Arnold de Vries's "Primitive Man and His Food," then in 1975 with gastroenterologist Walter Voglen's "The Stone Age Diet"—written by an explicit white supremacist and eugenicist. Modern paleo leaders have tried to disavow him, but the philosophy remained entangled with ideas about racial purity from the start. The diet as we know it took off in 2002 when Dr. Lauren Cordain published "The Paleo Diet," giving it academic credibility while keeping the same framework: modernity bad, ancestors good, individual consumer choice as the solution.
The demographics of this diet are extremely specific: primarily affluent white male followers, heavily represented in Silicon Valley (Peter Thiel is a notable adherent) and CrossFit communities. According to 2018 Gallup data, liberals are 5.5 times more likely to be vegetarian than conservatives. Research shows that omnivores identified more closely with the Republican Party and reported greater approval of Donald Trump's performance.
Paleo rebranded healthy eating as inherently masculine. Instead of dieting, you're eating like a hunter. Workouts became "primal movements" and "warrior training." You're not counting calories like a "neurotic dieter"—you're optimizing your biology like an engineer. It's boy dieting: a way for men to engage in body modification while reinforcing masculine identity. Paleo created a space where you could reject industrial food without embracing liberal solutions—the right-wing version of Whole Foods.
At the heart of Paleo is the naturalistic fallacy: the idea that natural equals good. The pitch is "our ancestors ate this way for millions of years, therefore it must be optimal." But that's like saying our ancestors died of infections, therefore antibiotics must be bad. On average, Paleolithic humans lived to 33.
One of the clearest rebuttals is lactase persistence—the ability to digest milk into adulthood. This evolved independently in several populations within the last 10,000 years. In East African populations, it went from essentially zero to nearly ubiquitous in just 3,000 years (150 generations). When paleo advocates say our bodies haven't adapted to grains and dairy, they're demonstrably wrong. Some populations have adapted to dairy very recently and very dramatically. We're not frozen in time—we're still evolving.
A 2019 meta-analysis in Nutrition Journal found average weight loss of 3.52 kg compared to standard dietary recommendations—but most studies were only 12 weeks long, and every single one noted that adherence was a huge problem. When paleo was compared to Nordic Nutrition Recommendations, the differences weren't dramatic by the end. Both diets worked, suggesting the specific "paleo" aspect wasn't the magic ingredient.
A 2015 systematic review claiming paleo benefits for metabolic syndrome received a scathing response in 2016 titled "Paleo Diet Still Lacks Evidence." The critique pointed out that paleo was being compared to low-fat diets we already know aren't optimal, and four out of six "significant improvements" weren't actually statistically significant. When paleo is compared to the Mediterranean diet or other evidence-based eating patterns, the benefits disappear.
A 2019 study in the European Journal of Nutrition found that paleo followers had lower populations of beneficial bifidobacteria, higher levels of TMAO (linked to cardiovascular disease risk), and less microbial diversity overall. For every 10 gram decrease in whole grain intake, TMAO levels increased—the exact opposite of what you want for heart health.
High protein intake increases calcium excretion in urine, and without dairy products, there's real concern about long-term bone health. The diet provides essentially no dietary vitamin D. A 2021 study found modern paleo diets are very high in red meat, which was associated with increased risk of cardiovascular disease, type 2 diabetes, colorectal cancer, obesity, and stroke. Wild game that Paleolithic humans ate contained less than 4% fat (mostly unsaturated), but modern meat can have 25-30% fat with much higher saturated fat content.
This is where paleo advocates are most clearly contradicted by evidence. Study after study shows whole grains reduce cardiovascular disease risk, type 2 diabetes risk, certain cancer risks, and are associated with lower all-cause mortality. Paleo conflates refined grains (which can be problematic) with whole grains (which are protective)—they're completely different health effects. For about 95% of people, whole grains are beneficial.
Research shows paleo can trigger eating disorders and orthorexia because it feeds an unhealthy obsession with eating "the right foods." The emphasis on purity, the moralizing language around food as good or evil, and the masculine performance angle of willpower can be dangerous for people predisposed to disordered eating. The restriction-binge cycle is real: binge eating and restriction are two sides of the same coin.
The science is mixed at best. Short-term studies show small benefits on certain metrics, but usually when compared to outdated diets, with small sample sizes, short durations, and high dropout rates. Emerging research shows concerning issues with gut health and potential long-term risks we don't fully understand. It's expensive ($12/day adjusted for inflation), environmentally unsustainable (if everyone ate paleo, we'd need several more planets), and probably no better than any dietary pattern that emphasizes vegetables, fruits, and whole foods without eliminating food groups humans have adapted to eat.
When people see benefits from paleo, they're likely benefiting from minimizing ultra-processed foods, eating more vegetables and fruits, and increasing protein intake—not from eliminating grains and beans. You could get the same benefits from the Mediterranean diet, which is the most well-studied dietary pattern in history, without the risks and restrictions. People can eat however they want, but let's not pretend paleo is just about health. It never was.
- 2019 meta-analysis in Nutrition Journal on paleo diet weight loss outcomes
- 2016 "Paleo Diet Still Lacks Evidence" response in American Journal of Clinical Nutrition by Jacobs et al.
- 2019 Giannone et al. study in European Journal of Nutrition on gut microbiome changes
- 2021 Science of the Total Environment study on sustainability and health impacts of paleo diets
- 2018 Gallup data on dietary patterns and political affiliation
- 2016 Journal of Nutrition study on paleolithic and Mediterranean diet pattern scores
- UC Davis 2020 info sheet on calcium excretion and bone health concerns
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References
Books
Arnold DeVries, Primitive Man and His Food (1952)
Walter L. Voegtlin, The Stone Age Diet: Based on In-Depth Studies of Human Ecology and the Diet of Man (1975)
Loren Cordain, The Paleo Diet: Lose Weight and Get Healthy by Eating the Food You Were Designed to Eat (2002)
Mark Sisson, The Primal Blueprint (2009)
John Durant, The Paleo Manifesto: Ancient Wisdom for Lifelong Health (2013)
Marlene Zuk, Paleofantasy: What Evolution Really Tells Us About Sex, Diet, and How We Live (2013)
Peer-Reviewed Research
Mannheimer et al., "Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis," American Journal of Clinical Nutrition (2015)
Jacobs et al., "Paleo Diets Still Lack Evidence," American Journal of Clinical Nutrition (2016)
Journal of Nutrition (2016) — Paleolithic and Mediterranean diet pattern scores and association with inflammation and oxidative stress markers
Anton et al., "How diets work: popular diet methods reviewed," Nutrients (2017)
Genoni et al., "Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations," European Journal of Nutrition (2019)
Science of the Total Environment (2021) — Sustainability and health impacts of Paleolithic diets
PMC, "The Paleolithic Diet" (2023) — Analysis of wild vs. domesticated meat fat content
Surveys & Reports
Gallup Poll, "Snapshot: Few Americans Vegetarian or Vegan" (2018)
UC Davis Nutrition Information Sheet (2020) — Calcium, Vitamin D, and bone health concerns
Other Sources
Adrienne Rose Johnson, food historian — on Voegtlin's advocacy for mass slaughter of dolphins and tigers
Hodson & Earle (2018) — Research on meat consumption, political ideology, and social dominance orientation
Dr. Peter Ungar, University of Arkansas — paleontological research on human teeth and diet