Digging into paleo and elimination diets

For National Nutrition Month, we tasked some of Parkview’s top dietitians with explaining some of today’s most popular nutrition trends. In this post, two team members take on a pair of timely topics: paleo and elimination diets.

Paleolithic diet

This content was written by Molly Brennan, RDN.

While the methods we use to obtain our meals has certainly evolved over the years, a fairly recent approach to eating – the Paleolithic diet – strives to reconnect with the dietary habits of our ancestors.

The Paleolithic diet, also known as the caveman diet or paleo, was designed with the intention of achieving a wholesome diet by mimicking our ancestor’s hunting and gathering eating patterns. This diet is comprised of lean meats (primarily grass-fed animals, wild game), omega 3- fatty acid-rich fish, fruits, vegetables, nuts and seeds. This diet eliminates grain products, dairy, legumes, potatoes, refined sugars and oils. Followers of this diet believe that these foods were only available following the agricultural revolution.

Free of these “inflammatory” foods associated with chronic disease, this diet is often promoted as a weight loss solution. But is this true? Is channeling our inner cave person the answer to a healthier lifestyle?

Establishments like Mayo Clinic have concluded that there is no statistically significant evidence to suggest that this diet will lead to better health other than mere calorie restriction.1 Nutrition expert, Heather Manigeri, MS, RDN, CSSD, LDN, a spokesperson for the Academy of Nutrition and Dietetics, explained in a recent Today’s dietitian article that the paleolithic diet is beneficial for some in the sense that it, “emphasizes fruits, vegetables, nuts, seeds and lean protein. However, any diet that suggests eliminating an entire food group can set you up for nutritional deficiencies, boredom, and an over focus on food."2

Because the diet eliminates grains and dairy based foods, the individual may need additional supplementation to meet recommended vitamin D and calcium requirements. Additionally, the 2015–2020 Dietary Guidelines for Americans recommends that individual consume at least half of their grains in the form of whole grain or whole wheat products. Furthermore, a 2016 meta-analysis of 45 cohort studies, published in The BMJ, examined the relationship between whole grain consumption and reduction of various chronic disease, such as CVD and cancer “Researchers concluded that intake of whole grains is associated with a reduced risk of coronary heart disease, CVD, cancers, respiratory and infectious diseases, and diabetes.”3 

Overall, the paleolithic diet is most likely healthier than what the average American typically consumes. Being comprised of primarily nutrient dense foods that are naturally lower in calories, it is no surprise that one may in fact lose weight following this eating pattern. However, any diet that eliminates one or more food group may not be beneficial toward one’s long term health. Living in the Midwest, where it’s only sunny six months out of the year, most of us rely on dairy products to meet our vitamin D and calcium needs. Removing this food group means missing out on vital nutrients. As the evidence suggests, whole grains and grain products are in fact worthy of our consumption. Bottom line: Do use your suburban foraging to fill your plate with nutrient dense foods and do what works best for your body. If this is a diet that works well for you, make sure to include carbohydrate-rich fruits and vegetables as well as other non-dairy foods rich in calcium and vitamin D.


Elimination diet

This content was written by Nick Patterson, RD, CD.

Symptoms caused by food sensitivities and intolerances can wreak havoc on your day. While food allergies are relatively easy to test for, food sensitivities can be much more difficult to pinpoint. Add to that, testing isn’t always reliable. Since we consume many different foods on a daily basis, determining which foods you may be sensitive or intolerant to can be a challenge. 

One of the common ways to rule out any food intolerances or sensitivities is to trial an elimination diet. The information provided below will help you determine if an elimination diet may benefit you.

The American Academy of Allergy, Asthma & Immunology defines a food intolerance or sensitivity as the difficulty digesting a particular food, which may lead to symptoms such as gas and bloating, abdominal pain or diarrhea. Keep in mind, that a food allergy involves the immune system and can cause much more severe reactions, while a food intolerance/sensitivity is thought to involve more of the digestive system and causes temporary symptoms or discomfort.  It may be helpful to first be tested for specific food allergies. 

Other symptoms, such as nasal congestion (stuffy nose) and headaches after eating certain foods have been linked to food sensitivities and intolerances. There can be many other causes for these symptoms, so check with your doctor first to rule out any other underlying issue.  Some of the most common food intolerances and sensitivities include:

•          Dairy products/lactose

•          Gluten (non-celiac gluten sensitivity)

•          Caffeine

•          Sugar alcohols

•          Monosodium glutamate (MSG)

•          FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols)

If you suspect a food intolerance/sensitivity, you might benefit from trialing an elimination diet.  An elimination diet is meant to be a temporary tool and only the foods found to cause symptoms should be eliminated long-term. This entails eliminating an individual food for a period of time, monitoring for changes in symptoms, and re-introducing the food. 

Most elimination diets work best if a food is eliminated for at least 2-3 weeks. Depending on how your symptoms change during that time period, this may give insight into a possible intolerance. Before eliminating a certain food for good, you may need to repeat this multiple times to confirm a true intolerance. You can eliminate multiple foods at once and re-introduce them one-by-one, but this can become overwhelming for some and be less reliable.

Tips for a successful Elimination Diet:

• Starting an elimination diet while traveling or during the holidays can make it more difficult to pinpoint trouble foods. Reserving elimination diets for regular weeks when you have a more consistent schedule can help.

• Keeping a journal and documenting changes in symptoms while eliminating and re-introducing foods is crucial for reliable feedback.

• Be patient. An effective elimination can take time, but it will be worth it if your symptoms improve.

Finally, be cautious of randomly following an elimination diet from the internet or social media.  While you can trial an elimination diet on your own, do not feel like you need to do it alone.  Meeting one-on-one with a Registered Dietitian to get you started on the right path can make things easier. This also allows for a catered plan that is specific to you. You may also find follow-up visits helpful to relay any feedback and make necessary adjustments. If you are struggling with symptoms caused by a food intolerance or sensitivity, an elimination diet may provide you with much needed relief.


 

Sources:

1.Paleo diet: What is it and why is it so popular. Mayo Clinic. 2017.

2. Amidor, T. (Feb 2018). Paleo: Spotlight on the Paleo Diet. Today’s Dietitian, vol. 20(2), p14.

3. Aune D, Keum N, Giovannucci E, et al. (2016 )Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 353:i2716.

4. Food Intolerance | AAAAI. (2019). Retrieved from https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/food-Intolerance.

5. Kabbani, T. (2014). Celiac disease or non-celiac gluten sensitivity? An approach to clinical differential diagnosis. Am J Gastroenterol, 109(5). doi:10.1038/ajg.2014.41.

6. Lavine, E. (2012). Blood testing for sensitivity, allergy or intolerance to food. Canadian Medical Association Journal, 184(6), 666-668. doi:10.1503/cmaj.110026.

7. Turnbull, J. L., Adams, H. N., & Gorard, D. A. (2014). Review article: The diagnosis and management of food allergy and food intolerances. Alimentary Pharmacology & Therapeutics, 41(1), 3-25. doi:10.1111/apt.12984.

 

 

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