Confused? Overview and Distinctions Between Paleo and Ketogenic Diets

The Paleo Diet was proposed as early as 1975 but was popularized in 2002 by Loren Cordain, PhD in his book The Paleo Diet. Based on the idea that our genes are well adapted to a world in which all the food eaten daily is hunted, fished or gathered from the natural environment, Dr. Cordain recommended a whole food diet containing meat, eggs, nuts, seeds, vegetables, and fruit.   He proposed that the core staples of our diet in this century – cereals, dairy products, refined sugars, fatty meats, and salted processed foods- were destroying our body’s metabolic machinery. He argues convincingly, that we have strayed from the path designed for us by nature.  He proposes that “The Paleo Diet is the key to speedy weight loss, effective weight control and above all, lifelong health”, (p.11).  Dr. Cordain’s original Paleo Diet has been substantially reinterpreted by many different nutritionists and practitioners so be aware that there is more than one “paleo” diet in the marketplace with wide variations on what is included and excluded and the recommended mix of macronutrients.  Below are Dr. Cordain’s original recommendations. Main Features include:

• Low Carbohydrate – Recommends about 22-40 % of calories come from carbohydrates, specifically non-starchy vegetables and all fruits, all nuts and all seeds. Starchy tubers like potatoes, yams and sweet potatoes are not allowed as well as all legumes (including peanuts and soy), all grains, all grain-like seeds (amaranth, buckwheat and quinoa), high sodium foods and fatty meats.  Dairy products and butter are excluded as well.  Cordain does not allow honey, though he believes it was a natural source of sugar obtained by early man, understandably, on rare occasion. He does allow dried fruit in limited portion. However, it is important to be aware that many recently published Paleo diets and cookbooks use a considerable amount of dried fruits in addition to sugar, maple syrup, fruit juices, molasses and honey as sweeteners and some versions include potato, sweet potato, yams, cassava, taro and plantains, which collectively can easily drive this to a moderate or even high carbohydrate diet depending on how the consumer makes food choices.
• Low to Moderate Fat – Recommends about 28-47% of calories come from fats. Saturated fats are for the most part discouraged including butter, meat fat, and cholesterol found in meats and fats. (At the time Dr. Cordain published in 2002, the world of research had yet to establish this error, but it has since been clearly validated over and over that we do need cholesterol. More updated versions of The Paleo Diet do allow butter and fattier cuts of quality meats though they tend emphasize a low to moderate fat intake and point to protein as the most important fuel.) Monounsaturated fats such as olive oil, nuts and avocados are recommended as well as polyunsaturated Omega 3 fats from fish oils, while Omega 6 sources in processed foods are discouraged.
• Moderate Protein – Recommends 19-35% of caloric intake come from protein. Cordain’s book recommends lean cuts of meat and poultry and encourages wild sourced meats such as wild game and seafood. Newer Paleo diets include bison and other wild meats, and often are perceived and described as High Protein diets so be aware there can be variations in protein recommendations.
• Recommendations: Paleo diets in general are sensitive to the importance of food quality, animal care and feed, and concerns about toxicity from pesticides, and genetic modification. Be aware however of the wide variations in quantity of protein, quality and quantity of fats and the collective possibility of high sugar/carbohydrate recipes in the marketplace.

Ketogenic Diet is the newest catch word in the market place and will likely continue to be in the new year to come. Dr. Adkins was the first to launch this concept in 1972, which was to suggest that lowering carbohydrates was essential to weight loss, however, his program even today still supports the use of artificial sweeteners, soy and damaged fats in his products and he did not adopt the high fat concept that is better understood today. Additionally, Adkins did not account for the damage associated with too much protein.   A Ketogenic diet is designed to address insulin and leptin resistance from consuming too many net carbohydrates (total carbs minus fiber) and too much protein.  It does this by taking away glucose as the primary fuel for the body, force the body into nutritional ketosis (not to be confused with ketoacidosis) in which the body burns fat as its primary fuel rather than glucose.  Dr. Ron Rosedale (www.drrosedale.com) and Dr. Joseph Mercola (www.mercola.com), are both proponents of this kind of diet for healing and good health. According to their websites and books, this kind of diet can be very healing and restorative to lose weight, lower inflammation, reduce risk of cancer and help with treating cancer as well as increasing muscle mass, normalizing appetite, improving mental clarity and reducing sugar and junk food cravings.  Once the body is “fat adapted”, meaning able to burn fats efficiently, then recommendations are to cycle in and out of nutritional ketosis by feasting on higher carbohydrate vegetables and fruits once or twice a week to maintain metabolic flexibility. Main Features include:

• Low Net Carbohydrate (Determined by subtracting fiber grams from carbohydrate gram to get net carbs). Ketogenic diets are usually in the range of less than 50 grams of net carbohydrate a day and are very specific about the source of the carbohydrates.  The diet excludes grains, sugar, milk, yogurts, beans and legumes as well as all processed foods such as chips and fries. It focuses on low carbohydrate vegetables, some nuts and seeds and sprouts. Caution should be used in reaching this level, if reduction in carbohydrates has never been done before, by slowly reducing carbohydrate intake over several weeks to avoid dramatic low blood sugar, until the body becomes efficient with sourcing and burning fat.
• High Fat –Emphasis is placed on the quality of the fat and is clearly defined by a group of foods and sources which provide it. Strong emphasis on avoiding refined oils, trans fat and fats high in Omega 6 inflammatory oils. Recommendations are for fats to be anywhere from 50-80 % of total caloric intake (e.g. 1200 calorie diet in which 600-960 calories come from healthful sources of fat). Caution should be used in reaching these levels of fats, accomplishing this by slowly increasing fat intake over several weeks to allow the pancreas and gallbladder time to adjust to a higher fat diet.
• Adequate Protein –An important nuance of the ketogenic diet, protein needs are determined by mathematical formula, personal health and activity level. The concept is to get adequate protein but not too little or too much.  Most people will need between 30-70 grams of protein a day, spread throughout the day.  This includes protein from plant and animal sources. According to Dr. Mercola, in his new book Fat for Fuel, excess protein can stimulate a regulatory pathway in the body which can promote inflammation, growth of cancer cells and can convert to glucose, thus negatively impacting blood sugar and insulin levels (pp. 47-48).  As with carbohydrates and fat, source matters and quality matters.
• Recommendation: This diet encourages intermittent fasting and optimally clean, unprocessed and undamaged foods. To minimize side effects and benefit from the ketogenic diet, we would recommend seeking guidance from a nutrition consultant knowledgeable about this diet and reading a book to ensure good understanding and proper implementation.