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Phil’s Paleo Diet

My friend Phil is a member of the diabetes support group that has been meeting every month in my apartment for the past couple of years. We are a group of people dedicated to tight control of our diabetes. Most of us follow a very low-carb diet and that way have found much better health.

For the past half year or so I have been following a type of low-carb diet that I learned from Dr. Loren Cordain, a professor at Colorado State University, which is about an hour north of where we live in Boulder. Dr. Cordain’s book, the Paleo Diet, overlaps considerably with the standard low-carb diet for people with diabetes, Dr. Bernstein’s Diabetes Solution. Dr. Cordain graciously waived his usual speaking fee when I asked him to speak to our diabetes support group and other local groups at the local hospital.

Besides myself since then several members of our diabetes support group, including my primary care physician, have begun to follow both then low-carb and paleo way of eating. Another member of the group asked each of us to write about what we eat. Phil’s response was so good that I’m forwarding it here with his permission.

Phil writes: Like several of us, I saw Loren Cordain give his presentation on the “paleo diet” at Boulder Community Hospital in late September. I for one immediately recognized it as a scientific paradigm I could “believe” in — after decades of dietary experimentation and uncertainty. I promptly bought the Paleo Diet book, and it was also immediately obvious how I could implement it.

If you are not familiar with that diet, it basically eliminates dairy, grains, and legumes — foodstuffs that arrived only with the neolithic “agricultural revolution.” It is based on what hunter-gatherers, both ancient and modern, ate for 2.5 millions years, plus modern nutritional research that confirms it. I tweaked it toward higher fat and lower carb to control my diabetes by eating only the high-fiber, low-starch vegetables, and eating only a little low glycemic-load fruit. I started out with the following simple and straightforward program:

1) Per the paleo diet, I eat some animal flesh every meal. Currently I do shrimp at breakfast, some kind of fish at lunch, and chicken at supper. Generally I eat no red meat, and I do eat one egg per day. I am age 63 now, and during my fifties I was basically a lacto-ovo vegetarian for the sake of the planet and in accordance with the vegetarian belief system. I still see value in that lifestyle and expect to move toward minimizing flesh-eating as I find reasonable ways to increase fat intake in order to get the calories I need to maintain my weight and substitute plant protein for animal.

2) I eat a bowl of three cooked low-glycemic-load vegetables at each meal that I buy frozen. Currently this is a random mixture of artichoke, asparagus, broccoli, Brussels sprouts, green beans, okra, spinach, and stir fry. It is very convenient for a bachelor who does not like to cook to pour these out of a plastic bag and nuke them in the microwave. Eventually I will probably find ways to increase the types of vegetables because this list seems rather limited.

3) I eat a bowl of “salad” — raw foodstuffs — at each meal. I prepare enough at one time to last five or six meals. Currently this consists of (in descending order of quantity) vegetables, nuts, fruits, and oil: namely avocado, bell pepper, berry medley, celery, clementine orange, cucumber, flax seed oil, macadamia nut, walnut, and yellow squash. Here again this seems limited in types, and I expect to find additional ingredients as time goes on.

Right after I started this diet, I used the USDA “Nutritive Value of Foods” handbook to calculate that I was getting about 100 grams of carbs, 50 grams of fiber, 150 grams of fat (only 25 grams of which was saturated), and 150 grams of protein per day. This was within parameters of the paleo diet for protein, but higher in fat and lower in carb, which was exactly what I wanted to help control blood sugar. I learned later that I do not need to fear saturated fat as much as Dr. Cordain seems to think, but what the heck, why seek it. I hope to tweak this macro-nutrient profile toward more fat and less protein while holding calories even.

There are a couple of things I learned from Dr. Cordain’s book that I would like to share here. First, the paleo diet is much more nutrient-dense per calorie than the “standard American diet” — which includes a lot of dairy, grains, and legumes. This makes it an excellent diet for both weight loss and health maintenance. Second, the paleo diet recommendation (in spite of the fact that I tweaked it to be high-fat) provides a good balance of omega 9, 6, and 3 fats: omega 6 should be no more than double omega 3. Only walnuts and macadamia nuts fall within that parameter, so that is why I put them in my salad and not something else. Also, flax seed oil is allegedly the best omega 3-heavy vegetable oil to put on the salad to balance the saturated animal fat in the paleo diet. More research will tell me if I can stop my fish-oil supplement if my body can convert the ALA in flax seed to the more bio-available DHA and EPA omega 3.

Speaking of food supplements, I take a vitamin and mineral formulation called EmpowerPlus from TrueHope. Six years ago this completely cured my bipolar affective disorder (for which I had been medicated for 17 years) exactly as if it were a nutritional deficiency. I also take daily 4000 IU of vitamin D3, Ubiquinol (bio-available form of CoQ10), and a digestive enzyme aid plus a “pro-biotic” because I seem to have a weak digestive system.

A few weeks after reading the Paleo Diet book, I read Jonny Bowden’s book, Living Low Carb. From it I learned about three dozen versions of the low-carb diet, including Atkins, Bernstein, and Rosedale — all familiar to our group. I also learned that protein has a glycemic load, but fat does not. I also learned that one can subtract the number of grams of fiber from the number of grams of carb to get “net” or “effective” carbs. On that basis, I am eating about 50 (net) grams of carb per day — low-carb for sure.  Soon I will get another A1C test to see how I am doing on this diet (plus exercise and metformin), and maybe tweak it all accordingly.

Like Phil, I am much healthier and feel a lot better on the paleo diet. I have completely eliminated grain and grain products — including all bread, bagels, pasta, etc. At first that was hard, because wheat in particular is addicting, as I have written here. But now that I’ve broken my addiction I don’t miss grain and grain products at all.

Because grains are full of starch, those of us who have diabetes have another reason to shun them. Wheat products in particular, but also rice and corn, spike our blood glucose levels.

While our paleolithic ancestors could not have been milking cows or goats or any other animals because they hadn’t domesticated them yet, dairy products are low glycemic. From time to time I still make exceptions for some of those cheese that have no carbohydrates.

Our paleolithic ancestors certainly didn’t tend to crops of legumes either, since nomads don’t farm. Uncooked legumes are loaded with anti-nutrients, and even cooking them doesn’t destroy all of them. But legumes, like dairy products, are low glycemic, and I can’t resist an occasional bowl of beef or buffalo chili with beans.

So I’m not a paleo purist. Even Dr. Cordain admits that we can’t eat a pure paleo diet now, since we’ve modified all the plants and meat (except wild fish) that we eat.

But I don’t question for a moment that, as he writes, “Just 500 generations ago — and for 2.5 million years before that — every human on Earth ate this way.” He’s surely right that our genetic makeup is basically the same as that of our Paleolithic ancestors and by moving back to the diet that we are genetically programmed to eat, “we can not only lose weight, but also restore our health and well-being.”

Our DNA has changed less than 0.02 percent in the past 40,000 years, as Dr. Cordain points out. This means that “literally, we are Stone Agers living in the Space Age.”

Now, we need to relearn how our Stone Age ancestors ate. We can.

This article is based on an earlier version of my article published by HealthCentral.

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  • Jane Marsh at

    Having read the above discussion, and having recently started studying Dr Sarah Myhill’s thoughts on her so-called Stoneage Diet, I’m interested in your thoughts on Intermittent Fasting as an add-on to these ‘paleo’ principles. There was recently a TV program on UK TV – Horizon, a respected scientific series – in which the benefits of IF were exposed in respect of reducing risk factors for all the major health issues in the Western World. Is it a good idea to combine the two ideas?

  • Mark at

    I also have lost weight and gained better control over blood sugar eating the paleo diet. Just a head’s up on a really great site for all things paleo: Mark’s Daily Apple http://www.marksdailyapple.com. Mark Sisson is incredibly insightful, sedulous in working his way toward reasoned conclusions, temperate and profound, plus he is a great writer and a lot of fun. Here is what he writes about diabetes: http://www.marksdailyapple.com/diabetes/ There are also many great recipes on his site. It’s very inspirational.

    • David Mendosa at

      Thank you. I have been reading Mark’s Daily Apple for some time now. But with your prompting I just subscribed.

  • shakeel at

    HI David, I read your blogs and do appreciate your insight,and the issues you highlight, I thank you for this.

    As I understand you followed a diet generally based or DR K.Bernstein, while talking metformin.

    And then you changed to low carb high fat and came of all diabetes medication.which gave you a good cholesterol profile

    But in this blog http://www.mendosa.com/blog/?p=902 Phil’s Paleo diet

    where you adjust towards a Paleo style diet

    you mention you also take metformin now, is this because the Paleo calls for more carbs,?

    And now with Hypothyroidism , do you notice your cholesterol profile is not as good,

    This below maybe of interest, paleo diet and leptin restistance


    kind regards

  • Pat at

    What do you think of The China Study and recommendations to limit animal products?

  • Bev at

    I was diagnosed as Type 2 diabetic twelve years ago. Have been on large quantities of oral meds ever since, and on insulin as well for a few years. I started recently to be way above my target blood sugar levels no matter what I did, and the only option seemed to be that much more medication. I heard about the Paleo diet almost accidently and not in conjunction with diabetes. I’ve only been on it for a week, but I feel better, am not hungry, am losing weight, and have decreased my medication once already. I’ve also been well within my target range at all times – lots of testing to make sure. I wish I had gone looking for this information a long time ago.

  • fredt at

    I have been Paleo “lite” (no sugar, grains, n-6, mep but allow traces or occasional dairy and legumes) for several years now, along the lines of PaNu. It has been good, off all medications. Insulin resistance gone or controlled with diet alone. Also lost a lot of weight.

    It seems that food controls the release of most metabolism hormones; insulin, glucgon, leptin, leptin resistance and ghrelin.

    It also seems that triglycerides must also be controlled by portion control of meats and fats.

    But what do I know

  • David Mendosa at

    Dear Ravi,

    Goat milk is likelier more healthy for humans than cow’s milk. So you raise an interesting question. But actually all the evidence that I can find confirms what Dr. Cordain says, that our paleolithic ancestors had not domesticated goats. For example, that the article, “The History of the Domestication of Goats” by K. Kris Hirst (at http://archaeology.about.com/od/domestications/qt/goats.htm ). Its conclusion is clear, that “Beginning about 10,000-11,000 years ago, Neolithic farmers in the Near East began keeping small herds of goats for their milk and meat, and for their dung for fuel, as well as for materials for clothing and building: hair, bone, skin and sinew.” Wikipedia confirms this.

    Best regards,


  • Ravi at

    With all due respect – the paleo cry “do not eat dairy” is highly suspect – while paleo’s generally have a pretty good f-off attitude towards conventional wisdom, they accept conventional anthropological assumptions that our paleo pals were not smart enough or capable enough to husband animals that provided milk/dairy nutritional adjunct… not true!- a close examination of the evidence leads to the conclusion that we very well could have and did keep at least goats – if not other mammals long into our paleo past enjoying the delectable white gold…

    Check out the argument here: http://daiasolgaia.com/?p=1302
    Ravi @ DaiaSolgaia.com

  • Maria Diabetes-Nurse at

    After finding out I have Celiac (24 years into the IDDM!) and going on the Specific Carbohydrate Diet/ low carb, I have to say one thing: wish I had known about it 25 years ago!!!!
    Makes diabetes SO much easier!!!!
    Now… if only I could get my Endo to read Bernstein…

  • Parth Adhyaru at

    Love this article!
    As if I’m reading all of my own thoughts!
    Amazingly written!

    Parth Adhyaru
    M.D. (AM)

  • Sarah at

    PS – Sorry for the long rambling post. I got excited that you brought up the paleo diet because it’s been a good thing for me.

    I should have specified in what ways I feel better. Hunger has been much less of a problem. If I have had a good paleo meal, that seems to keep me going through the day. In the past, if I skipped a meal, I would feel faint and disoriented. I had to be very careful to eat small high protein meals throughout the day, to keep my blood sugar, mood, and energy stable. This was especially true after I quit metformin without adjusting my diet adequately. Taking up the paleo diet seems to have been the adjustment I needed.

    I also don’t seem to suffer from orthostatic hypotension anymore. This means I can now stand up quickly from a sitting or lying position without losing my vision or beginning to pass out.

    So in general, I no longer have episodes of lightheadedness and I feel more alert. Does this mean that my blood pressure has gone up because of my terrible red meat and animal fat diet? I don’t know. Since I’m young and my cholesterol and blood pressure numbers are normal, I’m not too worried about this but I’m curious where it will go as I remain on the diet. (Having low blood pressure and low cholesterol is not a picnic, even if it’s the better end of the pole.)

    I also always used to be anemic when they bothered checking, and while I haven’t had it tested, I suspect that may have improved (or anyway I would hope so, given how iron-rich my new diet has been).

    So now I’ve written another rambling post but I wonder what other people’s experiences have been. I never thought I would go off grains entirely, so this has been quite an experiment for me!

  • Sarah at

    I’ve been trying out the low carb paleo diet (with cheating) for a few months now.

    I mainly cheat with low carb dairy (mostly heavy cream) — I figure the fact that I’m lactose tolerant says something about my personal ancestral diet?

    Soup is a big one for me that Phil didn’t mention — I like to stew some kind of bones over night to make a good stock, and then add vegetables and meat or fish with a few seasonings. So versatile and very filling!

    I actually seldom eat salad because I realized that for me, most vegetables are simply easier to digest and more palatable for me when they’re cooked. I’m wondering whether I’ll change my mind when summer rolls back around on the east coast!

    I have definitely found that eating low-carb paleo has reinforced a preference for foods that are or that seem relatively less modified – especially when it comes to fruit. The typical apple or orange can seem HUGE and syrupy sweet compared to, say, blackberries. I also pick out different vegetables — less celery, carrot, cauliflower, and more arugula, kale, broccoli rabe.

    I’m embracing saturated fats, since I have sources for pastured organic meats. Jennifer McLagan’s cookbooks have been really helpful in expanding which “parts of animal” I’m willing to eat, so that I can get more calories and more nutrients than I’d be getting from lean meat alone. I also found that getting adventurous at authentic ethnic restaurants has helped. Most other cuisines do a much better job at eating the whole animal in an unprocessed state! I can’t make pate or headcheese at home, but I’ve found that many Chinese dishes are easier to reproduce. I’ve found many favorite new foods this way.

    There’s a book “Four Fish” about how we’re domesticating fish even as we speak, so the fish exception may not hold for long, whatever that will mean for the future. I’ve found that sardines are my best bet when factoring in taste, nurition, price, and environmental impact, though whiting works better in soup.

    I feel healthier when I don’t rely on substitutes, but over Christmas I did a lot of baking with stevia, cocoa powder, coconut flour, and coconut oil. Not 100% paleo (some of the recipes were labeled “paleo deviant”), but it helped me get in the holiday spirit without totally derailing my new diet! Not many things bother my stomach, but it seems that Splenda does, so switching from Splenda to stevia/erythritol, for cheating purposes, was a good thing for me.