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Against the grain

Tue., Jan. 29, 2013

Old dietary standby isn’t old enough for Paleo followers

Alicia Troye was exhausted, and her joints hurt. “Everything hurt, all the time,” she said. She was 37.

Her doctor ruled out arthritis, thyroid problems and other potential causes of her fatigue and pain. Meanwhile, in an ongoing struggle to lose weight, the Coeur d’Alene woman zeroed in on gluten, a protein found in wheat, rye and barley.

“I wasn’t even thinking about the pain in my hands. I was thinking, ‘Well, what if I went gluten-free? Maybe that would help me lose weight.’ ”

It didn’t. But, slowly, she began to notice other changes.

“I could sleep again through the night, and it wasn’t bad sleep,” Troye said. “I didn’t feel as tired – I started exercising. And the pain wasn’t there anymore.”

She joined CrossFit, an exercise program offered at thousands of gyms in the U.S. Like many CrossFit members, she switched to the “Paleo diet,” casting all remaining grains from her plate.

That’s when she lost 40 pounds, she said, and her life was changed.

As the grain-free news spreads through diet books – including titles among Amazon and New York Times best-sellers – and among friends and online, grains are getting the boot from a lot of plates. For some, cutting grains – some or all – has led to weight loss and alleviated pain. The phrase “life changing” appears frequently on pro-Paleo websites. For many with celiac disease or gluten intolerance, gluten-free diets offer long-sought relief.

For others, the movement away from grains and toward more meat may be confusing: Wait, aren’t we supposed to be eating more whole grains? And why do some people feel so tired on grain-free diets while others seem to thrive? And is bacon good for us now?

‘In a perfect caveman world’

Just as there are many people seeking to improve their health, there are many takes on grain-free diets.

Gluten-free food has gained mainstream status – with more foods labeled gluten-free appearing on store shelves and menus – as more people have been diagnosed with celiac disease. Gluten triggers an immune reaction that damages sufferers’ small intestines and prevents absorption of some nutrients. Other people suffer from gluten sensitivity – not celiac disease, but pain or sickness that goes away after they drop gluten.

While the gluten-free diet cuts out grains containing that particular protein, the Paleo diet cuts all grains. Depending on the dieter’s interpretation, Paleo many also omit potatoes and dairy products.

It’s based on the idea that Paleolithic humans ate meat, vegetables and fruit and did well, nutritionally speaking.

“It’s the idea that in a perfect caveman world, while we were out wandering around, we didn’t have time to sit there and grow our oats or our wheat,” said Michael Smith, a physiologist at Gonzaga University who has studied the effects of the Paleo diet. “We just kind of hunter-gathered.”

While Troye exercises now much more than she did pre-Paleo, she credits the change in her diet for her weight loss. Once heavily reliant on macaroni and cheese or spaghetti at mealtimes, now she eats meat or fish at breakfast, lunch and dinner, along with eggs, vegetables, fruits and nuts.

“It worked for me,” said Troye, now 39 and a stay-at-home mother of 5- and 7-year-old daughters. “So I don’t argue it.”

But Smith said he has mixed feelings about Paleo.

He has cut all grains from his own diet, he said. And his research found that a Paleo diet reduces body fat among study participants. But it’s at a potential cost to their cardiovascular health. It turns out that lots of bacon is still not good for us.

A 10-week study Smith performed in 2012 linked the Paleo diet with higher levels of “bad cholesterol,” or low-density lipoprotein – the kind that leads to hard plaque deposits in the arteries.

“We found LDL went up significantly, even in our healthiest group of people, on this Paleo diet, which would be attributed to presumably the amount of saturated fat they substituted into their diet,” he said.

Cut off from potatoes, pasta and grains, they turned to indulgences that were allowed, he said.

“When you let people loose on this Paleo diet, they don’t necessarily always eat these great things for them,” Smith said. “They tend to eat things that are high in saturated fat. I think they may be replacing some of these sweets that maybe they’re craving with things like bacon.”

They also relied heavily on almonds, he said – good to a point, but not as a main caloric source – and drank a lot of whole milk, also rich in saturated fat. They tended to eat less fiber than they needed.

“These guys think they’re doing themselves a favor, and they are in a way,” Smith said, “but it’s almost like robbing Peter to pay Paul, unless you’re very careful about your saturated fat intake.”

Along with leaner bodies, though, many people on Paleo say they feel better, more energetic, with more stable moods, Smith said.

That may be because grains are fairly high on the glycemic index, he said, which measures how quickly food causes blood glucose levels to rise. The higher the food on the glycemic index, the more your blood sugar will rise after you eat it. Substitute spike-producing carb-heavy foods with anything lower on the glycemic index, such as vegetables, and you’ll probably feel better as you lose weight.

But Craig Hunt, a Spokane dietitian, said Paleo adherents risk too-low blood-sugar levels by removing grains as a source of carbs. While vegetables and fruits contain carbs, most are tied up in fiber – less accessible by the body.

We’re designed to eat carbohydrates, he said. Over the long term, those who go without enough often end up suffering.

“I can’t tell you how many times I’ve had a patient come in who’s physically active and trying to eat Paleo and they’re having significant problems with their blood sugars, where they’re shaky and light-headed when they’re working out,” Hunt said. “Their glucose has dropped.”

The anti-grain message also can be confusing given that whole grains are endorsed by dietitians and others as good sources of important B vitamins and minerals. Fiber from whole grains also may help reduce cholesterol levels and the risk of heart disease, obesity and Type 2 diabetes.

Urging consumers to make at least half their daily grains whole grains – foods like whole-wheat pasta and brown rice contain the entire grain kernel – the U.S. Department of Agriculture recommends daily intake levels based on age, sex and level of physical activity. It says women ages 31 to 50 who exercise less than 30 minutes a day should eat 6 ounces of grains a day, for example.

For people with grain intolerance, gluten-free or Paleo diets can be truly healing, Hunt said. But many others “end up with low blood sugars, they’re tired, they’re cranky, they’re not performing well at work. They end up binge-eating sugar.”

‘Too young to be feeling that way’

The Paleo diet lacks universally accepted guidelines. Some adherents say potatoes are OK, while others eschew them. Some say yams are OK in place of potatoes. Some do dairy.

But not eating grains is a hallmark of the diet.

Paleo dieters’ reasons for avoiding grains haven’t been fully delineated, Smith said. There’s no widely accepted, fully developed hypothesis to explain why, exactly, grains are bad.

Many adherents, however, point to the pesticides present in genetically modified grains, shown by some research to create a low-grade state of inflammation, which can lead to a spectrum of diseases. They also note grains’ carb content, which the body easily stores as fat unless it’s burned quickly during intense activity.

Troye, the Coeur d’Alene woman, said she views food differently now.

“When I say to my family, ‘Oh my God, my stomach, I feel sick,’ I’m realizing it’s because I ate so bad, whereas before I thought people just feel sick like that a lot. It’s not normal, I know now.”

Not that there’s no room for error. In Troye’s life, a Paleo diet doesn’t mean there’s no room for a splurge. “It doesn’t mean that when Hostess went out of business, I didn’t go out and buy every single Hostess I could find and eat it. Because I did do that,” she said.

She said it was her husband’s idea to fry them for breakfast like French toast, served with syrup. They told their children: We want you to sit down, and we want you to remember this day. They took pictures.

“You can’t live totally strict,” Troye said. “But I’ve learned that I can’t live the way I did. I was too young to be feeling that way. And that little piece of bread isn’t worth it to me.”

After researching the Paleo diet, Smith cut out the last grain left in his own diet. He replaced his morning oatmeal with a vegetable stir-fry, cooked with coconut oil and topped with avocado.

“The results were pretty shocking,” Smith said. While his weight remained the same, he dropped fat.

For those considering going grain-free, “I would recommend people try it for a couple of weeks, see how they feel, with the added caution of ‘Let’s make sure we’re replacing these calories with quality calories – fruits, vegetables, nuts, berries,’ ” he said.

Smith said he’ll continue to study grain-free diets. “I think the biggest question is standardization: What truly is a Paleo diet?” he said.

He already knows the modern “Paleo” diet won’t likely reflect real meals eaten during the Stone Age, which would have varied according to circumstances – lots of whale fat in northern regions, mangoes near the equator. Paleolithic people probably ate “spiders and grubs and really nasty things we wouldn’t even consider eating today.”

And, he added, “Let’s not forget cavemen only lived to 30.”

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