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© Loren Cordain, Ph.D. Professor Colorado State University Fort Collins, CO USA Nutritional and Health Comparisons of Paleo Vegetarian and Mediterranean Diets
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Page 1: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

©

Loren Cordain, Ph.D.

Professor

Colorado State University

Fort Collins, CO USA

Nutritional and Health

Comparisons of Paleo

Vegetarian

and

Mediterranean Diets

Page 2: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Contemporary

“Paleo” Diet

Page 3: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Basis for Contemporary “Paleo” Diets:Ancestral Plio-Pleistocene Hominid Diets:

The Known – An Omnivorous Diet

Minimally Processed,

Wild Plants and Animals

!Kung Woman displays fruits

of her gathering: tamma melons,

grewia berries, tortoise, roots

1Cordain et al. Am J Clin Nutr 2000;71:682-92

2Cordain et al. Am J Clin Nutr 2005; 81:341-54.

Page 4: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

229 Historically Studied

Hunter Gatherer Societies1

Plant Foods

(vegetables, fruits,

seeds, nuts, tubers,

roots, other)

34- 46 % calories

Animal Foods

(meats, fish, eggs,

poultry, seafood,

organ meats)

56- 64 % calories

The Average Hunter

Gatherer’s Food Pyramid

1Cordain L et al. Plant-animal subsistence ratios and macronutrient energy

estimations in worldwide hunter-gatherer diets. Am J Clin Nutr 2000;71:682-92

Page 5: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Humanity’s Evolutionary

Food Plate

1Cordain L et al. Plant-animal subsistence ratios and macronutrient energy

estimations in worldwide hunter-gatherer diets. Am J Clin Nutr 2000;71:682-92

“My Plate” replaced the USDA

Food Pyramid in June 2011

Page 6: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

These foods comprise (>70% energy)

in typical Western Diets

But were virtually unknown in

Ancestral Human Diets

Breads, Cereals, Rice and Pasta Dairy Products Added Salt

Refined Vegetable Oils Refined Sugars

(except honey)AlcoholProcessed

Meats

2Cordain et al. Am J Clin Nutr 2005; 81:341-54.

Page 7: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Foods Not Present in Pre-Agricultural

Diets (All Processed Foods)

Ubiquitous Food Mixtures:

(Grain/starch + refined fat/oil + refined sugar + salt + flavoring + dairy food)

So called “MONO-FOODS”

Pancakes CerealPizza

Cookies, doughnuts

Muffins, Roles

Bread, Cakes

Pies Chips, Crackers

Page 8: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Foods Not Present in Pre-Agricultural

Diets (All Processed Foods)

Ubiquitous Food Mixtures:

(Grain/starch + refined fat/oil + refined sugar + salt + flavoring + dairy food)

So called “MONO-FOODS”

Sandwiches

Cereal

Ice Cream

Potato Mixtures

Pretzels

Candy

Page 9: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Evolution of the Western Diet:

Neolithic (10,000 to 5,500 yrs ago) Food

Introductions

10

,00

0

9,0

00

8,0

00

7,0

00

6,0

00

5,0

00

4,0

00

3,0

00

2,0

00

1,0

00

Years ago

066100133167200233267300333Human

Generations

(30 yrs)

pre

sen

t

33

SUCROSE

WHEAT & BARLEY DOMESTICATED ~10,000 YRS AGO

WINE AND BEER

SHEEP, GOATS, COWS DOMESTICATED

FIRST DAIRYING EVIDENCE

FIRST SALT MINES

2Cordain et al. Am J Clin Nutr 2005; 81:341-54.

Page 10: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Evolution of the Western Diet:

Industrial Revolution (~200 yrs ago)

17

98

18

28

18

58

18

88

19

18

19

48

19

78Year

0234567Human

Generations

(30 yrs)

20

08

1

REFINED GRAINS

HFCS

HYDROGENATED OILS

SUCROSE

REFINED VEGETABLE OILS

FEEDLOT PRODUCED MEATS

2Cordain et al. Am J Clin Nutr 2005; 81:341-54.

Page 11: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Evolution of the Western Diet:

Industrial RevolutionProcessed Foods – The 20th Century

18

98

19

08

19

18

19

28

19

38

19

48

19

58

19

68

19

78

19

88

19

98Year

O234

Human

Generations

(30 yrs)

20

08

1

1900: HERSHEY’S CHOCOLATE BAR

1902: PEPSI

1906: KELLOGS CORN FLAKES

1911: CRISCO

1913: OREO COOKIE

1921: WONDERBREAD

1928: RICE KRISPIES

1932: CORN CHIPS

1941: M&M’s

1952: SUGAR FROSTED FLAKES

1969: PRINGLES CHIPS

Page 12: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Refined sugars, grains, vegetable oils and

dairy = 70.9% of energy in the U.S. food supply

Refined sugars, grains, vegetable oils and dairy represent

Neolithic & Industrial era foods that were not present in traditional

ancestral human diets

By default, their inclusion displaces minimally processed, wild

plant and animal foods.

15.71.4

3.1

3.3

4.8

0.8

10.623.9

17.8

18.6

Refined

SugarsRefined

Vegetable Oils

Vegetables

Fruits

Grains

Nuts, Seeds

Legumes

Eggs

Dairy

Meats,

Fish

Miscellaneous

Gerrior S, Bente I. 2002. Nutrient Content of the U.S. Food Supply, 1909-99: A Summary Report.

U.S.D.A, Center for Nutrition Policy and Promotion. Home Economics Research Report No. 55

Page 14: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet

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The Typical Mediterranean Diet

Bread, pasta, rice, whole

grain and potatoes are

daily dietary components

Beans and legumes are

daily dietary components

Cheese and yogurt are

daily dietary components

Highly salted foods

(cheese and olives) are

daily dietary components

Meat is only consumed

on a monthly basis

Varies from The Paleo Diet

In these key dietary elements:

Page 16: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for CVD and metabolic syndrome ?

1Grosso G et al. Mediterranean diet and cardiovascular risk factors: a systematic review. Crit Rev Food Sci Nutr. 2014;

54(5):593-610.

Abstract

“Fifty-eight studies exploring the relation between MD and lipoprotein concentration, antioxidative

capacity and inflammatory markers, hypertension, obesity, diabetes, and metabolic syndrome, were

identified and selected. These included 33 cross-sectional, 9 cohort, and 16 intervention studies. Most

of the studies showed favorable effects of MD on CVD, although a certain degree of controversy

remains in the respect of some issues, as obesity. Important methodological differences and limitations

in the studies make difficult to compare results, thus further studies, particularly randomized clinical

trials, are needed to finally substantiate the benefits of MD and to shed some lights on mechanisms.”

Observational meta analyses1

support that adherence to

Mediterranean Diets reduce CVD and

metabolic syndrome risk

Meta analyses of randomized

controlled trials (RCT) are less

supportive2

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets?

Page 17: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for cardiovascular disease?

2Rees K et al. 'Mediterranean' dietary pattern for the primary prevention of cardiovascular disease. Cochrane Database

Syst Rev. 2013 Aug 12;8:CD009825.

Abstract

“MAIN RESULTS: We included 11 trials (15 papers) (52,044 participants randomised). Subgroup analyses revealed statistically significant greater reductions in total cholesterol in those trials describing the intervention as a Mediterranean diet (-0.23 mmol/L, 95% CI -0.27 to -0.2) compared with control (-0.06 mmol/L, 95% CI -0.13 to 0.01). Reductions in blood pressure were seen in three of five trials reporting this outcome. None of the trials reported adverse events.

CONCLUSIONS: The limited evidence to date suggests some favourable effects on cardiovascular risk factors. More comprehensive interventions describing themselves as the Mediterranean diet may produce more beneficial effects on lipid levels than those interventions with fewer dietary components.”

Meta analyses of randomized

controlled trials (RCT) to reduce

CVD risk are less supportive2

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets?

Page 18: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for obesity/overweight?

3Buckland G et al. Obesity and the Mediterranean diet: a systematic review of observational and intervention studies.

Obes Rev. 2008 Nov;9(6):582-93.

Abstract

“We identified 21 epidemiological studies that explored the relationship between the

Mediterranean diet and weight. These included seven cross-sectional, three cohort and

11 intervention studies. Of these, 13 studies reported that Mediterranean diet adherence

was significantly related to less overweight/obesity or more weight loss. Eight studies

found no evidence of this association.”

Meta Analyses (both RCTs and

observational studies) indicate

that adherence to

Mediterranean Diets are

equivocal for control of

obesity/overweight or more

weight loss3.

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets?

Page 19: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for glucose control ?

4Carter P et al. A Mediterranean diet improves HbA1c but not fasting blood glucose compared to alternative

dietary strategies: a network meta-analysis. J Hum Nutr Diet. 2013 Jun 22. doi: 10.1111/jhn.12138.

Abstract

METHODS: We conducted a systematic review and meta-analysis aiming to determine the effects of a Mediterranean diet compared to other dietary interventions on glycaemic control irrespective of weight loss.

RESULTS: Eight studies met the inclusion criteria, seven examined fasting blood glucose (n = 972), six examined fasting insulin (n = 1330) and three examined HbA1c (n = 487). None of the interventions were significantly better than the others in lowering glucose parameters. TheMediterranean diet reduced HbA1c significantly compared to usual care but not compared to the Palaeolithic diet.

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets? YES

Meta analyses indicate that

adherence to Mediterranean diets

is ineffective for glucose control4

Paleo Diets are superior to

Mediterranean diets for HbA1c4

Traditional Greek Bread

Page 20: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for chronic disease?

5Lindeberg S et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in

individuals with ischaemic heart disease. Diabetologia. 2007 Sep;50(9):1795-807

Abstract

“RESULTS: Over 12 weeks, there was a 26% decrease of AUC Glucose (0-120) (p = 0.0001) in the Palaeolithic group and a 7% decrease (p = 0.08) in the Consensus group. The larger (p = 0.001) improvement in the Palaeolithic group was independent (p = 0.0008) of change in waist circumference (-5.6 cm in the Palaeolithic group, -2.9 cm in the Consensus group; p = 0.03). There was a tendency for a larger decrease of AUC Insulin (0-120) in the Palaeolithic group, but because of the strong association between change in AUC Insulin (0-120) and change in waist circumference (r = 0.64, p = 0.0003), this did not remain after multivariate analysis.”

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets? YES

A RCT demonstrated the Paleo

Diet to be superior to a

Mediterranean diet for blood

glucose concentrations and

waist circumferences changes

over 12 weeks5Traditional Italian Bread

Page 21: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Is it Healthful and does it reduce the risk

for chronic disease?

6Jönsson T et al. A paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals

with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7:85.

Abstract

RESULTS: The Paleolithic group were as satiated as the Mediterranean group but consumed less energy

per day (5.8 MJ/day vs. 7.6 MJ/day, Paleolithic vs. Mediterranean, p = 0.04). Consequently, the quotients of

mean change in satiety during meal and mean consumed energy from food and drink were higher in the

Paleolithic group (p = 0.03). Also, there was a strong trend for greater Satiety Quotient for energy in the

Paleolithic group (p = 0.057). Leptin decreased by 31% in the Paleolithic group and by 18% in the

Mediterranean group with a trend for greater relative decrease of leptin in the Paleolithic group. Relative

changes in leptin and changes in weight and waist circumference correlated significantly in the Paleolithic

group (p < 0.001) but not in the Mediterranean group. Changes in leptin receptor and free leptin index were

not significant.

YES, BUT WITH CAVEATS

Are there even healthier

alternative diets? YES

A RCT demonstrated the Paleo

Diet to be superior to a

Mediterranean diet for satiety,

and caloric intake over a 12 week

intervention6 Traditional Crete Bread with Olive Oil

Page 22: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Paleo vs. Mediterranean Diets:

Underlying MechanismsIs this Dish Paleo?

Mediterranean? or Both ? Both Paleo and Mediterranean Diets

have demonstrated therapeutic effects

upon metabolic disease symptoms and

obesity/overweight

In limited direct comparisons of Paleo

and Mediterranean diets, Paleo was

generally superior5,6

Why?

Paleo?

Paleo?

Paleo?

Paleo?

Mediterranean?

Page 23: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet

Higher total carbohydrate

Higher glycemic load

Not gluten free

Greater anti-nutrients

Lower total protein

Lower animal protein

Lower branch chain amino

acids (leucine, isoleucine,

valine)

Lower absorbable iron content

Lower absorbable zinc content

Lower vitamin B12

Higher salt (NaCl) content

Nutritional Components of

The Mediterranean Diet which

vary from The Paleo Diet:

Page 24: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Not so Healthfy Foods: Daily Bread & Grains

7Centers for Disease Control and Prevention (CDC). Vital signs: food categories contributing the most to sodium

consumption – United States, 2007 – 2008, February 7, 2012. 8Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J

Clin Nutr. 2002 Jul;76(1):5-56. 9Sebastian A et al. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid

ancestors. Am J Clin Nutr. 2002 Dec;76(6):1308-16. 10Cordain L, (1999). Cereal grains: humanity’s double edged sword. World Review of Nutrition and Dietetics, 84: 19-73.

Bread represents the highest single

source of salt in the western diet7.

Bread and cereals (even whole

grains) are high glycemic load

carbohydrates8.

Bread and cereals are the sole

dietary source of gluten

Bread and cereals are major

contributors to dietary acid load9

Bread and cereals may promote

adverse health effects10

Page 25: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Mediterranean Diet:Not so Healthy Foods:

Daily Cheese and Olives (High Salt)

7Centers for Disease Control and Prevention (CDC). Vital signs: food categories contributing the most to sodium

consumption – United States, 2007 – 2008, February 7, 2012. 11 http://www.cdc.gov/features/dssodium/

Common Salt content

Mediterranean mg/100 g

Cheeses cheese

Parmesan 4069

Gorgonzola 3447

Romano 3048

Feta 2835

Kasseri 2540

Asiago 2540

Provolone 2225

Fontina 2032

Mozzarella 1692

Olives

Kalamata olives 3833

Green olives 3890

Greek Olives and Feta Cheese

Bread, Cheese and Olives: High

Salt Foods

CDC Recommended Daily

Sodium Intake = 2300 mg7,11

or 5750 mg salt

Page 26: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Mediterranean Diet is less micro

nutrient dense than the Paleo Diet

2Cordain et al. Am J Clin Nutr 2005; 81:341-5411Cordain L, The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Neutraceut

Assoc 2002; 5:15-24.

Bread whole

grains and

dairy foods

are less

nutrient

dense in the

13 nutrients

most lacking

in the US

Diet

compared to:

Fresh

vegetables,

fish,

seafood, lean

meats, and

fruits2,11

Page 27: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Whole Whole Lean

Grains Milk Fruits Veggies Seafood Meats Nuts/seeds

Vitamin B12 (μg) 0.004 0.585 0.004 0.004 7.427 0.636 0.004

Vitamin B3 (mg) 1.124 0.141 0.893 2.735 3.196 4.737 0.352

Phosphorus (mg) 903 1525 331 1576 2197 1514 802

Vitamin B2 (mg) 0.052 0.266 0.093 0.337 0.094 0.145 0.041

Vitamin B1 (mg) 0.125 0.061 0.113 0.267 0.082 0.186 0.124

Folate (μg) 10.34 8.12 25.06 208.37 10.83 3.81 11.05

Vitamin C (mg) 0.01 1.54 74.26 93.67 1.95 0.12 0.43

Iron (mg) 0.904 0.081 0.692 2.597 2.076 1.105 0.863

Vitamin B6 (mg) 0.093 0.071 0.205 0.427 0.194 0.326 0.082

Vitamin A (RE) 22 505 946 6877 324 11 23

Magnesium (mg) 32.64 21.92 24.63 54.57 36.16 18.01 35.85

Calcium (mg) 7.62 194.37 43.04 116.86 43.15 6.11 17.53

Zinc (mg) 0.674 0.623 0.251 1.045 7.67 1.96 0.62

Sum Rank Score 42 43 47 82 66 51 39

Nutrient Density for Food Groups (100 kcal samples)Superscripts are rank scores (7=highest;1=lowest) for each nutrient

13 M

ost

Fre

qu

en

tly D

efi

cie

nt

Mic

ron

utr

ien

ts

2Cordain et al. Am J Clin Nutr 2005; 81:341-54

Page 28: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Food Group:Nutrient Density Ranking

(nutrient/ energy)

No. 1: Veggies (82)

No. 2: Seafood (66)

No. 3: Lean meats (51)

No. 4. Fruits (47)

No. 5. Whole Milk (43)

No. 6. Whole grains (42)

No. 7. Nuts/Seeds (39)

Nutrient

Density Rankings

per Food Group

Conclusion: Displacement of fish/seafood,

meat, poultry and vegetables

and fruit by milk, dairy and

grains reduces the overall

dietary micronutrient density

Page 29: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Vegetarian Diet

Page 30: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

The Typical Vegetarian Diet

Ovo/Lacto

Vegetarian

Vegan

Vegetarian

In the U.S. 3.2 %

adults or 7.3 million

people follow a

vegetarian diet

Whereas, 0.5 % adults

or one million

Americans are

vegans12

The study12 indicated

53 % of all vegetarians

ate their plant based

diet to improve overall

health

12Vegetarianism in American. Vegetarian Times Magazine, 2008.

http://www.vegetariantimes.com/features/archive_of_editorial/667

Page 31: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Vegetarian/Vegan Diets:Do Not Reduce Mortality from All Causes

13 Key TJ et al. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5

prospective studies. Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S. 14Key TJ et al. Mortality in British vegetarians: results from the European Prospective Investigation into Cancer and

Nutrition (EPIC-Oxford). Am J Clin Nutr. 2009 May;89(5):1613S-1619S

Key et al. (1999)13 conducted a large meta analysis comparing overall

death rates between 27,808 vegetarians and 48,364 meat eaters.

“There were no significant differences between vegetarians and non-

vegetarians in mortality from cerebrovascular disease, stomach cancer,

colorectal cancer, lung cancer, breast cancer, prostate cancer or all other

causes combined .”

A more recent 2009 analysis (The EPIC-Oxford Study) 14, employing the

largest sample of vegetarians (33,883) ever examined came up with

virtually identical conclusions.

“Within the study mortality from circulatory diseases and all causes is

not significantly different between vegetarians and meat eaters”.

or or or

Page 32: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Complete Absence of Vegetarians or Vegans in

in World Wide Hunter Gatherer

Societies (n = 229)

0 26

23

3035

4542

35

11

05

101520253035404550

0-5

6-1

5

16-2

526-3

5

36-4

5

46-5

5

56-6

5

66-7

576-8

586-1

00

Nu

mb

er

of

So

cie

ties (

n)

% Dependence upon animal foods (fished + hunted)

Mode = (56-65%)

Median =(56-65%)

58 % of all

societies

have > 56%

dependence

upon animal foods

1Cordain L et al. Plant to animal subsistence ratios and macronutrient energy estimations in world wide hunter gatherer

diets. Am J Clin Nutr, 2000, 71:682-92

Note:

No HG

are vegetarian/vegan

Page 33: Nutritional and Health Comparisons of Paleo Vegetarian and … · 2016-04-07 · Basis for Contemporary “Paleo” Diets: Ancestral Plio-Pleistocene Hominid Diets: The Known –An

Vegan/Vegetarian Diets:Poor Sources of Essential Nutrients

15Herrmann W et al.. Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and

hyperhomocysteinemia in vegetarians. Am J Clin Nutr. 2003 Jul;78(1):131-6. 16Obersby D et al. Plasma total homocysteine status of vegetarians compared with omnivores: a systematic review and

meta-analysis. Br J Nutr. 2013 Mar 14;109(5):785-94 17Humphrey LL et al. Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis.

Mayo Clin Proc. 2008 Nov;83(11):1203-12. 18Werder SF. Cobalamin deficiency, hyperhomocysteinemia, and dementia. Neuropsychiatr Dis Treat. 2010 May 6;6:159-9519 Krivosíková et al. The association between high plasma homocysteine levels and lower bone mineral density in Slovak

women: the impact of vegetarian diet. Eur J Nutr. 2010 Apr;49(3):147-5320 Forges T et al. Impact of folate and homocysteine metabolism on human reproductive health. Hum Reprod Update. 2007

May-Jun;13(3):225-38.

Plant foods are devoid of Vitamin B12

A study of 95 vegetarians showed 77% of

lacto/ovo and 93% of vegan subjects were B12

deficient when levels of both

holotranscobalamin II and methylmalonic acid

were employed15

B12 deficiencies elevate plasma homocysteine

A meta analysis, 15 of 17 studies showed

vegetarians had higher blood levels of

homocysteine than omnivores16

High homocysteine increases risk for CVD

(meta analysis)17, dementia18, osteoporosis19,

and infertility20

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Vegan/Vegetarian Diets:Poor Sources of Essential Nutrients

21Plourde M, Cunnane SC. Extremely limited synthesis of long chain polyunsaturates in adults: implications for their

dietary essentiality and use as supplements. Appl Physiol Nutr Metab. 2007 Aug;32(4):619-34. 22Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and

practical implications. Am J Clin Nutr. 2003 Sep;78(3 Suppl):640S-646S23 Foster M et al. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J

Sci Food Agric. 2013 Aug 15;93(10):2362-71. 24Obeid R et al. The impact of vegetarianism on some haematological parameters. Eur J Haematol. 2002 Nov-Dec;69(5-

6):275-9

Plant foods are devoid of long chain

omega 3 fatty acids (22:6n3 - DHA,

20:5n3 - EPA)

Plant food sources of (18:3n3 – ALA

are inefficiently converted in the body

to DHA (< 1%)21

Vegetarians and vegans are nearly

universally deficient in DHA and EPA22

Fe and Zn in whole grains and legumes

are poorly absorbed in vivo because

they are bound to phytate

Zn deficiencies are nearly universal in

vegetarians23 and Fe deficiencies are

common24

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Vegan/Vegetarian Diets:Poor Sources of Essential Nutrients

25Krajcovicová-Kudlácková M, et al. Iodine deficiency in vegetarians and vegans. Ann Nutr Metab. 2003;47(5):183-5.26Remer T, Neubert A, Manz F. Increased risk of iodine deficiency with vegetarian nutrition. Br J Nutr. 1999 Jan;81(1):45-9

27Tran L, wt al. Soy extracts suppressed iodine uptake and stimulated the production of autoimmunogen in rat thyrocytes.

Exp Biol Med (Maywood). 2013 Jun;238(6):623-30.28Doerge DR, Sheehan DM. Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect. 2002 Jun;110

Suppl 3:349-53.

Vegetarians and vegans

frequently maintain iodine

deficiencies25 and vegetarian

diets induced iodine

deficiencies in omnivores in as

few as 5 days26

Soybeans and soy products

contain antinutrients which

impair iodine uptake by the

thyroid gland27, 28

Soy consumption may be

associated with hypo-

thyroidism, goiter and auto-

immune thyroid disease28

Soybean products: tofu, tempeh,

soy milk, soy sauce, miso

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Vegan/Vegetarian Diets:Poor Sources of Essential Nutrients

29Crowe FL, et al. Plasma concentrations of 25-hydroxyvitamin D in meat eaters, fish eaters, vegetarians and vegans:

results from the EPIC-Oxford study. Public Health Nutr. 2011 Feb;14(2):340-6. 10Cordain L, (1999). Cereal grains: humanity’s double edged sword. World Review of Nutrition and Dietetics, 84: 19-73.31 Batchelor AJ, Compston JE: Reduced plasma half-life of radio-labelled 25-hydroxyvitamin D3 in subjects receiving a

high fiber diet. Brit J Nutr 1983;49:213-16.

The largest study of vegetarians

(The Epic-Oxford Study),

showed blood vitamin D levels

were highest in meat eaters and

lowest in vegans and

vegetarians29

Nearly 8% of the vegans

maintained clinical deficiencies

of vitamin D29

Whole grains contain

antinutrients which suppress

vitamin D metabolism10,31

Sunrise

At Tahoe

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Vegan/Vegetarian Diets:Concentrated Sources of Antinutrients

10Cordain L, (1999). Cereal grains: humanity’s double edged sword. World Review of Nutrition and Dietetics, 84: 19-7332Cordain L. (2012). The Paleo Answer. John Wiley and Sons, New York, NY, pp.

Whole grains, particularly

gluten containing grains,

(Wheat, Rye and Barley) are

concentrated sources of

antinutrients31, including:

Gluten

Lectins (wheat germ

agglutinin)

Phytate

Thaumatin like proteins

Alkyl resorcinols

Alpha amylase inhibitors

Tannins

Protease Inhibitors

Which may elicit multiple

adverse health effects10

Virtually all Legumes are

concentrated sources of

antinutrients32, including:

Saponins

Lectins

Phytate

Alpha amylase inhibitors

Polyphenols (tannins,

isoflavones)

Protease Inhibitors

Raffinose oligosaccharides

Cyanogenetic glycosides

Favism glycosides

Which may elicit multiple

adverse health effects32

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