What is the Paleo Diet: Benefits, Risks & Considerations

What is a Paleo-Based Diet?

The Paleo diet is sometimes called the Stone Age, hunter-gatherer, or caveman diet, which should give you some clues as to what it’s all about. The simplest way to look at it is that it is built exclusively around the foods our ancestors ate before farming or food manufacturing existed.

Think about the foods people living way back when would gather or hunt. Fresh fruits and vegetables, meats and fish, and nuts were all on the menu! Unlike today’s modern American diet, which research suggests^[1] typically includes 60% to 90% processed or ultra-processed foods, the Paleo diet focuses on the consumption of whole, nutritious ingredients to keep you looking and feeling your best.

Supporters of the Paleo diet believe our modern eating habits, full of processed foods and unhealthy quick fixes, aren’t doing our health any favors or match what our bodies are naturally built for, and that this is what subsequently leads to health issues linked to diet and lifestyle^[2] [3].

Of course, ancient humans couldn’t just drive to the grocery store, so they ate differently depending on where they lived. That means there’s no one-size-fits-all Paleo diet plan, although the availability of foods thanks to modern supply chains will give you as much flexibility as you like to follow Paleo as loosely or as closely as you want.

What Can I Eat on the Paleo Diet?

Don’t worry, we’re not about to say you need to go out hunting for your dinner!

Instead, a modern take on the Paleo diet means you’ll focus on eating naturally-raised animal products like grass-fed meat, wild-caught fish, and pasture-raised eggs, while also enjoying plenty of plant-based foods like fruits, vegetables, nuts, and seeds, the sort of things you might find outside without needing farms or factories to bring them to you. And as we’re going to discover, you can even follow the Paleo diet exclusively plant-based if you wish, too!

Paleo-Friendly Foods & Drinks

• Meat, ideally grass-fed
• Seafood, ideally wild-caught or sustainably raised
• Eggs, ideally pasture-raised
• Vegetables
• Fruit
• Tubers
• Natural fats, such as olive oil, coconut oil, red palm oil, ghee, lard, and duck fat
• Nuts and seeds
• Herbs and spices
• Probiotics and fermented foods, such as kombucha and sauerkraut
• Some Nut Milks - all Elmhurst Unsweetened Nut Milks are Paleo-friendly as they only contain two ingredients, nuts and water! That means you can enjoy as much of our Unsweetened Almond Milk, Unsweetened Cashew Milk, Unsweetened Walnut Milk, or Unsweetened Hazelnut Milk as you want!

Foods & Drinks to Avoid on the Paleo Diet

• Grains and pseudograins, such as wheat, barley, rye, corn, quinoa, and buckwheat
• Some legumes, but note that you can eat green beans, sugar snap, and snow peas on a Paleo diet.
• Dairy products, depending on the level of rigidity you’re adhering to
• Vegetable oils such as canola oil, sunflower oil, and soybean oil
• Refined sugars and artificial sweeteners

Is the Paleo Diet Right for Me?

Only you know the answer to that!

Some people regard the Paleo diet as an overly restrictive, lower-carb diet, given its limits on everyday agricultural products that are standard in many diets, including dairy, whole grains, and legumes.

And while it’s true that a focus on meat and nuts inherently favors fat and protein, you can see from our lists above that there is breathing room to incorporate carbohydrates to your liking.

To help you better understand whether a Paleo diet is healthy and sustainable for your needs, as well as something you might enjoy, let’s explore the benefits and potential risks of following this lifestyle.

Paleo Diet Benefits

You Can Moderate What You Eat and the Degree to Which You Adhere to Your Paleo Diet Plan

Evidence suggests the diets of hunter-gatherers varied substantially in carbohydrates depending on their proximity to the equator, ranging from anywhere between 3% and 50% of their total energy intake^[4], giving you the flexibility to customize your carbohydrate intake to your health and performance goals.

In contrast to Plant-Based diets, which require you to eliminate meat and fish, a Paleo diet encourages you to mimic the diet of historic hunter-gatherers. But that still leaves you with the option to avoid animal-based products - it’s a win-win!

A Paleo Diet May Help Decrease Your Risk Of or Treat Chronic Diseases

As the Paleo diet has become better known and more popular, so has our understanding of how it can affect a range of chronic diseases and conditions.

Let’s see what the evidence says about how the Paleo Diet may enhance your health.

Obesity

• Participants fed two Paleo-style meals and one according to World Health Organization guidelines, all on separate days, were found to exhibit significantly greater increases in satiety hormones glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), as well as reductions in glucose-dependent insulinotropic peptide (GIP) after the meal. The highest scores in satiety were observed after consumption of the Paleo meals, which may help with better appetite control.^[5]
• Obese, postmenopausal women were prescribed a diabetes diet or a Paleo diet for 24 months. Participants following the latter diet experienced significantly greater reductions in fat around their abdomen, chest, and shoulder areas at 6 months, as well as decreases in the inflammatory marker, C-Reactive Protein, at 25 months.^[6]
• In a similar study wherein half of the women received a diet based upon Nordic Nutrition Recommendations instead of the diabetes diet, those on the Paleo diet experienced a greater decrease in body fat and waist circumference at 6 months.^[7] 
• Men with one or more features of metabolic syndrome (e.g., Type II Diabetes, impaired glucose tolerance, waist circumference >37 inches) who followed a Paleo diet compared to a Mediterranean diet over 3 months were found to consume less energy and exhibited greater decreases in leptin (a fat hormone positively correlated to an individual’s body fat percentage).^[8]

A 2024 study supported these earlier findings that participants following a Paleo diet experienced greater reductions in body weight and waist circumference compared to those on a diabetes diet.^[9] However, several of these studies also point out that these differences may not always be sustained in the longer term. So while the Paleo diet may help you to lose weight in the short term, switching to an alternative like the Mediterranean diet may deliver better long-term results, or be worth considering if you struggle with Paleo from the outset.

Type II Diabetes

In a 2017 study among patients with Type II Diabetes who were prescribed a Paleo diet and randomized to follow a standard or supervised exercise regimen for 3 months, those who adhered to the standard exercise regimen experienced greater improvements in body fat percentage and circulating leptin than their counterparts, leading researchers to conclude that the Paleo diet is capable of exerting beneficial effects on overall metabolic health without the need for especially intensive workout regimens.^[10]

Short-term studies continue to show potential benefits for glycemic control, insulin sensitivity, and cardiovascular risk factors in Type II Diabetes patients. However, a 2020 systematic review and meta-analysis concluded that the Paleo diet did not lead to significantly better improvements in glucose and insulin homeostasis compared to other recognized healthy diets, like Mediterranean or standard diabetes diets.^[11]

The latter outcome perhaps indicates that the benefits for Type II Diabetes patients following a Paleo diet are associated more with generally being healthier and eliminating unhealthy foods and drinks rather than the Paleo diet itself.

Cardiovascular Disease

• Adherence by individuals with metabolic syndrome to a 2-week Paleo diet or control diet per the Dutch Health Council’s guidelines, both equal in energy density, led to significantly larger decreases in blood pressure and improvements in total cholesterol, triglycerides, and HDL cholesterol among those following the Paleo diet.^[12]
• In as little as 10 days, healthy participants who switched from their baseline diets to consuming a Paleo diet exhibited impressive changes in triglycerides, total cholesterol, and LDL cholesterol.^[13]
• Researchers saw little change in lipid levels among individuals with hypercholesterolemia who adhered to a diet according to the American Heart Association’s guidelines for 16 weeks; however, when they were prescribed a Paleo diet for 16 weeks, they saw significant reductions in triglycerides, LDL and total cholesterol, as well as increases in HDL cholesterol.^[14]

A 2024 network meta-analysis further highlighted that the Paleo diet can positively affect cardiovascular risk factors, including lipid profiles and blood pressure.^[15]

Despite these benefits being broadly accepted, evidence remains mixed. For example, a 2022 prospective cohort study linked higher Paleo diet scores to lower CVD risk, particularly when adherence to a Mediterranean diet pattern was also high, suggesting a benefit from avoiding ultra-processed foods. However, other reviews emphasize uncertainty regarding effects on BP and lipids, the need for more research, and potential downsides. Concerns include the exclusion of heart-healthy whole grains and legumes, and potential increases in TMAO (a metabolite linked to CVD) associated with high red meat intake and altered gut microbiota due to a lack of fiber from whole grains.^[16] [17]

Fatty Liver Disease

Obese, post-menopausal women who adhered to a Paleo diet or low-fat diet for 2 years displayed greater decreases in liver fat percentage on the former at 6 months, despite the diet’s liberalization of saturated fat. After 2 years, however, reductions in liver fat percentage were nearly identical between the diet groups, thereby revealing the potency and efficiency of a Paleo diet to combat fatty liver disease in a shorter amount of time.^[18]

Several studies also point out that weight loss is the primary factor in controlling liver fat, and that this is achievable via various diets, including the Paleo, Mediterranean, and Diabetes diets, although the Paleo diet’s strong emphasis on avoiding processed foods and sugars may be particularly beneficial. However, it is worth noting that the impact of dietary fat composition is complex, and very high-fat diets may be detrimental to health if not properly managed. Overall, a broad combination of lifestyle changes leading to weight loss is most important in avoiding fatty liver disease.

A 2023 case-control study later found further evidence that adherence to a Paleo diet, combined with lifestyle factors, reduces the risk of non-alcoholic fatty liver disease.^[19]

Autoimmune diseases

When patients with multiple sclerosis in a pilot study were given a Paleo diet high in plants (i.e., greens, colorful and sulfur-containing vegetables), those who remained in the study for a year experienced significant reductions in their Fatigue Severity Score.^[20]

It’s worth noting that research on specific diets for autoimmune diseases and conditions remains limited, and it can be challenging to isolate the particular effect of the diet itself. While following the Paleo diet is generally considered safe for managing autoimmune diseases if well-planned, you may need to consider the risks of any potential nutrient deficiencies as a result. A 2023 study supported the idea that a range of healthy, balanced diets can help improve the condition of multiple sclerosis patients specifically, and may even provide effective support for drug therapy.^[21] 

If you are specifically considering following the Paleo diet to deal with an autoimmune condition, there is also emerging research with promising early results around the effectiveness of the Autoimmune Protocol Diet.^[22]

Paleo Diet Risks

In addition to the considerations mentioned when outlining the potential benefits of the Paleo diet, there are two primary risks you should be aware of when deciding whether this diet is for you.

Potential Nutrient Deficiencies Linked to Bone Health

If you choose to follow the Paleo diet strictly, you’ll eliminate dairy products, which are key sources of vitamins A, D, and K2, as well as minerals like calcium, magnesium, and phosphorus that help to promote bone health and regulate blood pressure. Low intakes of these nutrients may increase your risk of developing bone diseases like osteoporosis.^[23]

As such, if you are considering following the Paleo diet, you should also look at supplementing what you eat with bone-supporting nutrients.

Potential Stress on the Kidneys

While excessive protein intake has been shown to overexert the kidneys and impair their functionality^[24], studies also show that high protein consumption among individuals with no pre-existing kidney issues has no lasting adverse effects^[25].

This point remains an ongoing debate in the scientific community, and studies continue. If you have a pre-existing kidney condition or are at a high risk of developing kidney disease, you should consult with your physician before adopting the Paleo diet.

Is Paleo Dairy-Free?

If you’re following a strict Paleo diet, then yes, as Paleo was not part of our hunter-gathering ancestors’ diets.

Some Paleo adherents argue that it is unnatural to consume another species’ milk and that it contributes to allergic reactions and the prevalence of conditions like lactose intolerance.

Can I Follow the Paleo Diet If I Eat Plant-Based?

Absolutely! One common misconception is that Paleo is essentially a carnivorous diet. But vegetables, potatoes, fruit, certain legumes, like green beans and sugar snap peas, and nuts are essential components of Paleo diets.

Following Plant-Based Paleo is commonly known as the Pegan diet.

What Nuts Can I Eat on the Paleo Diet? Are Almonds & Walnuts Paleo?

Tree nuts, including almonds, are acceptable on the Paleo diet as they exist in nature and can be eaten without any cultivation or processing.

As they are vegan sources of protein and fat, tree nuts like almonds, cashews, walnuts, and hazelnuts can be significant components of a Paleo diet, plant-based or not.

Does That Mean You Can Have Almond Milk and Elmhurst Nut Milks on the Paleo Diet?

Yes, our nutrient-dense Unsweetened Nut Milks are ideally suited for the Paleo diet, containing just two ingredients - the nut and water - and retaining all the goodness of the nut thanks to our patented HydroRelease™ method.

These four Elmhurst Nut Milks are all suitable for a Paleo diet:

• Unsweetened Almond Milk
• Unsweetened Cashew Milk
• Unsweetened Walnut Milk
• Unsweetened Hazelnut Milk

Is Oat Milk Paleo?

No, oat milk is not paleo because oats come from grains.

However, if you’re being flexible with your Paleo or Pegan diet, our Unsweetened Oat Milk is just as nutrient-rich as our Nut Milks if you prefer oat-based creaminess to nut-based creaminess.

Getting Started with the Paleo Diet

There’s much to consider before embarking on the Paleo diet, given the broad range of evidence supporting the benefits of this lifestyle, but also with the knowledge that other diets may be equally as effective in helping you reach your health goals.

Only you can answer whether the Paleo diet is right for you. Regardless of whether you decide it is or isn’t, Elmhurst Plant Milks are a healthy, delicious, and nutritious choice you can introduce into your diet immediately.

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