Jasmine Moghissi, M.D.

What is Paleo/Primal, and Why to Go to a Doctor that Understands It

Paleo (and Primal) lifestyles refer to living like our ancestors did. This does not mean you need to rent a cave to live in and wear animal skins! We as a species have spent many generations becoming optimized to certain foods and activities. We have now drifted away from them, to the detriment of our health. Let me explain.

Humans have been around for about 2 1/2 million years. For most of that time we were nomads, following our food supply. For the most part, we ate a lot of hoofed animals, but not so much plant material. We appeared to be pretty healthy, were tall and strong, but also probably pretty lazy, and only spent a few hours a day hunting, gathering, and sheltering. Our life expectancy was not very high, but that’s because we had a high infant mortality rate and also had a higher rate of dying from infections (no antibiotics) and trauma. But if we lived past those issues, we were generally very healthy in our old age, and had a similar life expectancy to what we have now. BTW – some of this information was extrapolated from knowledge of the health of hunter gatherer tribes which still existed 100 years ago.

Starting about 10,000 years ago, we began settling down, domesticating animals for food and growing crops. We consumed more calories, and began reproducing at a higher rate. But we also started developing diseases of the modern age, such as heart disease, cancer, osteoporosis, autoimmune disorders, even things like appendicitis, gall bladder disease and acne!

Today, when we have epidemics of obesity, diabetes, heart disease, and cancer, many people are looking at where we went wrong, and what we can do to fix it. With all of modern medicine, what have we accomplished? Our infant mortality rate is much lower, and we survive trauma much better. We also don’t die of complications from urinary tract infections and strep throat (at least not often). But aside from that, we are not living any longer, and we are often wracked with pain and disability as we age.

What is so different about how we live now? That’s where Paleo comes in. I don’t have the time nor the space to explain this fully, but there are several key elements.

The most important element is diet. Ancient man (and woman) did not eat grains, legumes or dairy. Potatoes were inedible, and sugar did not exist. The tribe would take down an animal, maybe a mastodon or a rhino or a pig, and eat the entire thing raw. The meat itself would have been lean, but they would have eaten all the organs including the marrow, making the entire meal fairly high in fat. We would have eaten our fill, then when we got hungry again, we’d take down another animal. (No 6 small meals a day!)

Edible vegetation would have been less available. Those that tasted good (like fruits) would have been smaller and less sweet than we have now, and also only ripe and available for a very short period during the year. Many vegetables would have been bitter and/or toxic. Also, we would not have hunted a mastodon and milked it, and even if we’d found some milk, we would have lost our ability to process milk sugars once we were past weaning age for human milk (generally age 3-6 years).

Our diet would have consisted mostly of animal products, some vegetables and fruits when they were ripe. We probably did a fair amount of walking and ran only when we were running after prey, or away from predators. We lifted and squatted and threw things. And we were apparently quite healthy.

For young people, trying to follow the paleo or primal lifestyle should hopefully give them a long healthy life. Using modern medicine judiciously should help assure they don’t succumb to their ancestors’ nemeses of infection, trauma or early death in childbirth.

Unfortunately for those of us who are little older, we may need a little more help. Because we often have done irreparable damage (through misguided advice we may have followed so far), diet and general lifestyle changes may not be enough. We may need some help from modern medicine to keep us healthy and prevent premature death. But we also don’t want to be over treated, and to inadvertently make us worse off by taking medications, which are too aggressive and cause adverse effects.

So, why would you want to see a physician that understands paleo/primal?

There is a fine line between too much and too little medical care. I try to balance that fine line, looking at the risk vs. benefit ratio for each intervention I do with my patients. You don’t need antibiotics every time you get a cold, but it would be stupid not to treat a significant infection with antibiotics and die of sepsis. Not everyone needs medication for their cholesterol, but there are clearly people alive today who would be dead if they hadn’t been on those medications.

My job is to work with you by advising you which interventions are most beneficial to you. We do that by discussing the risks and benefits of each therapy. Some aspects of the paleo/primal diet conflict with recommended guidelines. As a physician with 2+ decades experience, I’ve learned what tends to work and what doesn’t, and we can decide together to achieve meaningful goals.

I do specialized testing (like the Advanced Lipid testing and CIMT for heart disease) so we can get a better idea of what your risk really is, before I recommend a treatment. I listen to you, so we can try to fit any treatment recommendations into your lifestyle. And most importantly, I follow many of the same recommendations I give you, so I know what is involved.

The goal I have for all my patients is to live a healthy long life, requiring as few medical interventions (including pills) as possible. If that is also your goal, then we should talk.