‘Primal’ diet outperforms ‘Mediterranean’ eating in study

My latest book The True You Diet posits that the best diet for us is essentially one based on the foods that we’ve been eating the longest in terms of our evolution ” after all, these are the foods we are going to be best adapted to. A ‘primal’ diet is one that is devoid of grain and dairy products, as well as nutritional newcomers such as refined sugar and refined vegetable oils: what’s left is, basically, fruit, vegetables, root vegetables, meat, fish, eggs and nuts.

It is my experience that such a diet tends to work very well for enhancing wellbeing and optimising weight. However, while elements of this diet (e.g. its lower-carbohydrate nature) have been studied, the diet itself has not been subjected to much formal research.

So, I was interested to read this week of a study where the primal diet, also known as the ‘Palaeolithic’ or ‘Old Stone Age’ diet was pitted against a diet which was more ‘Mediterranean’ in nature (this diet included grains, low-fat dairy products and margarine) in a group of individuals suffering from heart disease and either type 2 diabetes or ‘impaired glucose tolerance’ (a precursor of type 2 diabetes). Each diet lasted for 12 weeks.

One of the measurements assessed in this study was blood sugar (glucose) levels. In the group eating the primal diet, glucose levels were found to drop by 26 per cent ” a statistically significant result. In contrast, those eating the Mediterranean-inspired diet did not see any significant drop in blood sugar levels. The group eating the primal diet also saw a shrinking in average weight circumference of 5.6 cm, which was significantly greater than the reduction seen in the other group (average reduction 3.3 cm).

Experience and scientific evidence show that for optimal health and wellbeing, a degree of ‘dietary individualisation’ is important: physiological studies show that we have differing abilities to handle foodstuffs such as fat and carbohydrate that dictate our ‘ideal diet’ (see http://www.thetrueyoudiet.com for more details about this).

What this very recent study very clearly shows is that there can be real health benefits for individuals who adopt a more ‘primal’ way of eating. This study provides some science which supports what I regard as common sense: that the best diet for us is one based on the foods which bee eating the longest and are therefore best adapted to.


Lindeberg S, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia. 2007 Jun 22 [Epub ahead of print]

26 Responses to ‘Primal’ diet outperforms ‘Mediterranean’ eating in study

  1. Ian 4 July 2007 at 9:26 am #

    As you say, just common sense really, but when it comes to dietetics, common sense just flies out of the window.

  2. Sophie 4 July 2007 at 10:18 pm #

    i can see the arguement in some of the comments made above but i have yet to read the cited paper, however i would argue that surely the whole point of evolution is adapting to our changing environment and physiological needs, why would a paleolithic hunter-gatherer style diet necessarily benefit a modern society that is on the whole more sedentary and that does not have to go through periods of feast and famine?

  3. Kate 6 July 2007 at 10:22 am #

    I was very pleased to read about this research and wondered when Dr Briffa was going to comment on it.
    Does this mean now, that there will be a few more Paleo diet books around?

    I wonder why the women in the study went back to their old eating habits?
    It doesn’t really make sense, as they must have felt better in themselves as well as their weight loss – except to note that family and social pressure to eat a ‘sensible’ and ‘balanced’ diet, is strong. People just don’t understand that following an eating plan like the Paleolithic diet is a bit of a struggle – in terms of having to often walk it alone.
    I have MS and since January, I’ve been eating this way and I feel a very great deal better. Fatigue is massively improved – and I have a feeling that often fatigue is all linked to blood sugar levels.
    The main MS diets are low fat and dairy-free – but not bread or grain-free. The Best Bet diet is similar to the Paleo diet, but still carbohydrate rich (rice is permitted).
    When I explained my good health to my neurologist on our yearly appointment, he did look at me with suspicion but had the good sense to congratulate me on my health.

    I am hoping that with Dr Briffa’s new book (sorry, not read it yet!) that people are going to start to realise that there is no one-size-fits-all approach to good health and diet. Fingers crossed, although I’m certainly not holding my breath.

  4. Kay Russell 6 July 2007 at 10:44 am #

    For someone always tending to put on weight, many years ago a nutritionist put me on pretty well the primal diet for her diagnosis of candida.

    Limited rice and rye were included, but not wheat. I gradually lost my weight AND my life-time spots on the face.

    (Candida wasn’t my problem – it turned out to be that I can’t use thyroxin, a tricky one to diagnose – but the results of this way of eating were a revelation.)

  5. Hilda Glickman 6 July 2007 at 12:58 pm #

    As a nutritionist I have always held that we should eat what we were ‘meant’ to eat, food found in nature, so I really agree with the Pal diet. The food pyramid with the bulk of the diet (bottom of the pyramid) being carbs and grains is not correct as far as I am concerned. Processed foods are being promoted all the time in adverts. No wonder people are confused. Hilda Glickman

  6. Sheila 6 July 2007 at 1:00 pm #

    What about porridge. I know it’s a ‘grain’, but I have it every morning (just with fruit) – could this be allowed?

  7. Linda Collier 6 July 2007 at 6:03 pm #

    This paleo diet resonates with the blood groups way of eating.

  8. Hellistile 7 July 2007 at 5:27 am #

    Dr. John:
    Although I agree that the primal diet is the correct one for humans, I cannot for the life of me figure out where these researchers came up with the idea of what comprises a mediterranean diet. Have these idiots re-written history – mostly grains, low-fat dairy and MARGARINE. What in the world were they smoking? Did I sleep through a couple of decades and miss the reincarnation of the “mediterranean diet,” into a low-fat diet?

  9. John Briffa 9 July 2007 at 9:33 am #

    Hellistile – agreed, this did seem to be an odd interpretation of the Med diet. I think the researchers got stuck on the fact that the Med diet is generally said to be higher in polyunsaturated fat, lower in animal fat, and richer in grain than more ‘Western’ diets.

    Sheila – while I don’t have any enthusiasm for a diet rich in grains, I do see oats quite a healthy grain (had in moderation). It has a moderate GI and seems much less likely to provoke food sensitivity reactions compared to, say, wheat.

  10. chris 10 July 2007 at 6:25 pm #

    there is so much research being published I think we are loosing sight of reality – and people are switching off – dont do this , dont do that. We need a consensus – everything is bad for you if that is all you eat – my own feeling is we need some middle ground . The primal diet is quite frankly ridiculous and the arguments perhaps do not weigh up , this is confusing people – no one advocates a very low fat diet but in reality eating alot of fat is nauseating – we should be working together not advocating a minimalist diet like the low carb route.

  11. Dr John Briffa 10 July 2007 at 6:58 pm #

    Chris – what is ‘ridiculous’ about the concept of eating a ‘primal’ diet? And what is ‘minimalist’ about consuming a diet comprised, in the main, of meat, fish, fruit, vegetables, nuts, seeds, pulses, eggs and water?

  12. chris 11 July 2007 at 1:39 pm #

    the boredom factor i would think – I did try it for a few weeks and felt lifeless and completly lacking energy. It restricts cooking too. I have not read your kids book so what do u advocate for kids – I have 3 teenagers and 2 boys with huge appetites – no carbs would I think see them on their knees as they are very lean and active . I would like some comments please.

  13. Dr John Briffa 11 July 2007 at 2:20 pm #

    Chris – even with quite rudimentary cooking skills there is no inherent reason individuals cannot cook healthy, truly nutritious and interesting lower-carb meals. Not sure why you didn’t benefit from a lower carb diet. My overwhelming experience is that the vast majority of people feel much more energised eating this way. With regard to your point on children’s diets, who said ‘no carbs’? Not me.

  14. chris 11 July 2007 at 7:49 pm #

    well explain to me then what u do advocate and when they become adults do u suggest – remove the carbs – I am just curious. I do not intend buying another book but what is the plan for kids!

  15. Dr John Briffa 11 July 2007 at 8:27 pm #

    Where, even for adults, have I ever suggested people ‘remove the carbs’. What, for instance, do you think most fruit and veg is mostly composed of (other than water)? And if you had actually read my book (instead of leaping to unfounded conclusions) you will have noticed that I haven’t even recommended the elimination of starchy carbs. Please do not misrepresent me. Read the book (all of it), then comment.

  16. chris 11 July 2007 at 9:11 pm #

    it is ridiculous u cheey pick all the time and never ans practical questions. Throwing studies around is one thing but people have to eat not starve!

    So what do u do when they become adults – I can just see a manual worker surviving – it is a joke.

    Whay do u feed kids with – do u heve any just out of interest

  17. Dr John Briffa 12 July 2007 at 6:51 am #

    Chris – if I’m cherry picking, perhaps you’d like to provide the orchard of evidence I am cherry picking from?

    Accusing me of ‘throwing studies around’ seems odd – do you really have that much disdain for research and what we can learn from it?

    As far as practicalities are concerned, in addition to the advice in this site, I have written several books that contain considerable practically-based information and advice about how to eat healthily. Do forgive me if I am disinclined to regurgitate it all here.

  18. chris 12 July 2007 at 7:09 am #

    Can u actaully cook then John – do you teach your patients to cook or go shopping with them. You didnt devise the recipes did you. I am an excellent cook – in fact dietitians actually have to learn to cook. How dare you speak to me in that tone – I read extensively – I cannot be bothered with this board – it is poorly attended anyway.

  19. Dr John Briffa 12 July 2007 at 7:36 am #

    Still no science. Glad you’re an excellent cook, though.

  20. chris 6 August 2007 at 8:23 am #

    mm John as a nutritionist don’t you teach people to eat – that includes cooking and shopping. That is the art of this profession turning it into practise – or maybe you do not feel it is important. i am still reading your book -didnt tak it on hols !

  21. Peter James 30 October 2007 at 1:03 am #

    I was led to an article in the “Daily Mail” of yours dated Tuesday 3-4-2001, referece to Mastica and the help it gives for stomach ulsers, I suffered for around twenty years after less than a week, I was cured, I would like to thank you deeply for your article that led me to Mastica. and I am sure this thankyou is also from the many people I have also told about it and have gained from the knowledge!
    Many many thanks again, also one other point April the third is my Birthday, one of the best presents ever!

  22. Peter James 30 October 2007 at 9:06 am #

    On other point I forgot to make and I hope you do not mind it being put here, please remove it if it offends, I do not know if you have heard of Dr Vasey, this is an link to some of his work on my web site.

    Peace and Light

    Peter James

  23. Basil Gala 30 December 2007 at 9:01 pm #

    You make a good start at the problem of good nutrition by looking at the foods with which we evolved; but our remote ancestors lived pretty much like chimps, being very active physically: moving for food in their territory, fighting intruders and for dominance each other, courting, and grooming. Today we sit at desks working in the day, watching shows at night, or surfing the Internet, hanging around with friends, and driving our cars. We clearly have different nutritional requirements.

    Ultimately, the optimal human diet is one which we can show with scientific studies on large groups that it maintains health, vigor, and longevity; that diet may be very different from a primitive one.

  24. Daniel 4 September 2008 at 10:46 pm #

    These arguements stating the rights and wrongs of the primal diet are petty to me. Forget anthropology, biology, and the scientific theories applying to primal eating. I propose you try it out foryourself and see the amazing results that it can perform on you body. For example, I at age 18 started drinking and eating excessive amounts of cooked food and the results were horrible. I lost half my hair, i had vericose viens, IBS, fatigue, no body growth, and numerouse defiences as a result off following normal human daily recommended nutrional guidlines. Now after four years of struggle emotional and physical pain i am finally overcoming a struggle. Simply by following a strict primal diet based on much raw meat, fats and little vegatables has begun to revitilize my body. And i feel the fire of health slowly eluding me from the inside out. Believe me, as proof to the primal diet and just try it. Forget what the social circles around you believe of this revolutionary diet and stand strong, healthy, not bound by mainstream human ideas.

  25. diane 21 January 2011 at 10:54 pm #

    i am starting on the ‘no fad diet’ by the heart association, dealing with portions. I am obese and sadly had lost the knowledge of differentiating between hunger and cravings. My daughter heard of this eating plan and told me about it, i am interested because as i cut portions i am becoming more aware of the quality of what i eat, and the pressures of our culture to suggest food as a means of entertainment. i have a vague idea to feed the gal in me that is not overweight, lean and eats to keep her body running efficiently.

    I hope to implement many of the ideas i have read on minimal diets and primal to see what works the best. thanks.


  1. Nutritional Therapy with Halina Osinski | Chelsea Natural Health Clinic - 10 January 2011

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