An assessment of the impact of cross-cultural variation in plant macronutrients on the recommendations of the Paleo Diet

Background: One of the main recommendations of the Paleo Diet is that individuals replicate the whole-diet macronutrient ranges of hunter-gatherer diets. These are suggested to be 19%-35% protein, 22%-40% carbohydrate, and 28%-58% fat, by energy. However, the plant food contribution to these ranges was estimated exclusively from Australian data, which is a potential problem. Objectives: We investigated whether estimates of the contribution of protein, carbohydrate, and fat to hunter-gatherer diets are impacted by using plant data from other regions of the world.Methods: The values that form the basis of the Paleo Diet' s recommended macronutrient ranges were generated with a set of equations. We combined these equations with published plant macronutrient data from a multi-region sample of 5 hunter-gatherer groups to generate new estimated macronutrient percentages and then statistically compared the old and new estimates. Subsequently, we collated plant macronutrient data for a sample of 10 hunter -gatherer groups from several regions and repeated the exercise.Results: The whole-diet macronutrient percentages we calculated are significantly different from those that underpin the Paleo Diet's recommendations. Additionally, the ranges derived from our whole-diet macronutrient percentages (14%-35% protein, 21%-55% carbohydrate, 12%-58% fat) are markedly wider than those recommended by the Paleo Diet.Conclusions: The estimated whole-diet macronutrient percentages that form the basis of the Paleo Diet's macronutrient recommendations are not robust. Using plant data from multiple regions leads to significantly different estimates. Additionally, the macronutrient ranges derived from our whole-diet macronutrient percentages overlap with those recommended by the US Department of Agriculture and the WHO. This undercuts one of the main jus-tifications for adopting the Paleo Diet-namely that because it is vastly different from Western diets, it can reduce the probability of experiencing noncommunicable diseases. There may still be reasons for adopting the Paleo Diet rather than a conventional diet, but healthier macronutrient percentages is not one of them.

Automated summary

The estimates of the macronutrient contribution to hunter-gatherer diets are impacted by using plant data from other regions. The macronutrient percentages recommended by the Paleo Diet are significantly different from the calculated ones. Furthermore, the macronutrient ranges derived from the calculated percentages overlap with those recommended by the US Department of Agriculture and the WHO.