The Paleo diet: Does it help your heart?

The Bottom Line

  • The Paleo diet encourages us to eat like our hunter-gatherer ancestors did in the Stone Age; it includes eating fish, vegetables, fruits, lean meat, eggs, and nuts, and excludes dairy, grains, processed foods, coffee, alcohol, and sugar and salt.
  • The Paleo diet may help you lose weight, trim your waistline, and reduce your body mass index, but its effect on other risk factors for heart disease—such as inflammation, blood pressure, and certain fats found in the blood—is less certain.
  • Overall, more research is needed to determine if this diet is safe and to confirm its effects on risk factors for heart disease.
  • Before adopting the Paleo diet, do a deep dive into what the diet entails and discuss your plans with a health care provider to determine if it is right for you and how to follow it properly.   

The Paleolithic (also known as “Paleo”) diet is tremendously popular these days. There are thousands of Paleo recipes on the internet, and Paleo offerings are popping up more and more on restaurant menus...or even as whole Paleo themed restaurants. But what is Paleo, exactly? And is it good for our hearts?

The Paleo diet encourages us to eat like our hunter and gatherer ancestors did more than 10,000 years ago, before the rise of agriculture and processed foods (1-4). It involves eating lots of fish, vegetables, fruits, lean meat, eggs, and nuts. On the other hand, dairy, grains, processed foods, coffee, alcohol, sugar, and salt are off-limits (1;3;5-8).

At first glance, the Paleo diet looks pretty healthy—after all, it tends to be lower in calories from processed fats and sodium, and higher in protein, vitamins C and E, and fiber (1;9-14). This has led many Paleo proponents to argue that this diet is a good way to combat the world’s biggest killer—heart disease (1;15)—which often arises when our blood vessels narrow or become blocked, leading to issues like heart attack and stroke (16). Putting another check in Paleo’s box, heart disease is lower in tribal populations that have continued to follow the hunter-gatherer lifestyle and eat a Paleo-like diet (1;17).

So, the Paleo diet is a great way to keep our hearts ticking along nicely, right? Unfortunately, the answer is not so cut-and-dry. Let’s take a look at where the evidence stands.

What the research tells us

Two systematic reviews found that the Paleo diet can lead to weight loss, trim the waistline, and lower body mass index (1;3). One of these reviews also found that the Paleo diet may impact other risk factors for heart disease by increasing the concentration of certain fats found in the blood like HDL (“good”) cholesterol, and lowering blood pressure, inflammation, and the concertation of other fats like triglycerides, total cholesterol, and LDL (“bad”) cholesterol. However, these latter findings didn’t hold up when researchers removed certain studies from their calculations, so they’re deemed less reliable and should be looked at more carefully (1). It’s also important to note that the reviews themselves were small in terms of the number participants included. In the end, more high-quality research is needed in this area to provide firm conclusions on the benefits of this diet on risk factors for heart disease (1;3).

Neither review paid much attention to the cons of the Paleo diet (1;3), but if you’re thinking of adopting this diet, you should consider them carefully! For example, the Paleo diet cuts out dairy, which may impact your calcium levels, a key element for bone health (1;18). If following the Paleo diet, it’s important to ensure you’re getting the needed amount of daily calcium from other food sources. The Paleo diet also recommends getting just one-third of your daily calories from carbohydrates, making it a “low-carb” diet. The safety of diets that restrict carbohydrate consumption to this degree is heavily debated and needs to be assessed further (1;19).

So, can the Paleo diet benefit our heart health? On the whole, there is some promising evidence, but it’s far from concrete. Before embarking on any drastic changes to your diet, speak with your health care provider or a certified nutritionist to make sure that any changes you plan to make are safe for you.

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  2. Konner M, Boyd Eaton S. Paleolithic nutrition: Twenty-five years later. Nutr Clin Pract. 2010; 25(6):594-602. doi: 10.1177/0884533610385702.
  3. de Menezes EVA, Sampaio HAC, Carioca AAF, et al. Influence of Paleolithic diet on anthropometric markers in chronic diseases: Systematic review and meta-analysis. Nutr J. 2019; 18(1):41. doi: 10.1186/s12937-019-0457-z.
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  10. Sun J, Buys N, Shen S. Dietary patterns and cardiovascular disease-related risks in Chinese older adults. Front Public Health. 2013; 1:48. doi: 10.3389/fpubh.2013.00048.
  11. Kerver JM, Yang EJ, Bianchi L, et al. Dietary patterns associated with risk factors for cardiovascular disease in health US adults. Am J Clin Nutr. 2003; 78(6):1103-1110. 
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