The Paleo Diet Part 6

Farmed fish are usually cheaper to bring to market than wild fish. In the United States, trout-unless you have caught it yourself in the wild-is almost always farmed. Fresh, wild salmon has a marvelous flavor; most farmed salmon is bland-tasting. Decide for yourself. Note: Some farmed fish is labeled as such; most is not. If you don't know, ask your grocer.

Should You Eat Canned Fish?

Canned tuna is America's favorite fish by far. But the canning process causes a number of problems, the least of which is a loss of fresh flavor. This is what happens: the tuna is cooked at high temperatures and then sealed in a can containing salt, vegetable oil, water, or a combination of these three ingredients. The canning process removes 99 percent of the vitamin A found in fresh tuna, 97 percent of the vitamin B1, 86 percent of the vitamin B2, 45 percent of the niacin, and 59 percent of the vitamin B . It also increases the level of oxidized cholesterol in the fish, specifically a molecule called "25-hydroxycholesterol" that is extremely destructive to the linings of arterial blood vessels-so destructive that oxidized cholesterol is routinely fed to laboratory animals to accelerate artery clogging in order to test theories of heart disease. In animal models of atherosclerosis and heart disease, only 0.3 percent of the dietary cholesterol needs to be in the form of oxidized cholesterol to cause premature damage to the arterial linings.

To complete the degradation of this formerly healthy food, the tuna is packed with salt water or vegetable oils, which usually are high in omega 6 fatty acids. If you have the choice, always choose fresh or frozen fish over canned fish. If you do eat canned tuna, try to find brands that are packed in water only (no salt) or in more healthful oils, such as olive. (Most water-packed tuna contains added salt, but this can be removed by soaking the tuna in a shallow pan filled with tap water and then rinsing the fish in a colander under a running tap.) Eggs: Good or Bad?

Eggs are healthful foods; our Paleolithic ancestors ate them seasonally, because they just weren't available all the time. Several recent studies have shown that eating one egg a day has no discernible effect on your blood cholesterol level and does not increase your risk of heart disease. So go ahead-enjoy a couple of eggs for breakfast every few days.

There's more good news on the egg front: you can buy chicken eggs that, like the wild bird eggs our ancestors ate, have high levels of omega 3 fatty acids. These enriched eggs-produced when chicken are fed omega 3-enriched feeds-are nutritionally superior and are available at many supermarkets and health food stores.

Because eggs are one of our richest dietary sources of cholesterol, the way they're cooked influences the level of oxidized cholesterol-which can damage the cells lining your arteries and increase your risk of developing atherosclerosis and heart disease. High heat-like that of a griddle-produces more oxidized cholesterol than slow cooking: poaching, hard-boiling, or baking. When you have the choice, avoid fried eggs.

A recent study demonstrated that eggs from free-range hens had up to 1/3 less cholesterol, less saturated fat, 2/3 more vitamin A, 2 times more omega 3 fatty acids, 3 times more vitamin E, and 7 times more beta-carotene, than battery-cage eggs.

Similar to the situation with gra.s.s-fed, free-range meats, eggs produced from chickens allowed to live and forage freely are more nutritious and healthful than are their factory-produced counterparts. One of the first poultry farmers to recognize the superiority of free-range eggs was my friend George Ba.s.s. You can sample George's eggs at his Web site for the Country Hen below. I also recommend that you visit Jo Robinson's Web site, www.eatwild.com, to find a local producer of free-range eggs near your home.

The Country Hen P.O. Box 333 Hubbardston, MA 01452 Phone: (978) 928-5333 countryhen.com How to Make the Most of Fruits and Vegetables One of the first changes you'll notice when you start the Paleo Diet is the large amounts of fresh fruits and veggies that you will need to keep on hand. Note: To help produce stay fresh longer, keep fruits and vegetables covered in plastic bags in your refrigerator.

The constant need to replenish your fresh produce supply gives you a good excuse to explore new venues. Try going to local farmers' markets in your area. They're wonderful sources of wholesome, fresh, and delicious fruits and vegetables. They may even inspire you to try growing your own vegetables at home. Also, take this opportunity to try out-of-the-ordinary fruits and vegetables (many are included in the recipes and meal plans in this book). You may want to look for exotic produce in Asian, Far Eastern, and ethnic markets if there are any in your community. As you gradually wean yourself from salty, sugary, and starchy foods, your taste buds will become attuned to the subtle flavors and textures of wonderful real foods.

To be on the safe side, be sure to wash all produce before you eat it (even if it comes in a bag that says it's been washed). Like fish, fresh produce can contain trace residues of pesticides, heavy metals, or other pollutants. The Food and Drug Administration has monitored the levels of contaminants in the U.S. food supply for almost forty years in a program called the Total Diet Study (you can read about it on the Web at: vm.cfsan.fda.gov/~comm/tdstoc.html). The study, which began in 1961, periodically examines more than 230 foods from eight regional metropolitan areas to determine which hidden ingredients-and how much of them-we're getting in our food. Since its inception, the study has found that our average daily intake of all toxic contaminants-including pesticides, industrial chemicals, heavy metals, and radioactive materials-is well below acceptable limits. Of course, it would be even better if our average daily intake of contaminants were zero, and we could rest a.s.sured that our food was completely free of any pollution-but it's pretty safe to say that this will not happen any time soon.

The bottom line is that fruits and vegetables have much to offer-antioxidants, vitamins, minerals, and all the healing benefits we've discussed in this book. We can't do without them; more than that, they need to play a starring role in our diet.

If you are concerned about pesticide exposure, artificial fertilizer, and other food safety issues, you may want to seek organically grown produce whenever possible, although it's a bit more expensive Nuts and Seeds Nuts and seeds are a good adjunct to the Paleo Diet, but they've got a lot of fat, so you need to eat them in moderation. Too many fatty foods-even beneficial nuts and seeds-can rapidly upset your balance of essential dietary fats and derail your weight-loss progress. Throughout the book, we've talked about the omegas-omega 6 and omega 3. One kind-omega 6 fats-is not good for you when eaten in excess. The other kind-omega 3 fats-can make you healthier in many ways. The ideal ratio of omega 6 to omega 3 fats should be between 2 and 3 to 1. For most Americans, unfortunately, it's between 10 and 15 to 1. All nuts and seeds-except for walnuts and possibly macadamia nuts-have unacceptably high omega 6 to omega 3 ratios. This is why you must eat them in small amounts.

Omega 6 to Omega 3 Fat Ratio in Nuts and Seeds

Nut or Seed Omega 6 to Omega 3 Ratio Walnuts 4.2Macadamia nuts 6.3Pecans 20.9Pine nuts 31.6Cashews 47.6Pistachio nuts 51.9Hazelnuts (filberts) 90.0Pumpkin seeds 114.4Brazil nuts 377.9Sunflower seeds 472.9Almonds extremely high (no detectable omega 3 fats) Peanuts (not a nut but a legume) extremely high (no detectable omega 3 fats)

But nuts are part of the Paleo Diet. They're high in monounsaturated fats and have been shown in numerous clinical trials to lower cholesterol. This is why they're on the diet in moderate amounts, in moderate amounts, so that you can benefit from the good things nuts have to offer. But the high quant.i.ties of omega 6 fats in these nuts can also predispose you to heart disease-because they displace the omega 3 fats, which are known to prevent fatal heartbeat irregularities, decrease blood clotting, lower blood triglyceride levels, and reduce the inflammatory profile of prostaglandins and leukotrienes (hormonelike substances that control the inflammation process). Omega 3 fats have also been shown to lessen the symptoms of many inflammatory and autoimmune diseases, including arthritis and inflammatory bowel disease. so that you can benefit from the good things nuts have to offer. But the high quant.i.ties of omega 6 fats in these nuts can also predispose you to heart disease-because they displace the omega 3 fats, which are known to prevent fatal heartbeat irregularities, decrease blood clotting, lower blood triglyceride levels, and reduce the inflammatory profile of prostaglandins and leukotrienes (hormonelike substances that control the inflammation process). Omega 3 fats have also been shown to lessen the symptoms of many inflammatory and autoimmune diseases, including arthritis and inflammatory bowel disease.

Peanuts are forbidden. As mentioned, they are not nuts at all; they're legumes-and legumes contain lectins and other antinutrients that can adversely affect your health, particularly if you are suffering from an autoimmune disorder.

Important note: Many people are allergic to nuts, and pine nuts can be particularly troublesome for some people. Listen to your body carefully as you begin the Paleo Diet and fine-tune the diet to your specific health needs. Although nuts and seeds are true Paleo foods-and were certainly part of the diets of our ancient ancestors-they were not the staples.

When you shop for nuts: * Try to buy raw, unsalted nuts. You can find them in their natural state at most supermarkets in the late summer and early fall when they come into season. * If you don't like cracking nuts, you can find packaged, hulled nuts at some supermarkets and most health food stores. However, read the package label. Hulled nuts are sometimes coated with trans fat-containing oils to increase their shelf life. * If you don't like cracking nuts, you can find packaged, hulled nuts at some supermarkets and most health food stores. However, read the package label. Hulled nuts are sometimes coated with trans fat-containing oils to increase their shelf life.* When in doubt, go for walnuts. They have the best omega 6 to omega 3 ratio and are your healthiest choice for a snack food or to use in other dishes. Other nuts should be considered garnishes in salads and other dishes, rather than eaten in quant.i.ty.

Purchasing Oils Vegetable oils were obviously not a component of any pre-agricultural or hunter-gatherer diet, simply because the technology to produce them did not exist. Oils made from walnuts, almonds, olives, sesame seeds, and flaxseeds were first produced using crude presses between 5,000 and 6,000 years ago. However, except for olive oil, most early oil use was for nonfood purposes, such as illumination, lubrication, and medicine. It wasn't until the beginning of the twentieth century, with the advent of mechanically driven steel expellers and hexane extraction processes, that vegetable oils started to contribute significantly to the caloric content of the Western diet. Today vegetable oils used in cooking, salad oils, margarine, shortening, and processed foods supply 17.6 percent of the total daily energy intake in the U.S. diet. The enormous infusion of vegetable oils into the Western diet, starting in the early 1900s, represents the greatest single factor responsible for elevating the dietary omega 6 to omega 3 ratio to its current and unhealthful value of 10 to 1. In hunter-gatherer diets, the omega 6 to omega 3 ratio was closer to 2 to 1. If we use the evolutionary template exclusively, vegetable oils should probably const.i.tute a minimal part of modern-day Paleo diets.

So, if this is the case, why should we not eliminate all vegetable oils from our diet?

I still believe that certain oils can be used to cook with and add flavor when making condiments, dressings, and marinades. Simply stated, there are four oils (flaxseed, walnut, olive, and avocado) that can promote health and facilitate your getting the correct balance of good fats into your diet. Because hunter-gatherers ate the entire carca.s.ses of wild animals (tongue, eyes, brains, marrow, liver, gonads, intestines, kidneys, and so on) and relished fatty plant foods (nuts and seeds), they did not have to worry about the correct balance of fatty acids in their diet. It came out correctly in the wash.

For most of us, the thought of eating organs is not only repulsive, but is also not practical as we simply do not have access to wild game. Consequently, by eating lean meats, fish, and seafood, along with healthful oils, nuts, and seeds, you can get the correct balance of fatty acids in your diet.

As you can see from the table on page 134, only three vegetable oils have omega 6 to omega 3 ratios of less than 3. These are flaxseed (0.24), canola (2.0), and mustard seed (2.6). Although I originally recommended mustard seed oil in the first edition of The Paleo Diet The Paleo Diet, I can no longer make this recommendation because of its high erucic acid (a long-chain monounsaturated fatty acid) concentration of 41.2 percent. Consumption of large quant.i.ties of erucic acid in laboratory animals causes adverse changes in their heart structure and function and other organs.

This leaves only two vegetable oils (canola and flaxseed) that do not contribute to an elevated intake of omega 6 fatty acids. A number of epidemiological (population) studies have shown a higher risk of developing prostate cancer with an increased consumption of alpha linolenic acid (ALA), a major fatty acid found in both canola and flaxseed oil. However, epidemiological studies are notorious for their conflicting results. For every six studies that support one nutritional concept, you can often find half a dozen more that conclude precisely the opposite. Such is the case linking ALA and flaxseed oil to an increased prostate cancer risk. A series of the most recent epidemiological studies was unable to statistically show that ALA consumption increased prostate cancer risk. More important, in experiments in which animals were fed flaxseed oil, the flaxseed actually inhibited the growth and development of prostate cancer. The case supporting flaxseed oil as a promoter of prostate cancer is currently based solely on epidemiological evidence and therefore remains inconclusive because of the total lack of confirming experimental evidence. Because the majority of epidemiological studies support the notion that ALA is protective against cardiovascular disease, flaxseed oil should still be viewed as healthful.

Since the original publication of The Paleo Diet The Paleo Diet in 2002, I have reversed my view of canola oil and can no longer support its consumption or use. Let me explain why. Canola oil comes from the seeds of the rape plant ( in 2002, I have reversed my view of canola oil and can no longer support its consumption or use. Let me explain why. Canola oil comes from the seeds of the rape plant (Bra.s.sica rapa or or Bra.s.sica campestris Bra.s.sica campestris), which is a close relative of broccoli, cabbage, Brussels sprouts, and kale. Clearly, humans have eaten cabbage and its relatives since prior to historical times, and I still strongly support the consumption of these health-promoting vegetables. The concentrated oil from the seeds of Bra.s.sica Bra.s.sica plants is another story. plants is another story.

In its original form, rape plants produced a seed oil that contained high concentrations (20 to 50 percent) of erucic acid (a monounsaturated fatty acid labeled 22:1n9), which I have previously explained is toxic and which causes a wide variety of pathological changes in laboratory animals. In the early 1970s, plant breeders from Canada developed a strain of rape plant that produced a seed with less than 2 percent erucic acid (hence the name canola oil). The erucic acid content of commercially available canola oil averages 0.6 percent. Despite its low erucic acid content, however, a number of experiments in the 1970s showed that even at low concentrations (2.0 percent and 0.88 percent), canola oil fed to rats could still produce minor heart scarring that was considered "pathological."

A series of recent rat studies of low-erucic canola oil conducted by Dr. Ohara and colleagues at the Hatano Research Inst.i.tute in j.a.pan reported kidney injuries, as well as increases in blood sodium levels and abnormal changes to a hormone, aldosterone, that regulates blood pressure. Other negative effects of canola oil consumption in animals at 10 percent of calories include decreased litter sizes, behavioral changes, and liver injury. A number of recent human studies of canola/rapeseed oil by Dr. Poiikonen and colleagues at the University of Tempere in Finland have shown it to be a potent allergen in adults and children and indicate that it may cause allergic cross-reactions from other environmental allergens in children with atopic dermat.i.tis (skin rashes).

Based on these up-to-date studies in both humans and animals, I prefer to be on the safe side and can no longer recommend canola oil.

Both olive oil and avocado oil are high (73.9 and 70.6 percent, respectively) in cholesterol-lowering monounsaturated fatty acids but have less than favorable omega 6 to omega 3 ratios of 11.7 and 13.5. Consequently, excessive consumption of both of these oils without adequate intake of long-chain omega 3 fatty acids (EPA plus DHA) will derail an otherwise healthy diet. I recommend that you get 1.0 to 2.0 grams of EPA and DHA per day in your diet from either fish or fish oil capsules. Because avocado oil is difficult to find and expensive, that pretty much leaves olive oil as the staple for cooking, salad dressings, and marinades.

If you can afford it, I recommend that you always choose extra-virgin olive oil, because this grade of oil is produced by physical means only, without chemical treatment, and it contains the highest concentrations of polyphenolic compounds, which protect against cancer, heart disease, and inflammation.

Although peanut oil has been promoted as a healthy, cholesterol-lowering oil because of its high monounsaturated fat content (46 percent of total fat), it has turned out to be one of the most atherogenic (artery-clogging) of all oils. In fact, it is routinely used to induce coronary artery atherosclerosis in monkeys and other laboratory animals. It's not clear exactly why this happens. Some scientific evidence suggests that peanut lectins (proteins that bind to carbohydrates) may be responsible for this effect.

Because soybean oil also contains residual lectin activity (SBA) and maintains a marginal (7.5) omega 6 to omega 3 ratio, it can't be recommended as a staple oil, either. A similar argument can be made for wheat germ oil, which has a marginal omega 6 to omega 3 ratio of 7.9 but also contains large quant.i.ties of the lectin WGA, one of the most widely studied and potentially most damaging of all the dietary lectins.

Coconut meat, oil, and milk are traditional foods of indigenous people who live in the tropics. These foods have high amounts of a saturated fat called lauric acid, which is known to elevate blood cholesterol concentrations-a risk factor for cardiovascular disease in modern Westernized populations. Paradoxically, traditional cultures that consume coconut foods have a minimal or nonexistent incidence of heart disease, stroke, or cardiovascular complications normally a.s.sociated with eating high levels of saturated fats, such as the lauric acid found in coconut food products.

Lauric acid apparently exerts a protective effect in our bodies by eliminating gut bacteria that increase intestinal permeability, a risk factor for cardiovascular disease via heightened chronic low-level inflammation. Based on the evidence of traditional Pacific Islanders who consume coconut, it appears that this food does not present a risk for cardiovascular disease when included as a component of modern Paleo Diets. Let your palate go back to the islands and enjoy the delicious health benefits of this traditional plant food.

SALAD AND COOKING OILS.

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Spices One of the key elements of the Paleo Diet is to cut way down on your use of salt-or, better yet, cut it out entirely. This doesn't mean you need to eat bland, tasteless food-far from it. If you haven't already plunged into the wonderful world of spices, now's your chance.

Lemon crystals and lemon pepper are good replacements for salt, and they give food a mouthwatering zing. There are also several good salt subst.i.tutes, commercially available spice mixes designed to take the place of salt. Note: Check the labels; sometimes spice mixes contain cornstarch, hydrolyzed wheat proteins, or other grain and legume products.

Some people-particularly if they are suffering from an autoimmune disease-should stay away from spices made from chili peppers (cayenne pepper and paprika). This botanical family of spices contains a substance called "capsaicin." Studies by Dr. Erika Jensen-Jarolim and colleagues at University Hospital in Vienna, Austria, have shown that capsaicin increases intestinal permeability and may play a role in the development and progression of certain autoimmune diseases. Again, let your body serve as your guide: if a spice seems to be irritating your system or causing problems, don't use it.

The good news is that most spices are easily digestible and well tolerated and add subtle flavors and overtones to almost all dishes. They'll make your food come alive.

Individualizing Your Diet The starting point for the optimal Paleo Diet lies in our genes. In some respects, we're all the same. We've all got the basic human genome, shaped by more than 2 million years of evolution and adapted to eat lean, wild animal meats and uncultivated fruits and vegetables. But we're all different, too. Our own genetic differences ultimately influence how we react to certain foods or food types, or how much of a particular nutrient, vitamin, or mineral we need to maintain good health. Even though seafood should be a central part of the Paleo Diet, for example, it's clearly out of the question for people who are allergic to it. If you have a nut, sh.e.l.lfish, or other food allergy, then obviously these foods cannot be part of your individualized program.

The National Academy of Sciences has provided DRIs (Dietary Reference Intakes) for vitamins and minerals. However, these one-size-fits-all guidelines aren't necessarily perfect for everyone. For example, people who are exposed to extra environmental pollutants (say, cigarette smoke) have been shown to require extra antioxidant vitamins. Certain diseases and disorders are known to impair the body's ability to absorb nutrients; pregnant women and breast-feeding mothers need more nutrients than other women do.

No universal dietary recommendations apply to everybody, even though we all have the same starting point-our evolutionary past.

Many people don't even know that some foods-particularly, grains, dairy products, legumes, and yeast-are to blame for some of their health problems. They may not make the diet/health connection until they eliminate these foods and then reintroduce them. Listen to your body as you gradually return to the diet nature intended for us all. Find out what works for you and be sensible ; alter your diet so that you can live with it-but remember, the further you stray from the basic principles of the diet (lean animal protein, fresh fruits, and vegetables), the less likely you'll be able to reap its health benefits.

Vitamins, Minerals, and Supplements When we eat the foods that we're genetically programmed to eat, we won't develop nutritional deficiency diseases. As I discussed earlier, pellagra (niacin deficiency) and beriberi (vitamin B1 deficiency) have never been found in hunter-gatherers-modern or Paleolithic. In chapter 2 I showed how the vitamins and the minerals eaten every day on the Paleo Diet-a modern Paleo diet-far exceed the RDAs in almost every category. This diet is nutrient-rich by any standard, and it provides us with everything we need to be healthy. deficiency) have never been found in hunter-gatherers-modern or Paleolithic. In chapter 2 I showed how the vitamins and the minerals eaten every day on the Paleo Diet-a modern Paleo diet-far exceed the RDAs in almost every category. This diet is nutrient-rich by any standard, and it provides us with everything we need to be healthy.

This does not mean that people on the Paleo Diet don't need supplements. You may choose to bolster your diet with certain supplements, including those discussed next.

Vitamin D Except for fatty ocean fish, there is very little vitamin D in any commonly consumed natural (that is, not artificially fortified) foods. This wasn't a major problem for our Paleolithic ancestors, who spent much of their time outdoors and got all the vitamin D they needed from sunlight. Today, for most of us, sunlight exposure is a hit-or-miss proposition. This is why, to prevent rickets and other vitamin D-deficiency diseases, processed foods such as milk and margarine are fortified with vitamin D.

Do you get enough sun? ("Enough" means about fifteen minutes a day.) If you don't, and you've stopped eating margarine and milk, you should supplement your diet with this nutrient. The DRI for vitamin D is 200-600 IU (for "international units"). Because many studies have suggested a link between low vitamin D levels in the blood and a number of cancers-including breast, prostate, and colon cancers-you may want to boost your daily supplementation to 2,000 IU. However, this is not one of those "more is better" nutrients. Vitamin D is fat-soluble, which means it can acc.u.mulate in your tissues and eventually become toxic if you take too much of it. The tolerable upper limit for vitamin D in adults is 2,000 IU daily, although recent studies have challenged this value and suggest that a more accurate limit is 10,000 IU.

Here are the keys to healthy sun exposure: * Build up sun time gradually (fifteen minutes or less at first, depending on your skin color and ability to tan).* Never let your skin burn.* Where it is possible, take the sun year round.* Use sunscreens at first to prevent burning; look for sunscreens that block both ultraviolet A and ultraviolet B sunlight.* However, because sunscreens also impair vitamin D and melanin production, as your tan develops, you can gradually reduce the level of sunscreen protection.

Antioxidants Although our bodies are basically the same as those of our ancient ancestors, we live in a vastly different world. The pristine, unpolluted Paleolithic environment no longer exists; we are regularly exposed to numerous toxic substances that didn't exist 100 years ago. The food we eat, the air we breathe, and the water we drink contain minuscule residues of pesticides and chemical and industrial contaminants. These pollutants are inescapable; they're even found in remote parts of Antarctica and Greenland.

n.o.body knows the effects of a lifetime exposure to these noxious agents. However, it's clear that a well-functioning immune system-bolstered by antioxidant vitamins and minerals-may help protect you from a variety of environmentally dependent cancers and diseases. The medical literature is overflowing with studies showing the potential of supplemental antioxidants to reduce the risk of heart disease and many cancers.

The Paleo Diet is exceptionally rich in antioxidants-even with no supplementation. It contains, on average, more than 500 milligrams of vitamin C (more than nine times the RDA), more than 25 IU of vitamin E (more than three times the RDA), and more than 140 micrograms of selenium (more than 2.5 times the RDA). Also, because this diet is loaded with fresh fruits and vegetables, it's high in beta-carotene and many other plant substances (phytochemicals) that protect against many types of cancer. But for some antioxidants, it may be beneficial to supplement your diet. These include: * Vitamin E: Vitamin E: Many of the beneficial effects of vitamin E have been shown to occur with pharmacological doses that cannot be achieved by diet alone. Because vitamin E is completely safe and has virtually no side effects, daily doses between 200 and 400 IU may provide additional disease protection. Many of the beneficial effects of vitamin E have been shown to occur with pharmacological doses that cannot be achieved by diet alone. Because vitamin E is completely safe and has virtually no side effects, daily doses between 200 and 400 IU may provide additional disease protection.* Vitamin C: Vitamin C: Here, too, you may want to bring your daily level higher than you could reach with diet alone. Daily supplementation of 500 to 1,000 milligrams has been shown to improve immune function, lower cholesterol, and reduce the risk of some types of cancer. Here, too, you may want to bring your daily level higher than you could reach with diet alone. Daily supplementation of 500 to 1,000 milligrams has been shown to improve immune function, lower cholesterol, and reduce the risk of some types of cancer.* Selenium: Selenium: Selenium may be one of our most important allies in preventing or waylaying the cancer process. In a randomized, double-blind study (the "gold standard" in medical research) of 1,312 older people, selenium doses of 200 micrograms reduced the overall incidence of cancer by 42 percent and cut cancer death rates in half. The selenium content of fruits and vegetables varies greatly, depending on how much selenium was in the soil where the produce was grown. To make sure you get ample amounts of selenium, you would do well to supplement your diet with 200 to 400 micrograms a day. Selenium may be one of our most important allies in preventing or waylaying the cancer process. In a randomized, double-blind study (the "gold standard" in medical research) of 1,312 older people, selenium doses of 200 micrograms reduced the overall incidence of cancer by 42 percent and cut cancer death rates in half. The selenium content of fruits and vegetables varies greatly, depending on how much selenium was in the soil where the produce was grown. To make sure you get ample amounts of selenium, you would do well to supplement your diet with 200 to 400 micrograms a day.

Fish Oil Capsules Some people just don't like fish or sh.e.l.lfish, no matter how it's prepared. If you're one of them, I recommend that you take daily fish oil capsules. There are two active ingredients, both fatty acids, in fish oil that produce its many beneficial effects-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). You should try to take 1 to 2 grams of EPA and DHA daily. Depending on the brand and the size of the capsules, you will need to take about four to eight capsules per day to get sufficient EPA and DHA. Regular fish oil supplementation will decrease your risk of cancer and heart disease and may reduce certain symptoms of autoimmune diseases and inflammatory disorders.

Food Availability and Preparation Issues One of the keys to making this diet work is ensuring that your modern Paleo food is always available. Many of us have schedules away from home or at our jobs, where it is impossible to prepare or buy fresh, unadulterated fruits, veggies, and lean meats. This means you will need to prepare some of your food at home and bring it with you. But this isn't a problem. For most people, lunch is the most common meal away from home, and "brown-bagging" lunch is the norm for many working people.

You don't have to prepare three separate Paleo meals from scratch every single day. What works best for most people is to simply double or triple the size of the evening meal and then bring the leftovers for lunch. Put parts of your salad and main dish in a sealed container that night and take them with you the next morning. Toss in a piece of fresh fruit, and you've got a terrific lunch! You can also cook two or more main dishes in the evening, use one, and immediately refrigerate the other for use later in the week.

This same principle works for your condiments (salad dressings, salsas, marinades, dips, etc.). Mix up a big batch on the weekend or in the evening, put it in a container, and store it in the refrigerator until you need it. Nothing could be simpler.

Most supermarkets now stock precut, washed salad vegetables and mixes of lettuces. Completely mixed salads (spinach, Caesar, etc.) in sealed plastic bags without added dressing are also commonly available. These packaged veggies are great for people on the go who want to eat fresh foods but don't have time to prepare them. So if time is of the essence, you can make a wonderful, healthful salad by simply opening a bag of cut, washed, and mixed salad greens. Try tossing in some cold shrimp, shredded crabmeat, and olive oil or dressing that you have made beforehand, and you've got another instant Paleo lunch.

Dining Out, Travel, and Peer Pressure You're invited over to a close friend's house for dinner, and it's spaghetti and meatb.a.l.l.s. That's okay, just this once. Your daughter baked you a triple-chocolate birthday cake and would be devastated if you didn't eat at least a piece. That's okay, just this once. Things happen-and a few occasional and minor dietary indiscretions won't make much difference to your overall health if you follow the diet the rest of the time. However, if these indiscretions become the rule and not the exception, you will increasingly lose the healthful benefits and weight-loss effects of the Paleo Diet.

Dining Out How can you make the Paleo Diet work in the real world? Do the best you can. When you dine out, it can be a challenge-or downright impossible-to follow the Paleo Diet to a T. In the real world, many restaurants build their menu around most of the foods you're trying not to eat. Even though many restaurants now offer low-fat or vegetarian meals, few restaurants sponsor Paleo cuisine. In the best situations, you'll be able to stick pretty close to the Paleo Diet; in the worst cases, you may have to throw in the towel.

However, most of the time, you should be able to pull it off with just a few transgressions. The key is "triage." a.s.sign your priorities based on urgency: 1. Your number one concern is to get a main dish that is not a starch-based food. get a main dish that is not a starch-based food. Avoid pancakes for breakfast, for example, sandwiches for lunch, and pasta for dinner. Avoid pancakes for breakfast, for example, sandwiches for lunch, and pasta for dinner.2. Try to choose lean meat or seafood, cooked in a simple manner-by baking, broiling, sauteing, roasting, poaching, or steaming-without added starches and fats.3. Always try to get some fresh fruit or a nonstarchy vegetable at every meal.4. Keep the meal as simple as you can; the fewer ingredients, the better.

Breakfast Most breakfast restaurants serve fresh fruit and some form of eggs. Because fried and scrambled eggs are usually cooked with trans fat-containing margarine or shortening, order your eggs poached or hard-boiled. Or have an omelet filled with veggies-hold the cheese and skip the toast. A cup of coffee is okay. Sometimes you can find smoked salmon or fish for breakfast or shrimp-stuffed omelets; try to include healthful omega 3 fats whenever possible. A lean ham slice or pork chop or a lean breakfast steak is another option-but make sure that you also get a big bowl of fruit to balance the acid-producing protein load. Try to keep salt to a minimum (this is probably the most difficult aspect of dining out).

Lunch Lunches are usually pretty easy, now that most restaurants offer salads, lean meats, and fish as entrees. If your salad comes with croutons, ignore them, and try to get an olive oil-based dressing. For dessert, order fresh fruit.

Dinner Dinners out are usually fairly easy, too. Even pasta-heavy Italian restaurants usually have seafood or meat entrees. You can ask to have these dishes prepared without added flour or breading, skip the potatoes, and get a side order of steamed vegetables. Treat yourself to an occasional gla.s.s of wine with dinner. j.a.panese restaurants are a breeze. They almost always have fish, sh.e.l.lfish, or lean beef and plenty of steamed veggies; just skip the rice and the soy sauce (it's far too salty, and most soy sauces are made with wheat). Chinese restaurants can also be dealt with deftly by avoiding dishes that are rich in sugary, salty sauces, such as sweet and sour pork and deep-fried "crispy" dishes. Go with stir-fried chicken dishes or, better yet, steamed crab or fish. Use the same strategy in ordering Chinese vegetable side dishes; ask your waiter or waitress to omit any sauces and just bring fresh steamed veggies. Mexican restaurants are a bit of a challenge, but again, with careful selections you can stick pretty closely to the Paleo Diet. Once in a while, there will be no choice; you'll have to accept whatever food is available. In those cases, limit your portions.

When You Travel You may choose to dine out, buy food and take it with you in a cooler, or buy it in supermarkets, grocery stores, and even roadside markets along the way. Fresh fruit and veggies are universally available, and they travel well in an ice-filled cooler. Try making your own beef jerky (see chapter 10); it's delicious and filling, and it tastes great with fresh fruit. Hard-boiled eggs, cooked beforehand and stored in the cooler, can be indispensable for breakfasts on the road.

Instead of stopping where most traveling Americans do-at the first exit with a fast-food restaurant that looks fairly clean-drive a mile or two from the highway and find a supermarket. Most food stores have deli sections with premade salads, and many offer a salad bar. Apply the triage principle and do the best you can. For example, precooked chicken (roasted or rotisserie-cooked) is available at most supermarket deli counters and is an option in a pinch. Make sure to take the skin off before you eat it. If you didn't bring any paper plates and plastic utensils, pick some up while you're at the store. Water-packed tuna isn't ideal, either, but it will do while you're on the road.

Ask Your Friends and Family for Support The support of your spouse, immediate family, and friends can make a world of difference in any big life change. Tell them what you're doing and why-whether it's to lose weight or to improve your health. Explain the logic and rationale of the Paleo Diet and share your successes with them. You don't necessarily have to put the entire family on the diet, and many of the meals that you'll be eating on this lifetime program of nutrition are not very different from the types of food you ate before. You can always include bread, rolls, or potatoes with your family meals and give family members the option of eating them. In nearly all public settings, unless you call it to their attention, most people won't even realize that your diet has changed-until they notice your weight loss, increase in energy level, and improvement in health. Who knows? They may see the healthful changes you're experiencing and want to join you.

The Paleo Diet is humanity's normal normal diet. The abnormal diet, the odd diet, the out-of-the-ordinary diet is actually the grain-, dairy-, and processed food-based diet that currently pervades the Western world. It's time for a change. diet. The abnormal diet, the odd diet, the out-of-the-ordinary diet is actually the grain-, dairy-, and processed food-based diet that currently pervades the Western world. It's time for a change.

9.

The Meal Plans for the Three Levels of the Paleo Diet The Paleo Diet is a lifelong way of eating that will gradually restore your normal body weight, health, and well-being. If you follow the dietary guidelines and principles I have laid out, you will reap all the benefits that humanity's original diet has to offer. Your health will immediately improve, and you will definitely begin to lose weight.

In this chapter, you'll find three two-week meal plans. Any of them will work for you; the only difference is in the number of Open Meals. Level I allows you three Open Meals per week, Level II allows two per week, and Level III allows one. Just use the appropriate number of Open Meals for your level of the diet, and you're set. Use these guidelines and the recipes in chapter 10 to help you embrace the diet that nature designed for us all.

If you are a beginner, you may want to adhere to Level I for two to four weeks before you move to Levels II and III-or, if you're happy there, you may want to stay at this level of the diet. Note: You should try to include no more than one Open Meal on any given day, and do not try to make up for lost time with your meal choices. Use them as a safety net as you get used to humanity's real real foods: fresh, lean meats, seafood, and fruits and vegetables. foods: fresh, lean meats, seafood, and fruits and vegetables.

Should you definitely plan to move up to Levels II and III? Not necessarily. Depending on your nutritional and weight-loss goals, you may be happy with the results you achieve at Level I, particularly if you limit your consumption of the non-Paleo foods while consuming your Open Meals.

If you decide to jump into the Paleo Diet more rapidly by advancing to Level II, then you may subst.i.tute two Open Meals a week for any of the meals in the meal plans.

If you are one of those people who can make long-term behavioral changes abruptly and want to go cold turkey to the Stone Age, or if it is absolutely essential that you maximize the weight-loss and health benefits of this program, then you should adopt Level III. On Level III you should subst.i.tute one Open Meal a week for any of the meal plans.

However, most people do quite well at Level II, and this is the level I recommend for maintenance, except for dieters with chronic diseases, who may do better with long-term adherence to Level III.

Snacks When our ancient ancestors were out foraging for food, they often snacked on some of the food they gathered, or they took portions of a previous meal along their journey. The snacks on the Paleo Diet-like those of our Paleo ancestors-are healthy, wholesome, and made of real food. Most of them are easily portable, so you may want to bring some of them along on your own daily journeys. You may eat snacks between meals whenever you become hungry.

* Fresh fruit of any kind* Homemade beef jerky (without salt)* Homemade dried salmon strips (without salt)* Raw vegetables: carrots, celery sticks, cherry tomatoes, mushrooms, broccoli, cuc.u.mbers, cauliflower (with homemade guacamole or salsa dip)* Cold skinless, broiled chicken breast* Avocado or tomato slices* Nuts: almonds, pecans, walnuts, filberts (limit to 4 ounces a day if you're trying to lose weight)* Dried fruit (limit to 2 ounces a day)* Hard-boiled egg* Cold slices of lean beef* Peel-and-eat shrimp * Unsalted sunflower seeds (limit to 4 ounces a day if you're trying to lose weight) * Unsalted sunflower seeds (limit to 4 ounces a day if you're trying to lose weight) Level I: Entry Level The key to Level I is the 85-15 rule, and here's how it works: Most people eat about twenty meals a week, plus snacks. On this beginning level, three of your meals-15 percent of the meals you eat all week-can be "open." This way, you don't have to give up your favorite foods. Again, the flexibility of the Paleo Diet allows you to cheat occasionally without losing the overall benefits of the diet. The three Open Meals provide a good opportunity to taste some of the foods you may miss the most.

There is great potential for abuse here, and you should do your best to avoid it. Do not consider these Open Meals as your chance to pig out on forbidden foods. For example, having two pints of Ben & Jerry's Chunky Monkey ice cream for lunch would be a bad move and self-defeating. But if you're invited to a party or go out to eat with friends, the Open Meal is your chance to indulge a bit. A single scoop of Chunky Monkey won't hurt, particularly if you've been on the diet all week. Or eat a slice of toast with your breakfast or have some potatoes with your dinner entree. But again, don't eat six slices of toast or a pound of mashed potatoes. The basic idea is to ease the feeling of deprivation that generally accompanies the start of any change in diet. If you handle these Open Meals wisely-treating yourself, but not to excess-you'll soon find that you don't need to cheat at all.

At first, many people find it difficult to give up bread, cereals, and dairy products. But when you cut down on these foods gradually, you'll eventually be able to replace them with more healthful fruits and vegetables. With Level I, you may want to use some "transitional" condiments. These contain sugar and salt but are low in fat. As you become accustomed to your new eating plan, you'll want to reduce or eliminate them. Transitional condiments include: * Low-fat salad dressings. Use these in moderation and read the labels. Stay away from brands that contain large amounts of corn syrup or salt.* Commercial sauces. Mustard, hot sauces, prepared salsa. Note: No catsup No catsup (except for the Paleo version, the recipe for which is included in chapter 10); regular catsup is too high in salt and fructose. (except for the Paleo version, the recipe for which is included in chapter 10); regular catsup is too high in salt and fructose.

If you are a coffee, beer, or wine drinker, you may continue to enjoy these non-Paleo beverages in moderation, working toward cutting back on them as you become accustomed to the Paleo Diet. Transitional beverages include: * Sugar-free soft drinks. Use these in moderation. All of them contain artificial sweeteners, which are best left out of your diet.* Alcoholic beverages. Use these in moderation.* Coffee. Use it in moderation. Excessive caffeine is a.s.sociated with a number of illnesses and health problems.

Sample Two-Week Meal Plan for Level I

SUNDAYOpen Almond Chicken Salad*

Herbal tea Tomato and avocado slices Grilled skinless turkey breast Steamed broccoli, carrots, and artichoke Bowl of fresh blueberries, raisins, and almonds Water with lemon slice Basic Beef Jerky,* celery sticks MONDAYBowl of diced apples, shredded carrots, and raisins Poached eggs Cup of decaffeinated coffee Brockway Tuna Salad*

Handful of almonds Mineral water Escargots (prepared without b.u.t.ter) Tossed green salad Broiled halibut steak with lemon juice and dill Steamed asparagus Sliced. kiwi fruit and tangerine wedges Gla.s.s of dry white wine cold lean beef slices, carrot sticks TUESDAYCantaloupe, strawberries Broiled lean pork chops Herbal tea Spinach salad with choice of Paleo dressing*

Broiled orange roughy with fresh orange juice and oregano Steamed cauliflower Apple Mineral water Paleo Zucchini Soup*

Slow-Cooked Veal with Salsa*

Figs Iced tea hard-boiled eggs, walnuts, raisins WEDNESDAYGrapefruit Strawberries with blackberries Cold leftover Veal with Salsa*

Cup of decaffeinated coffee Open Avocado and tomato slices Oysters on the half sh.e.l.l Altamira Stuffed Chicken*

Ratatouille*

Fresh boysenberries, raisins, and almonds Cup of decaffeinated coffee mango, unsalted macadamia nuts, Dried Salmon*