Paleolithic diet

Last updated

Foodstuffs compatible with paleolithic diet Paleo food.jpg
Foodstuffs compatible with paleolithic diet

The Paleolithic diet, Paleo diet, caveman diet, or Stone Age diet is a modern fad diet consisting of foods thought by its proponents to mirror those eaten by humans during the Paleolithic era. [1]

Contents

The diet avoids food processing and typically includes vegetables, fruits, nuts, roots, and meat and excludes dairy products, grains, sugar, legumes, processed oils, salt, alcohol, and coffee. [2] Historians can trace the ideas behind the diet to "primitive" diets advocated in 19th century. In the 1970s, Walter L. Voegtlin popularized a meat-centric "Stone Age" diet; in the 21st century, the best-selling books of Loren Cordain popularized the Paleo diet. [3] As of 2019 the paleo-diet industry was worth approximately US$500 million. [4]

In the 21st century, the sequencing of the human genome and DNA analysis of the remains of early humans have found evidence that humans evolved rapidly in response to changing diet. This evidence undermines a core premise of the paleolithic diet that human digestion has remained essentially unchanged over time. [5] Anthropological science has found that human diets in paleolithic times were more varied and less meat-centric than had previously been assumed.

Advocates promote the paleolithic diet as a way of improving health. [6] There is some evidence that following it may lead to improvements in body composition and metabolism compared with the typical Western diet [7] or compared with diets recommended by some European nutritional guidelines. [8] On the other hand, following the diet can lead to nutritional deficiencies, such as an inadequate calcium intake, and side effects can include weakness, diarrhea, and headaches. [9]

History and terminology

Adrienne Rose Johnson writes that the idea that the primitive diet was superior to current dietary habits dates back to the 1890s with such writers as Emmet Densmore and John Harvey Kellogg. Densmore proclaimed that "bread is the staff of death", while Kellogg supported a diet of starchy and grain-based foods in accord with "the ways and likings of our primitive ancestors". [10] Arnold DeVries advocated an early version of the Paleolithic diet in his 1952 book, Primitive Man and His Food. [11] In 1958, Richard Mackarness authored Eat Fat and Grow Slim, which proposed a low-carbohydrate "Stone Age" diet. [12]

In his 1975 book The Stone Age Diet, gastroenterologist Walter L. Voegtlin advocated a meat-based diet, with low proportions of vegetables and starchy foods, based on his declaration that humans were "exclusively flesh-eaters" until 10,000 years ago. [13]

In 1985 Stanley Boyd Eaton and Melvin Konner published a controversial article in the New England Journal of Medicine proposing that modern humans were biologically very similar to their primitive ancestors and so "genetically programmed" to consume pre-agricultural foods. Eaton and Konner proposed a "discordance hypothesis" by which the mismatch between modern diet and human biology gave rise to lifestyle diseases, such as obesity and diabetes. [14]

The diet started to become popular in the 21st century, where it attracted a largely internet-based following using web sites, forums and social media. [15]

This diet's ideas were further popularized by Loren Cordain, a health scientist with a Ph.D. in physical education, who trademarked the words "The Paleo Diet" and who wrote a 2002 book of that title. [16]

In 2012 the paleolithic diet was described as being one of the "latest trends" in diets, based on the popularity of diet books about it; [17] in 2013 and 2014 the Paleolithic diet was Google's most searched weight-loss method. [18]

The paleolithic or paleo diet is also sometimes referred to as the caveman or Stone Age diet. [19]

Foodstuffs

Roast beef. Some recent paleo diet variants emphasize the consumption of unprocessed animal products. Roastbeef.jpg
Roast beef. Some recent paleo diet variants emphasize the consumption of unprocessed animal products.

The basis of the diet is a re-imagining of what Paleolithic people ate, and different proponents recommend different diet compositions. Eaton and Konner, for example, wrote a 1988 book The Paleolithic Prescription with Marjorie Shostak, and it described a diet that is 65% plant-based. This is not typical of more recently devised paleo diets; Loren Cordain's  probably the most popular  instead emphasizes animal products and avoidance of processed food. [20] Diet advocates concede the modern paleolithic diet cannot be a faithful recreation of what paleolithic people ate, and instead aim to "translate" that into a modern context, avoiding such likely historical practices as cannibalism. [21]

Foodstuffs that have been described as permissible include:

The diet forbids the consumption of all dairy products. This is because milking did not exist until animals were domesticated after the Paleolithic era. [25]

Ancestral diet

Adopting the Paleolithic diet assumes that modern humans can reproduce the hunter-gatherer diet. Molecular biologist Marion Nestle argues that "knowledge of the relative proportions of animal and plant foods in the diets of early humans is circumstantial, incomplete, and debatable and that there are insufficient data to identify the composition of a genetically determined optimal diet. The evidence related to Paleolithic diets is best interpreted as supporting the idea that diets based largely on plant foods promote health and longevity, at least under conditions of food abundance and physical activity." [26] Ideas about Paleolithic diet and nutrition are at best hypothetical. [27]

The data for Cordain's book came from six contemporary hunter-gatherer groups, mainly living in marginal habitats. One of the studies was on the !Kung, whose diet was recorded for a single month, and one was on the diet of the Inuit. [28] Due to these limitations, the book has been criticized as painting an incomplete picture of the diets of Paleolithic humans. [29] It has been noted that the rationale for the diet does not adequately account for the fact that, due to the pressures of artificial selection, most modern domesticated plants and animals differ drastically from their Paleolithic ancestors; likewise, their nutritional profiles are very different from their ancient counterparts. For example, wild almonds produce potentially fatal levels of cyanide, but this trait has been bred out of domesticated varieties using artificial selection. Many vegetables, such as broccoli, did not exist in the Paleolithic period; broccoli, cabbage, cauliflower, and kale are modern cultivars of the ancient species Brassica oleracea . [30]

Trying to devise an ideal diet by studying contemporary hunter-gatherers is difficult because of the great disparities that exist; for example, the animal-derived calorie percentage ranges from 25% for the Gwi people of southern Africa to 99% for the Alaskan Nunamiut. Descendants of populations with different diets have different genetic adaptations to those diets, such as the ability to digest sugars from starchy foods. Modern hunter-gatherers tend to exercise considerably more than modern office workers, protecting them from heart disease and diabetes, though highly processed modern foods also contribute to diabetes when those populations move into cities. [31]

A 2018 review of the diet of hunter-gatherer populations found that the dietary provisions of the paleolithic diet had been based on questionable research, and were "difficult to reconcile with more detailed ethnographic and nutritional studies of hunter-gatherer diet". [32]

Researchers have proposed that cooked starches met the energy demands of an increasing brain size, based on variations in the copy number of genes encoding amylase. [33]

Health effects

The paleolithic diet is controversial in part because of the exaggerated health claims made for it by its supporters. [34] In general, methodological quality of research into the diet has been poor to moderate. [35]

The aspects of the paleolithic diet that result in eating fewer processed foods and less sugar and salt are consistent with mainstream advice about diet. [36] Diets with a paleolithic nutrition pattern have some similarities to traditional ethnic diets, such as the Mediterranean diet, that have been found to be more healthful than the Western diet. [37] Following the paleolithic diet, however, can lead to nutritional deficiencies, such as those of vitamin D and calcium, which in turn could lead to compromised bone health; [38] it can also lead to an increased risk of ingesting toxins from high fish consumption. [39]

There is some evidence the diet helps achieve weight loss, possibly because of the increased satiety from the foods typically eaten. [40] One trial of obese postmenopausal women found improvements in weight and fat loss after six months, but the benefits had ceased by 24 months; side effects among participants included "weakness, diarrhea, and headaches". As with any other diet regime, the paleolithic diet leads to weight loss because of overall decreased caloric intake, rather than a special feature of the diet itself. [41]

There is no good evidence that following a paleolithic diet lessens the risk of cardiovascular disease or metabolic syndrome. [42] There is no evidence the paleolithic diet is effective in treating inflammatory bowel disease. [43]

The paleolithic diet similar to the Atkins diet encourages the consumption of large amounts of red meat, especially meats high in saturated fat. This has a negative effect on health in the long run as medical studies have shown that it can lead to increased incidence of cardiovascular disease. [44]

Proposed rationale and reception

Melvin Konner, co-author of a 1985 paper setting out a hypothetical basis for the paleolithic diet Melvin Konner closeup.jpg
Melvin Konner, co-author of a 1985 paper setting out a hypothetical basis for the paleolithic diet

The stated rationale for the paleolithic diet is that human genes of modern times are unchanged from those of 10,000 years ago, and that the diet of that time is therefore the best fit with humans today. [45] Loren Cordain has described the paleo diet as "the one and only diet that ideally fits our genetic makeup". [46]

The argument is that modern humans have not been able to adapt to the new circumstances. [47] According to Cordain, before the agricultural revolution, hunter-gatherer diets rarely included grains, and obtaining milk from wild animals would have been "nearly impossible". [48] Advocates of the diet argue that the increase in diseases of affluence after the dawn of agriculture was caused by these changes in diet, but others have countered that it may be that pre-agricultural hunter-gatherers did not suffer from the diseases of affluence because they did not live long enough to develop them. [49]

According to the model from the evolutionary discordance hypothesis, "many chronic diseases and degenerative conditions evident in modern Western populations have arisen because of a mismatch between Stone Age genes and modern lifestyles." [50] Advocates of the modern paleo diet have formed their dietary recommendations based on this hypothesis. They argue that modern humans should follow a diet that is nutritionally closer to that of their Paleolithic ancestors.

The evolutionary discordance is incomplete, since it is based mainly on the genetic understanding of the human diet and a unique model of human ancestral diets, without taking into account the flexibility and variability of the human dietary behaviors over time. [51] Studies of a variety of populations around the world show that humans can live healthily with a wide variety of diets and that humans have evolved to be flexible eaters. [52] Lactase persistence, which confers lactose tolerance into adulthood, is an example of how some humans have adapted to the introduction of dairy into their diet. While the introduction of grains, dairy, and legumes during the Neolithic Revolution may have had some adverse effects on modern humans, if humans had not been nutritionally adaptable, these technological developments would have been dropped. [53]

Since the publication of Eaton and Konner's paper in 1985, analysis of the DNA of primitive human remains has provided evidence that evolving humans were continually adapting to new diets, thus challenging the hypothesis underlying the paleothic diet. [54] Evolutionary biologist Marlene Zuk writes that the idea that our genetic makeup today matches that of our ancestors is misconceived, and that in debate Cordain was "taken aback" when told that 10,000 years was "plenty of time" for an evolutionary change in human digestive abilities to have taken place. On this basis Zuk dismisses Cordain's claim that the paleo diet is "the one and only diet that fits our genetic makeup". [55]

Paleoanthropologist Peter Ungar has written that the paleo diet is a "myth", on account both of its invocation of a single suitable diet when in reality humans have always been a "work in progress", and because diet has always been varied because humans were spread widely over the planet. [56]

Anthropological geneticist Anne C. Stone has said that humans have adapted in the last 10,000 years in response to radical changes in diet. In 2016, she was quoted as saying "It drives me crazy when Paleo-diet people say that we've stopped evolving—we haven't". [57]

Melvin Konner has said the challenge to the hypothesis is not greatly significant since the real challenges to human non-adaptation have occurred with the rise of ever-more refined foodstuffs in the last 300 years. [58]

Environmental impact

A 2019 analysis of diets in the United States ranked consumption of a paleolithic diet as more environmentally harmful than consumption of an omnivorous diet, though not so harmful as a ketogenic diet. [59]

Elizabeth Kolbert has written the paleolithic diet's emphasis on meat consumption is a "disaster" on account of meat's comparatively high energy production costs. [60]

Popularity

A lifestyle and ideology have developed around the diet. [61] "Paleolithic" products include clothing, smartphone apps, and cookware. Many paleolithic cookery books have been bestsellers. [62]

As of 2019 the market for products with the word "Paleo" in their name was worth approximately $US500million, with strong growth prospects despite pushback from the scientific community. Some products were taking advantage of the trend by touting themselves as "paleo-approved" despite having no apparent link to the movement's tenets. [63]

Like many other diets, the paleolithic diet is promoted by some by an appeal to nature and a narrative of conspiracy theories about how nutritional research, which does not support the supposed benefits of the paleolithic diet, is controlled by a malign food industry. [64] Paleolithic diet advocate John Durant has blamed suppression of the truth about diet in the United States on "the vegetarian lobby". [65]

See also

Tree of life.svg   Evolutionary biologyportal

Foodlogo2.svg   Foodportal

Citations

  1. de Menezes et al. 2019: "The Paleolithic diet has been gaining ground in the field of fad diets. It is based on food patterns of human Paleolithic ancestors, about 2.6 million to 10,000 years ago, a period that precedes the advent of industrial agriculture and is different from today's modern society".
  2. British Dietetic Association 2014 - "The Paleo diet (also known as the Paleolithic Diet, the Caveman diet and the Stone Age Diet) is a diet where only foods presumed to be available to Neanderthals in the prehistoric era are consumed and all other foods, such as dairy products, grains, sugar, legumes, 'processed' oils, salt, and others like alcohol or coffee are excluded."
  3. Ask EN 2010; Johnson 2015; Fitzgerald 2014.
  4. Decker 2019.
  5. Whoriskey 2016; Zuk 2013 , p. 133: "No one [...] can legitimately claim to have found the only 'natural' diet for humans. We simply ate too many different foods in the past, and have adapted to new ones".
  6. NHS 2008.
  7. Katz & Meller 2014.
  8. Manheimer et al. 2015.
  9. For calcium deficicency see Tarantino, Citro & Finelli 2015; for other risks see Obert et al. 2017.
  10. Johnson 2015.
  11. Newton 2019 , p. 102.
  12. Hill 1996; Smith 2015 , p. 117: "Mackarness, who founded the first British National Health Service clinical ecology clinic in Basingstoke, pioneered the so-called Stone Age Diet, in the belief that humans had not evolved to consume foods, including wheat and milk, developed since Paleolithic times (in fact, today's weight-reduction version of Mackarness's Stone Age diet is called the 'Paleo diet')."
  13. Zuk 2013 , pp. 111–112.
  14. Johnson 2015.
  15. Chang & Nowell 2016.
  16. Ask EN 2010. For Cordain's qualifications see Chang & Nowell 2016. For trademarking see Lowe 2014.
  17. Cunningham 2012.
  18. Chang & Nowell 2016.
  19. Shariatmadari 2014.
  20. Chang & Nowell 2016.
  21. Kolbert 2014.
  22. Tarantino, Citro & Finelli 2015.
  23. Manheimer et al. 2015.
  24. Katz & Meller 2014.
  25. Longe 2008 , p. 180: "No dairy products are allowed while on this diet. This means no milk, cheese, butter, or anything else that comes from milking animals. This is because milking did not occur until animals were domesticated, sometime after the Paleolithic age. Eggs are allowed however, because Paleolithic man would probably have found eggs in bird's nests during foraging and hunting."
  26. Nestle 2000.
  27. Milton 2002.
  28. Ungar & Teaford 2002; Lee 1969; Eaton, Shostak & Konner 1988.
  29. Ungar & Teaford 2002.
  30. Jabr 2013.
  31. Gibbons 2014.
  32. Pontzer, Wood & Raichlen 2018.
  33. Zimmer 2015; Hardy et al. 2015.
  34. Pitt 2016; Kolbert 2014  : "[...] proponents of the paleo diet make all sorts of claims for its efficacy. Some contend that it cures autoimmune diseases, others that it reverses diabetes."
  35. Pitt 2016; Obert et al. 2017.
  36. British Dietetic Association 2014.
  37. Tarantino, Citro & Finelli 2015; Katz & Meller 2014.
  38. British Dietetic Association 2014; Pitt 2016.
  39. Tarantino, Citro & Finelli 2015.
  40. de Menezes et al. 2019.
  41. Obert et al. 2017.
  42. Ghaedi et al. 2019; Manheimer et al. 2015.
  43. Hou, Lee & Lewis 2014: "Even less evidence exists for the efficacy of the SCD, FODMAP, or Paleo diets. Furthermore, the practicality of maintaining these interventions over long periods of time is doubtful."
  44. Longe 2008 , p. 182.
  45. Obert et al. 2017.
  46. Gibbons 2014.
  47. Carrera-Bastos et al. 2011.
  48. Cordain et al. 2005
  49. Ungar, Grine & Teaford 2006.
  50. Elton 2008 , p. 9.
  51. Turner & Thompson 2013.
  52. Leonard 2002.
  53. Jabr 2013.
  54. Whoriskey 2016.
  55. Zuk 2013 , p. 114.
  56. Ungar 2017.
  57. Whoriskey 2016.
  58. Whoriskey 2016.
  59. O'Malley et al. 2019.
  60. Kolbert 2014.
  61. Goldstein 2010; Wilson 2015.
  62. Chang & Nowell 2016.
  63. Decker 2019.
  64. NHS 2008; Kolbert 2014; Hall 2014: "Fad diets and 'miracle' diet supplements promise to help us lose weight effortlessly. Different diet gurus offer a bewildering array of diets that promise to keep us healthy and make us live longer: vegan, Paleo, Mediterranean, low fat, low carb, raw food, gluten-free [...] the list goes on."
  65. Kolbert 2014.

Related Research Articles

<span class="mw-page-title-main">Paleolithic</span> Prehistoric period, first part of the Stone Age

The Paleolithic or Palaeolithic, also called the Old Stone Age, is a period in human prehistory that is distinguished by the original development of stone tools, and which represents almost the entire period of human prehistoric technology. It extends from the earliest known use of stone tools by hominins, c. 3.3 million years ago, to the end of the Pleistocene, c. 11,650 cal BP.

<span class="mw-page-title-main">Hunter-gatherer</span> Peoples who forage or hunt for most or all of their food and life

A hunter-gatherer or forager is a human living in a community, or according to an ancestrally derived lifestyle, in which most or all food is obtained by foraging, that is, by gathering food from local naturally occurring sources, especially edible wild plants but also insects, fungi, honey, bird eggs, or anything safe to eat, and/or by hunting game. This is a common practice among most vertebrates that are omnivores. Hunter-gatherer societies stand in contrast to the more sedentary agricultural societies, which rely mainly on cultivating crops and raising domesticated animals for food production, although the boundaries between the two ways of living are not completely distinct.

<span class="mw-page-title-main">Fad diet</span> Popular diet with claims not supported by science

A fad diet is a diet that is popular, generally only for a short time, similar to fads in fashion, without being a standard scientific dietary recommendation, and often making unreasonable claims for fast weight loss or health improvements; as such it is often considered a type of pseudoscientific diet. Fad diets are usually not supported by clinical research and their health recommendations are not peer-reviewed, thus they often make unsubstantiated statements about health and disease.

<span class="mw-page-title-main">Raw foodism</span> Diet of uncooked and unprocessed food

Raw foodism, also known as rawism or a raw food diet, is the dietary practice of eating only or mostly food that is uncooked and unprocessed. Depending on the philosophy, or type of lifestyle and results desired, raw food diets may include a selection of fruits, vegetables, nuts, seeds, eggs, fish, meat, and dairy products. The diet may also include simply processed foods, such as various types of sprouted seeds, cheese, and fermented foods such as yogurts, kefir, kombucha, or sauerkraut, but generally not foods that have been pasteurized, homogenized, or produced with the use of synthetic pesticides, fertilizers, solvents, and food additives.

<span class="mw-page-title-main">Plant-based diet</span> Diet consisting mostly or entirely of plant-based foods

A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian, but are defined in terms of low frequency of animal food consumption.

<span class="mw-page-title-main">Evolutionary medicine</span> Application of modern evolutionary theory to understanding health and disease

Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern biomedical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in the understanding of cancer, autoimmune disease, and anatomy. Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula. The International Society for Evolution, Medicine and Public Health coordinates efforts to develop the field. It owns the Oxford University Press journal Evolution, Medicine and Public Health and The Evolution and Medicine Review.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Protein poisoning</span> Form of malnutrition

Protein poisoning is an acute form of malnutrition caused by a diet deficient in fat and carbohydrates, where almost all bioavailable calories come from the protein in lean meat. The concept is discussed in the context of paleoanthropological investigations into the diet of ancient humans, especially during the Last Glacial Maximum and at high latitude regions.

<span class="mw-page-title-main">Protein (nutrient)</span> Nutrient for the human body

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue and can also serve as a fuel source. As a fuel, proteins provide as much energy density as carbohydrates: 4 kcal per gram; in contrast, lipids provide 9 kcal per gram. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.

<span class="mw-page-title-main">Melvin Konner</span> American anthropologist

Melvin Joel Konner is an American anthropologist who is the Samuel Candler Dobbs Professor of Anthropology and of Neuroscience and Behavioral Biology at Emory University. He studied at Brooklyn College, CUNY (1966), where he met Marjorie Shostak, whom he later married and with whom he had three children. He also has a PhD from Harvard University (1973) and a MD from Harvard Medical School (1985).

<span class="mw-page-title-main">Western pattern diet</span> Modern dietary pattern

The Western pattern diet is a modern dietary pattern that is generally characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy and sweets, fried foods, industrially produced animal products, butter and other high-fat dairy products, eggs, potatoes, corn, and low intakes of fruits, vegetables, whole grains, pasture-raised animal products, fish, nuts, and seeds.

<span class="mw-page-title-main">Inuit cuisine</span> Culinary traditions of the Inuit

Historically Inuit cuisine, which is taken here to include Greenlandic cuisine, Yup'ik cuisine and Aleut cuisine, consisted of a diet of animal source foods that were fished, hunted, and gathered locally.

<span class="mw-page-title-main">Peter Ungar</span> American paleoanthropologist (born 1963)

Peter S. Ungar is an American paleoanthropologist and evolutionary biologist.

<span class="mw-page-title-main">Staffan Lindeberg</span>

Staffan Lindeberg (1950–2016) was an associate professor of family medicine at the Department of Medicine, University of Lund, Sweden. He was a practicing GP at St Lars Primary Health Care Center, Lund, Sweden. Lindeberg researched the paleolithic diet.

Loren Cordain is an American scientist who specializes in the fields of nutrition and exercise physiology. He is notable as an advocate of the Paleolithic diet.

S. Boyd Eaton is a radiologist and one of the originators of the concept of Paleolithic nutrition. In 1985, he and Melvin Konner published a paper, Paleolithic Nutrition, in The New England Journal of Medicine which attracted some attention from other researchers.

The diet of known human ancestors varies dramatically over time. Strictly speaking, according to evolutionary anthropologists and archaeologists, there is not a single hominin Paleolithic diet. The Paleolithic covers roughly 2.8 million years, concurrent with the Pleistocene, and includes multiple human ancestors with their own evolutionary and technological adaptations living in a wide variety of environments. This fact with the difficulty of finding conclusive evidence often makes broad generalizations of the earlier human diets very difficult. Our pre-hominin primate ancestors were broadly herbivorous, relying on either foliage or fruits and nuts and the shift in dietary breadth during the Paleolithic is often considered a critical point in hominin evolution. A generalization between Paleolithic diets of the various human ancestors that many anthropologists do make is that they are all to one degree or another omnivorous and are inextricably linked with tool use and new technologies. Nonetheless, according to the California Academy of Sciences, "Prior to about 3.5 million years ago, early humans dined almost exclusively on leaves and fruits from trees, shrubs, and herbs—similar to modern-day gorillas and chimpanzees."

<span class="mw-page-title-main">Nina Teicholz</span> American journalist

Nina Teicholz is a journalist who advocates for reducing restrictions on naturally-occurring fats, including saturated fats, in the American diet.

<span class="mw-page-title-main">Richard Mackarness</span> British physician

Guy Richard Godfrey Mackarness was a British psychiatrist and low-carbohydrate diet writer. He is best known for his book Eat Fat and Grow Slim, published in 1958. Mackarness was an early advocate of the Paleolithic diet and authored books on food allergies.

References

Further reading