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Scoping review of Paleolithic dietary patterns: a definition proposal

Published online by Cambridge University Press:  02 June 2020

Víctor de la O
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain IdiSNA Pamplona, Spain
Itziar Zazpe
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain IdiSNA Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
J. Alfredo Martínez
CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain IdiSNA Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain IMDEA Food, Madrid, Spain
Susana Santiago
IdiSNA Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
Silvia Carlos
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain IdiSNA Pamplona, Spain
M. Ángeles Zulet
CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain IdiSNA Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
Miguel Ruiz-Canela*
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain IdiSNA Pamplona, Spain
*Corresponding author: Miguel Ruiz-Canela, email


The Paleolithic diet (PaleoDiet) is an allegedly healthy dietary pattern inspired by the consumption of wild foods and animals assumed to be consumed in the Paleolithic era. Despite gaining popularity in the media, different operational definitions of this Paleolithic nutritional intake have been used in research. Our hypothesis is that specific components used to define the PaleoDiet may modulate the association of this diet with several health outcomes. We comprehensively reviewed currently applied PaleoDiet scores and suggested a new score based on the food composition of current PaleoDiet definitions and the theoretical food content of a staple dietary pattern in the Paleolithic age. In a PubMed search up to December 2019, fourteen different PaleoDiet definitions were found. We observed some common components of the PaleoDiet among these definitions although we also found high heterogeneity in the list of specific foods that should be encouraged or banned within the PaleoDiet. Most studies suggest that the PaleoDiet may have beneficial effects in the prevention of cardiometabolic diseases (type 2 diabetes, overweight/obesity, CVD and hyperlipidaemias) but the level of evidence is still weak because of the limited number of studies with a large sample size, hard outcomes instead of surrogate outcomes and long-term follow-up. Finally, we propose a new PaleoDiet score composed of eleven food items, based on a high consumption of fruits, nuts, vegetables, fish, eggs and unprocessed meats (lean meats); and a minimum content of dairy products, grains and cereals, and legumes and practical absence of processed (or ultra-processed) foods or culinary ingredients.

Review Article
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

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