The Paleo Diet and B-Vitamin Deficiencies: The Critics vs. The Data
According to its critics, the Paleo Diet excludes entire food groups, thereby promoting nutrient deficiencies, particularly calcium, vitamin D, and various B-vitamins. This article will only investigate potential B-vitamin deficiencies. First, let’s give some attention to the concept of “excluding entire food groups.”
When Paleo critics use this phrase, they refer specifically to dairy, cereals, and legumes, three food groups excluded from most, but not all, Paleo templates. I should say upfront that despite being very much aligned with the Paleo approach, I don’t necessarily support the wholesale exclusion of these food groups. For those who tolerate dairy, for example, I strongly recommend traditionally fermented foods like full-fat yogurt and kefir. I also recommend butter, an extremely low-lactose, superior-quality fat. Regarding cereals and legumes, my primary concerns are their anti-nutrients and high carbohydrate levels. Proper preparations, including soaking and fermenting, can improve the nutritional values of these foods, thus making them more acceptable for everyday consumption. I cover these issues extensively in Nutritional Grail.
So the question remains. Can humans who “exclude entire food groups” be healthy? Put another way, can we thrive without foods that only appeared on our plates within the past 12,000 years? This evolutionary blink-of-an-eye represents only 6 percent of our time as Homo sapiens (200,000 years) and just 0.5 percent of the Homo genus (2.3 million years). We evolved as hunter-gatherers and only very recently began consuming agricultural foods (dairy, cereals, and legumes). This doesn’t mean agricultural foods are necessarily unhealthy, but certainly we can thrive without them, as evidenced by 2.3 million years of evolution.
The Elephant in the Room
Most nutrition/health institutions (AHA, AND, ADA, ACS, USDA, etc.) recommend high-carbohydrate diets based on cereals and, to a lesser degree, legumes. The exclusion of these food groups, they claim, encourages nutrient deficiencies, especially B-vitamin deficiencies. They should consider the following question: what other entire food groups are excluded from modern diets? When you begin analyzing foods and food groups for B-vitamin nutrient density, one thing becomes strikingly clear—cereals and legumes are by no means the most abundant sources of B-vitamins. The Paleo critics have overlooked an entire food group, one traditionally prized by all cultures until very recently.
Regarding nutrient density, and especially B-vitamins, cereals and legumes don’t even come close to organ meats. Since the Paleolithic, and all the way through modern times, humans have practiced so-called nose-to-tail eating, consuming whole animals, including their nutrient dense livers, kidneys, hearts, tongues, etc. Though still appreciated and regularly practiced throughout much of the world, organ meat consumption declined sharply in the US beginning around the 1970s. It’s making a comeback today, thanks in part to the Paleo Diet. But as you will see, regarding B-vitamins, the Paleo diet has plenty more to offer.
Where Do You Get Your B?
As shown in the charts attached below, organ meats are by far the richest sources of B-vitamins. It’s interesting that Paleo critics take exception to the diet’s exclusion of supposedly B-vitamin-rich cereals and legumes while failing to acknowledge that most Paleo advocates strongly encourage the consumption of organ meats. But even a Paleo Diet without organ meats can still provide more than enough B-vitamins.
Besides organ meats, many Paleo foods are just as B-vitamin-rich (if not richer) than cereals and legumes. These include fish, meat, eggs, mushrooms, and particular vegetables. Although the Paleo Diet is sometimes criticized for lacking B-vitamins, an objective look at nutritional data proves it offers an abundance of B-vitamins, and perhaps considerably more than the USDA’s high-carbohydrate, cereal-based diet.
In case you’re unfamiliar with the B-vitamin deficiency claim, each of the following articles either directly asserts that the Paleo Diet lacks sufficient B-vitamins or implies this much by questioning its exclusion of cereals and legumes.
- The paleo diet: can it really be good for you? The Telegraph, January 29, 2014
- Whole30: Could it Work for You? ABC News, May 5, 2014
- Is the Paleo Diet Healthy? Calorie Secrets, December 17, 2012
- How We Rated 32 Eating Plans, US New and World Report, January 7, 2014
- How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked, Scientific American, June 3, 2013
- Paleo Diet: Health or a Hoax? Huffington Post, March 12, 2013
- Is the Paleo Diet Health? CNN, September 9, 2011
- Top Diets Review for 2014, NHS (UK)
- The Paleo Diet: for and against, Sydney Morning Herald, March 13, 2012
- Should We Eat Like Our Caveman Ancestors? Academy of Nutrition & Dietetics, April 2013
Explanation of the Charts
Attached below is a series of seven charts, one for each of the seven primary B vitamins. All numbers come from the USDA’s National Nutrient Database for Standard Reference via Nutrition Data, a highly recommended, user-friendly website. Vitamin B7 (biotin) numbers have not been included because they are not currently accessible via Nutrition Data.
All foods are compared as 100-gram portions. There is, however, one important caveat. Dry, uncooked cereals are much more nutrient dense than cooked cereals, which are generally 50 to 80 percent water. It doesn’t make sense, therefore, to compare dry, waterless cereals and legumes to fresh meats and vegetables, which are 70 percent water or more. Once cooked, depending on the cooking method, a 100-gram portion of meat or vegetables will likely weigh less than 100 grams. For cereals, however, a 100-gram starting portion will weigh two to six times more after cooking. I don’t see the logic in comparing, for example, a 100-gram portion of chicken with a 412-gram portion of cooked bulgur, which indeed weighed 100 grams before it was cooked.
I have taken all this into account regarding the charts. Both cooked and uncooked cereal/legume nutrient values are shown. For the uncooked values, I also indicate how much the food weighs after cooking, so you can make more informed comparisons. To make things visually easy, the uncooked cereals and legumes are shaded green while the cooked versions are shaded purple. Each of the seven charts shows food rankings, in descending order, shaded in blue, for one of the seven B vitamins.
Vitamin B1 (Thiamin): The best source is pork, followed by organ meats, and cereals/legumes. Fish such as trout and pike are also very high in B1. A 100-gram serving of these fish yields an equal amount of 300 grams of various cooked cereals/legumes.
Vitamin B2 (Riboflavin): Organ meats are by far the richest sources. Almonds, fish roe, mackerel, eggs, mushrooms, blueberries, lamb, pork, trout, and sardines are tier-2. Cereals/legumes are tier-3 since a 300 gram serving yields roughly the same amount as a 100-gram serving of fish or meat.
Vitamin B3 (Niacin): Organ meats as well as tuna and mackerel are the most potent sources. Other fish, meat, and mushrooms are tier-2 with cereals/legumes being tier-3.
Vitamin B5 (Pantothenic acid): Organ meats have three to six times more than tier-2 foods, which include trout, various mushrooms, eggs, and chicken. Uncooked cereals, with cooked serving portions ranging from 220 to 615 grams, are comparable to 100-gram servings of tier-2 foods.
Vitamin B6: Organ meats as well as pork are the best sources. Beef, lamb, fish, walnuts, and bell peppers are also potent sources. Cereals/legumes are decent sources. 300-grams of cooked cereals/legumes yields roughly the same as 100 grams of meat/fish.
Vitamin B9 (Folate): Organ meats and pulses are the best sources. If you consume neither, then it’s best to eat walnuts, fish roe, eggs, and plenty of vegetables, particularly spinach, okra, broccoli, cauliflower, asparagus, and bell peppers.
Vitamin B12: Only present in animal foods, the richest sources by far are organ meats. Mackerel and sardines are also particularly potent. By eating meat, fish, and eggs regularly, you’ll consume plenty of B12.
Paleo critics warn that excluding cereals and legumes from one’s diet can promote B-vitamin deficiencies. They neglect to mention, however, that modern, grain-based diets also typically exclude an entire food group—organ meats, the most nutrient dense food group by far. Those who follow the Paleo Diet, particularly those who eat organ meats regularly, consume plenty of B-vitamins, and probably far more than those who follow typical USDA-type diets. But even Paleo diets without organ meats still provide more than enough B-vitamins. In the case of the latter, pork, lamb, beef, eggs, mackerel, sardines, tuna, mushrooms, peppers, broccoli, and cauliflower are important foods.
The idea that cereals and legumes are somehow necessary does not square with easily attainable nutritional data. Furthermore, the idea that cereals and legumes are the richest sources of B-vitamin probably comes from comparisons of uncooked, waterless grains with fresh animal and vegetable foods, which are 70 percent or more water.