Chapter 14
The Paleo Diet for Children
Treating Type 1 Diabetes: JoAnne’s Story
On September 10, 2009, I took my six-year-old daughter to the pediatrician for what I thought was a urinary tract infection. She had been very thirsty and going to the bathroom excessively. Little did I know that these were symptoms of hyperglycemia. Her blood glucose was tested at 542 in the doctor’s office, and she spent two days in the hospital. During that time, she was diagnosed with type 1 diabetes. Her A1c [a long-term marker of glucose and insulin metabolism] was 10.8. They sent us home to begin a regimen of insulin injections: one basal in the evening, one before each meal. We did what any parent would do: what the doctors told us.
After a week or so, however, we realized that we were counting carbohydrates in foods such as Pop-Tarts. It seemed absurd. We decided that all of us needed to clean up our diets. Since we worked out in a CrossFit gym, the diet that came to mind was the Paleo Diet.
What happened next was amazing! My daughter’s insulin needs plummeted. During the next week, we made numerous calls to the endocrinologist to adjust her dosages downward. After about two weeks, she was completely off insulin. That was October 1, 2009. She has continued with BG testing, endocrinologist visits, and the Paleo Diet, and as of this day, January 31, 2010, she has close-to-normal BG and requires no insulin. My challenge is to make a believer out of the endocrinologist. He believes she is in remission and that it will surely wear off. Yet as more time goes by, I can see his curiosity beginning to awaken. He said that there are some cases of remission lasting this long, but if she makes it to a year, he will have to write a paper.
A few months later
I wanted to give you an update on my daughter. She had her quarterly checkup with the endocrinologist today. Her A1C was 5.7! She has been eating around 100 or 125 grams of carbohydrates a day, mostly in the form of fruit and some vegetables and tree nuts. We have been about 95 percent faithful to the diet. She eats eggs every other morning for breakfast, and occasionally she has a treat, which is a diet soda or a gluten-free cookie made of rice flour. I have found those are best eaten either right after a meal or with some other fat or protein food, or else it spikes her blood sugar.
We now have a solid six months of total remission under our belts.
With the growing popularity of the Paleo Diet, many people have asked me for more information about adapting the Paleo Diet to the growth and nutritional needs of infants and young children. With a little modification, the Paleo Diet can meet your children’s nutritional requirements, help them escape the rising childhood obesity epidemic, and build lifelong eating habits to lower their risk of disease and ensure them long and healthy lives.
The best model we have for infant nutrition comes from the example given to us by our hunter-gatherer ancestors. Obviously, we cannot precisely duplicate their nutritional patterns, nor would it be practical. Yet we can certainly do better than the typical diets most infants in the United States must tolerate.
Hunter-gatherer children were generally introduced to solid food later than what is considered normal in the United States and the Western world. Studies of foraging societies show that the average age of weaning was 2.9 years. Hunter-gatherer infants were highly dependent on their mother’s milk for most of their daily nutrition. Obviously, it would be impractical or nearly impossible for most Western women to nurse for such an extended period, but there are some important lessons to be learned.
First, hunter-gatherer diets were rich in omega 3 fatty acids, compared to typical Western diets. Mother’s milk contained more of these essential fats than milk from Western mothers does. This difference is crucial because numerous studies have revealed the importance of sufficient omega 3 fatty acids during pregnancy and nursing for proper brain and cognitive development of your child. By eating fatty fish two or three times a week or by taking fish oil capsules (EPA plus DHA), you can be guaranteed that your milk will contain ample amounts of omega 3 fatty acids for your infant’s normal development.
Although weaning at age 3 may be impractical, you should delay weaning as long as possible—preferably until 1 to 1.5 years of age. After weaning, I recommend that you give your infant formula that is enriched with both docosahexaenoic acid (DHA) and arachidonic acid (AA). Also, try to stay away from soy-based formulas. Do not give your infant either fish oil or fish oil capsules in any form because they contain an omega 3 fatty acid, EPA, that competes with AA metabolism and can result in impaired motor nerve development.
Human milk contains very little iron; nonetheless, infants are born with sufficient iron stores to last for about nine to twelve months. Hunter-gatherer mothers introduced their infants to solid foods by thoroughly chewing meat, marrow, nuts, seeds, fruits, and so on, and then giving these premasticated foods to their infants. Obviously, you don’t have to go to these extremes. Pediatricians typically recommend that infants’ first solid foods be iron-fortified cereals to restore depleted iron supplies in their little bodies. I completely disagree with this recommendation. I suggest that you consider commercial baby meats, such as beef, pork, and chicken, as better alternatives to cereals. Processed baby meats are good sources of iron with high bioavailability. Make sure that these meats don’t contain added cereal fillers or other additives. Baby cereals should be avoided for all of the same reasons that adults should steer clear of these second-class foods.
Lorrie and I fed all three of our infant sons commercial baby meats because of the difficulty of mincing and pureeing fresh meat into a consistency that could be easily swallowed without the risk of choking. Scrambled omega 3 eggs are easy to swallow and are good sources of protein for your infant’s first solid foods. With our three boys, we mainly tried to feed them fresh fruits and veggies that we prepared ourselves rather than giving them processed commercial versions of these foods. It’s easy to make homemade applesauce, pureed carrots, mashed sweet potatoes, pureed fruits, and pureed veggies. Simply cook your veggies until soft and then puree them in a blender. Be creative and try to give your infant variety. Also be sensitive to your baby’s tastes. Don’t force foods on your baby—when he or she spits out your homemade creations, it is a pretty good sign that your child may not like a certain food.
Virtually all pediatricians recommend that cow’s milk and other dairy products, such as yogurt and cheese, be excluded from infant diets during their first year of life. Early exposure to dairy products has been implicated in an increased risk of developing allergies and autoimmune diseases, particularly type 1 diabetes. I believe this recommendation is not stringent enough. I suggest that dairy products should be excluded for an even greater period, lasting until at least age two or beyond. With all three of our boys, we never gave any of them milk during their infant years or even during their childhood. We simply do not stock it in our home. To this day, as young men and teenagers, they don’t drink milk. By the way, all three boys grew up to be tall, lean, and athletic. None wears glasses, and dental cavities have been few and far between in our family. Eliminating milk from your child’s diet inadvertently eliminates another problem—breakfast cereals. Without milk, breakfast cereals taste about as good as dried cardboard. In our household, we occasionally stock cheese, but rarely do ice cream or frozen yogurt find their way into our refrigerator. As they became teens, all three boys quickly discovered the connection between ice cream and acne flair-ups.
When you switch your infant to solid foods after weaning, I recommend that you focus on the same basic food types that I recommend for adults: fresh fruits, vegetables, nuts, seeds, fresh meats, fish, shellfish, and eggs.
There is evidence that children’s livers are less able to deal with high intakes of protein—around 30 to 40 percent of total calories—than adults’ livers are. Fattier meats and fish should not be restricted in your child’s diet because giving them fattier meats will help lower their protein intake. Fresh lamb and pork are delicious fattier cuts of meat that most children relish. High-fat plant foods, such as nuts, olives, avocados, and healthful oils, are also useful, but monitor your child for nut allergies. Omega 3–enriched eggs should be the eggs of choice, as they are good sources of brain-healthy EPA and DHA.
I also believe that you should supply your children with as much dried fruits (dates, raisins, and figs) as they want. Healthy, normal-weight, active children have exquisitely tuned insulin and glucose metabolisms, so these foods present few health problems. Dried fruits will not promote obesity and represent some of the healthiest natural sweets you can give your child. Trail mix and gorp without added candy make delicious snacks for active children. Other good concentrated carbohydrate sources include bananas, yams, and sweet potatoes.
I don’t advocate completely restricting processed foods from children because eating involves multiple behavioral issues that go far beyond the mere nutritional aspects of diet. The best way to get a child to eat junk food is to completely forbid it. In our home, we serve Paleo foods at every meal. We also stock very few processed foods in our refrigerator and pantry, so if our children are hungry, their choices are primarily healthy foods. We don’t allow unlimited access to TV, computers, or electronic games, but we do encourage outdoor play.
For active children who exercise outdoors, I don’t believe that processed high-glycemic-index foods are harmful on an occasional basis. Built into the Paleo Diet is the 85/15 rule, which allows you and your children to cheat and eat three non-Paleo meals per week if you decide to do so. Birthday parties are part of being a kid, and your child should have the option of eating pizza or cake once in a blue moon. Yet even though we allowed our boys to eat these foods occasionally, our oldest son who is now in college is strictly Paleo and wouldn’t even consider pizza or cake. We have always given our children the choice to make their own decisions, and this policy seems to have worked.
While most people in nearly all Western countries view tall children and adults positively, height has a downside, particularly from a lifelong health perspective. Scientists have known for decades that tall adults and children maintain an increased risk for developing many cancers, myopia (nearsightedness), and acne. Although the nature of this relationship remains somewhat obscure, it is becoming increasingly clear that diet represents a powerful environmental factor underlying these conditions and illnesses.
Milk drinking during childhood is known to increase adult stature because it elevates a hormone (IGF-1) that promotes growth and height. As I discussed, milk and dairy consumption also raise the risk for breast and prostate cancer from the same hormonal mechanism that increases stature. The typical U.S. diet not only contains loads of milk and dairy products but also high-glycemic carbohydrates that elevate IGF-1. Milk, dairy, and high-glycemic-index carbohydrates make up about half of the calories in the normal U.S. diet, so it is not surprising that our nation produces some of the tallest, heaviest people in the world whose risk of dying from cancer is second only to heart disease.
Before I move on to Paleo diets for teenagers, there’s one more topic about nutrition and your child’s health that I need to address—overweight children. Every few months, we hear about yet another study showing that Americans are the fattest people on the planet and that we keep getting fatter. More alarming are the studies showing that our children are following in our footsteps. In the chart above you can see that the percentage of obese children and teenagers between the ages of two and nineteen has more than tripled since 1971.
In 2002, when I wrote the first edition of The Paleo Diet, the most effective type of weight-loss diet was still being hotly debated within scientific circles. It was thought that low-fat, high-carb diets were the way to go, although the first well-controlled scientific studies of low-carb, high-fat diets, such as Atkins, were being tested. At the time, just a trickle of studies had suggested that a more effective strategy to get weight off and keep it off was a high-protein, low-glycemic-index diet. These are just the recommendations I made in The Paleo Diet, recommendations that have been validated by a great deal of scientific research since the publication of my first book.
A 2010 randomized trial involving 773 subjects and published in the New England Journal of Medicine confirmed once again that high-protein, low-glycemic-index diets were the most effective strategy to keep weight off. More important, the same beneficial effects of high-protein, low-glycemic-index diets were dramatically demonstrated in the largest nutritional trial, the DiOGenes Study, ever conducted in children, with a sample of 827 subject. Children assigned to low-protein, high-glycemic diets became significantly fatter during the six-month experiment, whereas those overweight and obese children assigned to the high-protein, low-glycemic nutritional plan lost significant amounts of weight.
I find it curious that the National Institutes of Health spends hundreds of millions of dollars on research attempting to determine the causes of the obesity epidemic sweeping our country, when the simple answer lies before their very eyes. If you don’t want your children to become part of the obesity epidemic, start them early on the Paleo Diet.
Paleo Diets during the Teenage Years
As a father of three teenage boys, I have personally experienced the trials and tribulations parents go through with this age group. Remarkably, Lorrie and I have enjoyed this time of life with our children, and I believe that diet, along with parental compassion, love, and consistency, guide children toward healthy, productive lives. It’s important to realize that proper diet eliminates environmental elements that may contribute to or worsen the stresses of this pivotal stage of your child’s life. The same dietary characteristics that help you optimize your health will also do the same for your children as they grow and develop during their teen years. A high-protein, low-glycemic-index diet with minimal processed foods, no cereal grains, few dairy products, and lots of fresh fruits and veggies represents the ideal diet not only for adults, but also for teenagers.
Making the transition from childhood to adulthood is not easy, as hormones affect every tissue in a teen’s rapidly growing body—including the brain. Lorrie and I have noticed that the Paleo Diet has had a calming effect on all three of our sons’ behavior, compared to typical adolescents’. Both dairy and wheat contain psychoactive substances called exorphins that enter the bloodstream and bind opioid (pain) receptors in the brain. Dr. Dohan has shown that wheat- and dairy-free diets have proven healing value in schizophrenic patients under clinical settings. In perhaps the most comprehensive review examining cereals and schizophrenia, Dr. Lorenz from Colorado State University concluded, “In populations eating little or no wheat, rye, and barley, the prevalence of schizophrenia is quite low and about the same regardless of type of acculturating influence.”
Wheat- and dairy-free diets such as the Paleo Diet also appear to have therapeutic potential in other mental disorders, such as attention deficit disorder (ADHD), depression, and autism. Few well-controlled experiments have been carried out to examine the efficacy of wheat- and dairy-free diets in children or adults with these mental conditions. Nevertheless, the preliminary evidence is encouraging. In a review of the seven trials that eliminated either wheat or dairy, or both, from the diets of autistic children, Drs. Christison and Ivany summarized, “All [trials] reported efficacy in reducing some autism symptoms, and 2 groups of investigators also reported improvement in nonverbal cognition.”
In a study of 132 celiac patients, Drs. Niederhofer and Pittschieler reported that “ADHD-like symptomatology is markedly overrepresented among untreated celiac disease patients and that a gluten-free diet may improve symptoms significantly within a short period of time.” Similar beneficial results with gluten-free diets have been reported for celiac patients with chronic depression.
Paleo Helped My Son at School: Suzanne’s Story
I tried the diet out on my ten-year-old son. I noticed an immediate improvement in his concentration, problem-solving skills, and ability to deal with stressful situations. When he “falls off the wagon” at his grandmother’s house or with his dad, who thinks this diet philosophy is a lot of baloney, my son becomes cranky, difficult, and indecisive. He makes mistakes on his homework, and his test grades slip.
Acne is a huge health issue that targets most teens. Metabolically, we know that acne develops during this time of life because adolescence is a period of natural insulin resistance, which aggravates acne. When high-glycemic-load carbohydrates, refined sugars, and dairy products are added into this mix, it becomes a perfect formula for producing adolescent acne. No wonder 90 percent of all U.S. teenagers get acne, as processed foods are staples in their diets. In sharp contrast, my research team and I found absolutely no acne in more than three hundred non-Westernized adolescents living on the remote island of Kitava.
Sometimes it may prove difficult to convince your teens to forgo pizza and soda, but if they know that their complexions will clear up, this decision may become much easier.
Healing Acne: Lara’s Story
Our fifteen-year-old son is a competitive swimmer and has had acne for several years. A few weeks ago, we decided it was time to help him follow the Paleo Diet. His acne has cleared up. Last weekend, he had a big invitational meet. He swam like never before in his six years of competition. Everyone who saw his times was amazed.
He is already lean, anyway, but in these last few weeks he is looking more fit than ever. His muscles are more obvious, especially in his back. Now he trains under a college coach six days a week. His training is quite intensive. He realized after this last swim meet, and as his acne has cleared, that there is something to the Paleo Diet.
My daughters also eat the Paleo way at home. They are ages eleven and eight and are competitive gymnasts. We started on the Paleo Diet a couple of years ago, and it was fascinating to watch my oldest daughter’s body change. She became extraordinarily strong and muscular, and her stamina far exceeds that of the other girls on the team.
I always insist that she have a protein snack before she goes to gymnastics practice. One day she left for gymnastics practice from a teammate’s house. The other mom gave the girls a cookie and lemonade for a snack. My daughter was shocked to discover that she couldn’t make it through practice. She found herself sitting on the side, tired like the other girls on the team. She was used to being the girl who always had enough energy for another rep.