Health is more than just numbers. Cholesterol and blood pressure measurements are nice, but in the real world, most people also care about how they look and feel: do they feel sick and tired and weak all the time, or do they feel strong and full of energy?
In studies, researchers use health-related quality of life (HRQOL) to measure that overall feeling on a scale from crummy to fantastic. HRQOL is basically a weird, officious-sounding acronym for quantifying how people are doing physically, emotionally, mentally, and socially, beyond invisible and abstract numbers like blood pressure.
HRQOL encompasses questions like
- Can I run around and play with my kids, or am I too out of shape and weak?
- Do I have energy for hobbies and fun after work, or am I too exhausted?
- Do I get sick all the time or am I usually healthy?
If Paleo is a “good diet,” (aka deserving of your precious time and effort), then it ought to improve people’s HRQOL, not just their weight or other numbers. So here’s a look at 5 big-picture Paleo eating patterns that improve HRQOL - instead of going through lists of specific foods, we’re looking at patterns of eating with research-backed benefits for quality of life.
Paleo Eating Pattern 1: Fit your Carb Level to Your Body
Mainstream diet advice is still focused on a high-carb, low-fat diet. But Paleo takes a different approach: fit your carb level to your body. It’s not that everyone needs to do low-carb. But in the real world, where a lot of people don’t have great metabolic health and struggle with problems like insulin resistance and diabetes, low-to-moderate carb diets are really worth considering
Research supports this approach for improving HRQOL. For example, this study made exactly that point. The researchers compared a low-carb diet to a low-fat diet in people with Type 2 Diabetes. Both diets produced the same amount of weight loss, but only the low-carb diet improved health-related quality of life.
Paleo Eating Pattern 2: Focus on Health, Not Just Weight Loss
The study above hints at a bigger point: health is more than weight loss. Research suggests that the Paleo approach to weight loss - treating it as one aspect of overall health, not as the only goal worth pursuing - has benefits for HRQOL in the long run.
In 2010, one nutrition professor famously lost weight by eating 1800 calories of Twinkies, Oreos, and other sugary snacks every day: if you only care about a lower number on the scale, you could do it that way, too.
But Paleo is about more than weight loss. Paleo is about improving health. In the 21st century world, better health often involves weight loss, but the weight loss doesn’t just come from forcing an energy deficit on your body; it comes from realigning hunger and appetite hormones, changing the way your fat cells behave, normalizing stress hormone levels, regulating gut health, and other improvements. In other words, Paleo weight loss is a byproduct of better health.
This way of approaching weight loss seems to be best for improving HRQOL. A systematic review found that weight loss per se doesn’t actually improve people’s HRQOL. Weight-loss programs only help if they also improve health. So the all-Twinkie diet might make you lose some pounds on the scale, but it probably wouldn’t do much for your HRQOL.
If your goal is better quality of life, focusing only on weight loss as a goal is misguided. Health-related quality of life comes from better health, not lower weight - that’s what Paleo is all about.
Paleo Eating Pattern 3: Reduce inflammation
(If you don’t know what inflammation is or why it’s a problem, this post explains it all.)
As part of improving health, Paleo puts a big emphasis on reducing chronic inflammation, which turns out to have huge benefits for HRQOL.
There’s been a pile of research on this. It’s true in people with obesity, in veterans, in people with inflammatory gut disorders, and more generally in the human population as a whole:
“This study confirms that there is a relationship between HRQoL and low-grade inflammation. In particular, SF-36 scores [used to measure HRQOL] are significantly lower in a group with joint elevation of IL-6 and CRP, [two different biomarkers of inflammation] in comparison with elevation of either one of them.”
A Paleo diet is anti-inflammatory because (a) it’s rich in polyphenols, antioxidant nutrients like vitamin C and selenium, and Omega-3 fats, and (b) it’s low in pro-inflammatory gut irritants, Omega-6 fats, and refined sugars. The research above suggests that all this anti-inflammatory goodness is one reason why people who eat Paleo see such huge increases in HRQOL.
Paleo Eating Pattern 4: Listen to your Gut
As this study goes over in detail, gut health affects everything from your digestion to your immune system to your appetite and weight - is it really surprising that improving gut health improves HRQOL? Paleo puts a lot of emphasis on gut health and gut healing, including special diets and gut-healing supplements like probiotics for people who can use them. And research shows that eating for gut health improves HRQOL quite a bit.
General steps to improve gut health, like taking probiotics, can improve HRQOL. For example, one study found that probiotics improve HRQOL in college students.
Specific steps to address your particular gut issues or sensitivities can also be really valuable. For example, some studies estimate that about 1 in 10 people suffer from Irritable Bowel Syndrome (IBS). IBS is basically gut problems (gas, bloating, constipation, diarrhea, etc.) with no clear cause. People with IBS are often sensitive to a group of fibers called FODMAPs. This study found that a diet eliminating FODMAPS carbohydrates significantly improved quality of life in patients with IBS. By addressing their specific sensitivity, these IBS patients improved their HRQOL in a big way. A couple of studies (one, two) have also found that probiotics have big HRQOL benefits for IBS patients.
To take another example of addressing a specific gut condition, in patients with Celiac disease, following a gluten-free diet improves their HRQOL.
Improving gut health - by taking a good probiotic, eliminating gut irritants, and addressing any particular sensitivities that you personally might have - has really clear benefits for HRQOL. (Get 5 quick tips for improving gut health here.)
Paleo Eating Pattern 5: Combine a Great Diet with Other Lifestyle Factors
Paleo isn’t just about food; it’s also about movement, sleep, stress, and other lifestyle factors. Unsurprisingly, there’s a huge amount of research showing that regular exercise of almost any kind improves HRQOL in just about every population. But when you combine diet and exercise, the whole is even better than the sum of its parts.
That was what this study found in women trying to lose weight; it was also what this study found in adults with metabolic syndrome (the diet in this case was the Mediterranean diet, which isn't Paleo but definitely beats the typical American diet). Diet is good; exercise is good; diet + exercise is fantastic.
In another study, the researchers specifically looked at red meat combined with an exercise program in older women. The high-quality animal protein and B vitamins in the meat dramatically increased the benefits of the exercise, proving for the millionth time that red meat and animal protein isn't actually a straight shot to illness - in fact, it might be a straight shot to better health!
The evidence shows that combining nutrient-dense foods with exercise as part of a whole-lifestyle intervention helps to improve HRQOL in ways that diet or exercise alone can’t. That’s the approach that Paleo takes: humans are biologically adapted to move in certain ways just like we’re biologically adapted to eat in certain ways, and a whole-person approach to health has to consider both.
Summing it Up
Instead of focusing on particular foods, here we focused on five Paleo eating patterns that improve health-related quality of life (HRQOL) - remember, that’s the big-picture, “can I play with my kids?” type of health:
- Fit your Carb Level to Your Body
- Focus on Health, Not Just Weight Loss
- Reduce inflammation
- Listen to your Gut
- Combine a Great Diet with Other Lifestyle Factors
These are big ideas that you can apply to any style of Paleo, from super low-carb carnivorous keto to a high-carb vegetarian modification. Research shows that addressing these big-picture issues improves HRQOL, and isn’t that what we all want anyway?
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