Taken within the context of modern food culture, Paleo can easily start to seem like an endless list of limitations: no grains, no legumes, no seed oils, no processed foods... Paleo appears to be a series of restrictions or deviations from the “normal” diet that everyone would presumably eat otherwise. But Paleo only appears restrictive in the context of a warped food system that floods our diet with toxins because it privileges industrial profits over human health. Despite this less than ideal context, defining “health” as simply avoiding these toxins is short-sighted and ultimately misleading. The absence of toxins is a prerequisite for health, but the normal functions of the human body also require the presence of nutrients. Paleo, in other words, can also be defined by what we do eat: enough energy and nutrients to support vibrant physical and mental health.
With this different attitude toward food comes a focus on maintaining a well-balanced nutritional framework, rather than simply avoiding junk. This framework consists of two types of nutrients: macronutrients (protein, fat, and carbohydrates), which supply energy in the form of calories, and micronutrients (vitamins and minerals), which support the various biochemical processes in your body. An ideal diet should provide enough micro- and macronutrients to keep your body healthy and strong.
Keeping track of macronutrients is fairly simple – there are only three, and most people have a rough idea of what kinds of foods supply which ones. But tracking every single micronutrient in your diet to make sure you meet your RDA would be impossibly tedious. Luckily, you don’t have to. First of all, the official government recommendations are often flawed goals. The recommendations for any particular nutrient are based on how much of that nutrient you need to avoid the associated deficiency disease. So for example, if you eat the RDA of Vitamin C every day, you won’t get scurvy. But simply avoiding a deficiency disease doesn’t necessarily mean that you have enough of a nutrient for optimal health. One study found that some problems associated with calcium and Vitamin D deficiency build up slowly over several decades, even in the absence of the official deficiency disease; preventing these long-term problems may require more than the RDA.
But more important than the imperfection of any one set of nutritional recommendations is the fact that humans thrived for millennia before we even knew what vitamins were, much less had the capacity to measure them. If we were all so fragile that we couldn’t survive without tracking and controlling every nutrient to the last microgram, we would have died off as a species long ago. Simply eating a wide variety of vegetables, animal products, and other nutrient-rich foods is enough to meet most people’s nutritional needs.
Groups with special micronutrient needs
While most people don’t need to spend much worrying about individual vitamins and minerals, some people – especially people who enter the Paleo lifestyle with pre-existing deficiencies to address – have special requirements for one or more micronutrients.
Pregnant and nursing women
Pregnant and nursing women need to pay special attention to the nutrients in their diet because they have to eat for two. Since their iron needs are higher, pregnant women are particularly at risk for a deficiency of iron, which helps carry, store, and use oxygen in your bloodstream, and supports a variety of enzymatic reactions. As well as causing symptoms of anemia in the mother, iron deficiency can increase the risk for a premature birth. Even after birth, low iron levels in a nursing mother can impair the normal motor functions and mental development of the baby. Dietary sources of iron include clams, oysters, organ meats, spinach, and red meat.
Expecting mothers should also take care to get enough folate. Folate supports the growth and maintenance of new cells, making it especially vital for anyone undergoing rapid growth or physical changes, like infants and pregnant women. Folate also complements the functions of iron in the body: like an iron deficiency, a folate deficiency can cause anemia, premature birth, low birth weight, and slow development. On the positive side, adequate levels of folate in the pregnant woman can greatly reduce the risk of problems with the baby’s spine, skull, and brain. Several of the same foods that provide iron, like liver and spinach, are high in folate as well; asparagus and avocado are also good sources.
People with Malabsorptive Digestive Disorders
Many kinds of diseases can interfere with the absorption of nutrients from food. As well as diseases of the digestive system like Crohn’s disease or Celiac disease, HIV/AIDS, certain types of cancer, parasite infections, and other problems can prevent the body from absorbing micronutrients even if you eat enough of them. Symptoms of malabsorption include all kinds of general digestive problems like bloating, gas, diarrhea, and weight loss, and can lead to more serious deficiency diseases like anemia, kidney stones, and osteoporosis if left untreated. As well as seeking treatment from a doctor, many people find that the severity of the malabsorption decreases significantly after spending some time on a Paleo diet – bone broth and fermented foods are particularly helpful for restoring normal gut function. A probiotic supplement might also be useful.
People on Antibiotics
Antibiotics are sometimes necessary to treat diseases that would otherwise be a serious threat, but one of their unfortunate side effects is disruption of the gut flora, the helpful bacteria that live in your intestines and support your digestive function. Essentially, the antibiotic kills everything that isn’t you, without making a distinction between harmful and helpful bacteria. This can cause temporary depletion of several vital nutrients, including iron, magnesium, and vitamins B and K. Fortunately, Paleo supports your immune system well enough that you should rarely get diseases or infections that require antibiotics, and eating organic, pastured meat and dairy products will reduce your exposure to antibiotics from your food. If you do need a course of antibiotics, eat fermented foods or supplement with a probiotic to reduce the damage to your gut flora, and make an extra effort to eat a nutrient-rich diet: if you feel too sick or nauseous to for solid food, try a green smoothie.
Alcohol abuse impairs nutrient digestion and absorption by damaging the pancreas, stomach, and intestines. Because alcoholism causes extensive damage to your liver, it can also reduce your body’s ability to use the nutrients you do absorb. And since many addicts replace food with alcohol, they aren’t even taking in enough nutrients in the first place. Alcoholics are at special risk for deficiency of Vitamin A,, which aids in cell reproduction, bone growth, and vision, but also commonly have inadequate levels of vitamins C and B, as well as calcium, iron, and folate . Recovering alcoholics should be sure to get enough of these nutrients in their diet, but since large doses of Vitamin A can be toxic, don’t assume that more is necessarily better. Getting adequate Vitamin A from foods like sweet potatoes, carrots, kale, and spinach will slowly but surely yield better results than deliberately over-supplementing.
Ex-Vegetarians and Vegans
Paleo attracts a lot of nutritionally aware, health-conscious people – and if you’ve tried to eat healthy in modern society for any length of time, chances are you’ve at least considered becoming a vegetarian or vegan. Unfortunately, maintaining a diet devoid of meat for any length of time can leave you with serious iron deficiencies. Iron comes in two forms: heme iron (found in meat and animal products), and non-heme iron (found in beans, legumes, and spinach); vegetarians, obviously, are restricted to non-heme iron sources. This can cause problems because your body uses heme iron much more efficiently, so consuming 5mg of iron from kidney beans doesn’t do you nearly as much good as consuming 5mg of iron from a steak. Vegetarians are therefore at greater risk for iron deficiency and anemia. Fortunately, the cure is tasty: dietary sources of heme iron include clams, oysters, organ meats, and red meat.
Low levels of iron can contribute to another common deficiency among vegetarians and vegans: anemia can impair the uptake of B12 vitamins, which naturally occur only in meat and animal products. Vitamin B12 plays a crucial role in the formation of red blood cells, cognitive function, mental health, and the immune system; B12 deficiency is alarmingly common, and related to all kinds of chronic diseases like Alzheimer’s and dementia. Clams, liver, trout, salmon, tuna, haddock, and beef are all good sources of B12.
People with a current or former eating disorder
Eating disorders can lead to a broad spectrum of nutrient deficiencies in several different ways. Anorexics may simply not eat enough to get all the nutrients they need – calcium deficiency is particularly common, sometimes resulting in osteoporosis. Orthorexics may follow a diet so restrictive that it doesn’t include enough sources of certain nutrients (although which specific nutrients depends on the particular diet). Bulimics may also develop deficiencies, from eliminating their food before it’s digested: the constant purging can deplete the body’s stores of sodium, potassium, magnesium, and phosphorous. Anyone recovering from an eating disorder should concentrate on maintaining a generally nutrient-rich diet: especially for anorexics and orthorexics, a precise focus on specific micronutrients might be more triggering than helpful.
Nourishing and Delicious: Paleo Nutritional All-Stars
Any version of Paleo will supply a rich variety of micronutrients, but some foods are so rich in nutrients that they deserve special mention. They’re the nutritional equivalents of that kid in high school who captained three varsity sports, led the debate team, got straight As in his full schedule of AP classes, and still found time to volunteer at the local retirement home and teach himself to play guitar. These are great additions to your diet because they have exceptionally high levels of multiple nutrients, but no one of them is required: if you can’t stand the taste of kale, don’t force yourself to choke it down.
When most people think of organ meats, they think of liver. Liver is the Paleo version of a multivitamin. It’s high in protein and packed with Vitamins A, B6, and B12, folate, iron, phosphate (also called phosphorous), zinc, copper, and selenium. The cholesterol in liver also helps you synthesize Vitamin D. Many people like to sauté liver with onions, but if you’re not the biggest fan of the taste, try toning it down with some liver pâté. You could also disguise the liver a little by including it in a recipe for hamburgers or meatballs, along with a healthy helping of ground beef and spices.
Other organ meats, like heart, kidney, tongue, or brain also provide many more micronutrients than traditional muscle meat – and as a bonus, they’re usually cheaper. Like liver, heart contains high levels of B vitamins, thiamin, folate, selenium, phosphorous, and zinc, and heart tastes very similar to a roast, making it more palatable if you’re used to muscle meat. Kidney is also a good source of Vitamins C and B12, selenium, iron, zinc, copper, riboflavin, and phosphorous. Like liver, kidney has a strong taste – mixing it with steak in a casserole can tone down the flavor, or go all-out and try some Irish kidney soup. Other organ meats include sweetbreads (the thymus and pancreas glands of young animals), tongue, tripe, gizzards, and brains. The best place to get organ meats is from a butcher you know, but most supermarket meat sections have at least beef and chicken livers, and sometimes they have other organs behind the counter if you ask.
One cup of kale provides a hefty dose of Vitamin C, as well as manganese and Vitamins A and K. It also has smaller amounts of a variety of nutrients, including calcium, copper, and Vitamin B6. If straight-up kale tastes too bitter or tough for you, jazz it up with a little bacon, or whip up some kale chips for a salty, crunchy Paleo snack. Kale is also a wonderful ingredient in soups or stews.
Popeye, as it turns out, was wrong: spinach isn’t actually a great source of iron. But it does deliver Vitamins A, C, and K, as well as folate and manganese. Spinach can make a delicious replacement for lettuce in any kind of salad, but if you don’t enjoy the taste, you can unobtrusively add quite a lot of spinach to a curry or any spicy dish: the leaves shrink drastically when you cook them, and the flavor is almost undetectable.
Mollusks pack an incredible nutritional punch. Mussels, clams, octopus, and oysters are powerhouses of B vitamins, and also have high levels of Vitamins C and A, riboflavin, niacin, iron, phosphorous, zinc, copper, manganese, and selenium. The last two make mollusks especially useful for anyone avoiding nuts: nuts are commonly cited as excellent sources of manganese and selenium, but they’re not the only ones. Mollusks can be as simple or as fancy of a dinner as you have time for. In a rush, you can steam them, throw some butter on top, and call it dinner. For a slightly more sophisticated meal, try steaming your mussels with tomato and basil, or spicing up your clams with some coconut-lime sauce. These oyster dolmades even include spinach, another nutritional MVP.
Seaweed is best known for its iodine content – iodine is an essential micronutrient that supports cell metabolism and healthy thyroid function. Most Americans have no problem getting enough iodine, since they consume huge amounts of processed foods loaded with iodized salt. But on a diet devoid of takeout pizza and Doritos, your salt intake is likely to be much lower, especially if you also switch to sea salt (which contains other minerals but does not provide iodine). This makes seaweed a smart addition to your meals, especially since it’s also full of all kinds of other minerals that it absorbs from the sea. You can eat seaweed as a salad, or add it to soups and broths for a salty, delicious flavor.
Bone broth gives you access to nutrients stored in the animal’s bones, which you wouldn’t get from just eating the meat. As well as containing generous amounts of minerals like calcium, magnesium, and phosphorous, bone broth is also a source of gelatin, which supports your body’s connective tissues (this is why it congeals when refrigerated – if you end up with beef Jell-O, you’re doing it right). As well as containing nutrients in its own right, bone broth also helps heal your gut from any damage caused by irritating foods or chronic disease, making you better able to absorb other nutrients. You can make broth on a stove or in your slow cooker. It does a while, but you can spend almost all of that time doing other things while your broth simmers slowly away.
Fermented foods don’t necessarily contain high levels of nutrients themselves. Instead, they support the beneficial gut flora that allow you to digest and use those nutrients from other foods. For all these vitamins and minerals to do you any good, your body has to be able to process them first. Yogurt is the most common fermented food in the modern supermarket, but if you react poorly to dairy, you still have a wide range of options including sauerkraut, kimchi, kombucha, and water kefir. You can buy these at your local grocery store, or save a little money by making them yourself.
It’s not technically a food, but sunshine does deliver one essential micronutrient. When you go out in the sun, cholesterol in your skin reacts with the UVB rays to synthesize Vitamin D. While some foods (most notably fatty cold-water fish like salmon) do contain Vitamin D, sunshine is an essential part of the equation because most people can’t get enough from dietary sources alone.
Unfortunately, this makes the modern lifestyle the perfect way to develop a deficiency of one of the most important vitamins for overall health: most people work indoors, drive home to spend their leisure time inside, and wear sunscreen (which blocks the absorption of UVB rays and prevents the synthesis of Vitamin D) when they do go outside. Vitamin D is crucial for bone health; low levels of Vitamin D are also strongly associated with diabetes (both Type 1 and Type 2 ), metabolic problems, and obesity. Inadequate Vitamin D can provoke an autoimmune response in the gut, and some evidence also links low Vitamin D levels to certain types of cancer.
While you shouldn’t rush out to lie on the beach all day without sunscreen, regular sun exposure is the best way to make sure you get enough Vitamin D: do your body a double favor by combining your sun time with a walk or a swim.
Good Sources of Specific Nutrients
If you do have one of the conditions listed above, or need to pay special attention to any one micronutrient for some reason, the table below lists dietary sources for the most common micronutrients.
|Dietary sources (in descending order)
|Especially important for
|Sardines, salmon, turnip greens, kale, bok choi, broccoli
|Older women, people with eating disorders, and vegetarians
|Beef liver, spinach, asparagus, avocado, papaya, and broccoli
|Pregnant women and nursing mothers
|Seaweed, cod, iodized salt, shrimp, eggs, tuna, prunes, apple juice, green peas, bananas
|Pregnant women and people who do not use iodized salt
|Clams, oysters, organ meats, pumpkin and squash seeds, spinach, beef, sardines, duck, and lamb
|Pregnant women or nursing mothers, ex-vegetarians
|Almonds, spinach, cashews, potatoes, bananas, milk, raisins, halibut, and avocado
|Diabetics, alcoholics, and anyone with chronic malabsorptive disorders
|Any kind of meat
|Bulimics, people with chronic diarrhea, or people who use prescription diuretics or laxatives
|Sweet potatoes, beet greens, potatoes, clams, halibut, yellowfin tuna, and winter squash
|Bulimics, people with chronic diarrhea, or people who use prescription diuretics or laxatives
|Brazil nuts, tuna, cod, turkey, chicken breast, chuck roast, sunflower seeds, and ground beef
|Anyone with a chronic malabsorptive disorder
|Sweet potatoes, liver (beef or chicken), spinach, carrots, cantaloupe, red peppers, mangos, dried apricots, broccoli, herring, milk, eggs, squash, salmon, pistachios, and tuna
|People with alcohol dependence
|Beef liver, yellowfin tuna, sockeye salmon, chicken breast, turkey, banana, ground beef, and squash
|Older adults, people with kidney problems, autoimmune disorders, or alcohol dependence.
|Clams, liver, trout, salmon, tuna, haddock, beef, milk, ham, and eggs
|People with malabsorptive disorders and vegetarians
|Red peppers, oranges, kiwifruit, green peppers, broccoli, strawberries, Brussels sprouts, grapefruit, cantaloupe, cabbage, cauliflower, potatoes, tomatoes, spinach, and green peas
|Smokers and people with chronic malabsorptive disorders
|Swordfish, salmon, tuna, sardines, beef liver, and egg yolks
|People who get little or no sun exposure on a regular basis, diabetics.
|Sunflower seeds, almonds, hazelnuts, olive oil, spinach, broccoli, kiwifruit, mango, and tomatoes
|(deficiency of Vitamin E is rare)
|Kale, spinach, turnip greens, collard greens, Swiss chard, mustard greens, parsley, romaine lettuce, green leaf lettuce, Brussels sprouts, broccoli, cauliflower, and cabbage
|People on antibiotics
Even if you make an effort to maintain a healthy diet, a multivitamin seems like a tempting safety net. But vitamin supplements are not strictly regulated, and often contain vitamins in a form your body can't absorb, making them useless. And a useless multivitamin might actually be the lesser evil. The nutrients that you do absorb can harm you by overloading your body with more of a vitamin than it can handle. Taking individual supplements instead of one multivitamin can also throw your levels of micronutrients completely out of balance: all the elements in your diet interact with each other, and artificially high levels of one nutrient can cause more harm than good.
Fortunately, a diet rich in nutrients from a variety of healthy foods will meet most people’s nutritional requirements without requiring any extra supplements. Eat a wide range of meat from different parts of different animals, vegetables of different colors, fermented foods, and healthy sources of fat – $10 spent on free-range liver will do you more good than $10 spent on a bottle of gummy candies shaped like Fred Flintsone, no matter how much iron they claim to contain.
Many people switching to a Paleo diet worry specifically about how to get enough calcium without consuming dairy products. It’s an understandable concern, but an unnecessary one. First, many people have calcium deficiencies not because they don’t consume enough, but because they can’t absorb what they do consume. Consuming more of other nutrients like vitamin D, magnesium, and vitamin K will increase your body’s ability to absorb calcium, meaning that you can get a greater benefit even from smaller amounts. Moreover, more calcium is not necessarily better: over-supplementing can cause a hypercalcemia, which can damage your kidneys and interfere with the absorption of other nutrients like iron and magnesium. Unless you have a specific medical condition requiring very high levels of calcium, you don’t need a supplement.
Even if you have one of the specific medical conditions listed above (or another condition that requires you to take in unusually high levels of certain nutrients), make supplement pills a last resort, not a first line of defense. Similarly, people who live in very dark climates (like Scandinavia during the winter) might need to supplement with Vitamin D, but don’t turn to a pill until you’ve tried all your other options. As a rule, a well-balanced diet will give you everything your body needs, in an amount and form you can actually use.
The “Paleo diet” isn’t a set of restrictions designed to help you lose weight at the expense of your overall health. It’s a way of eating that nourishes your body with a rich supply of energy and nutrients to support your body’s essential functions. Getting enough vitamins and minerals is important, but most people who eat a balanced diet rich in fruits, vegetables, and different kinds of animal products don’t need to spend time or money tracking down deficiencies and loading up on extra supplements to correct them. Unless you have a medical condition requiring special focus on one nutrient or another, supplements should take a distant back seat to a healthy diet: pack up some sauerkraut and a healthy chunk of beef heart, and spend your time enjoying a picnic lunch in the sun instead of obsessing over micrograms of selenium.