Bottom Line with Paleo, Low Carb and Keto Diets

Whether you’re trying to lose weight, live longer, get rid of symptoms or transform yourself in some way, there’s a diet for that. And if you’re like most of the population,  you’ve tried more than one type of diet to reach your goals. Maybe you’ve even combined a few, taking the aspects that you like from each and creating what works for you. Let’s take a closer look at the popular paleo, low carb, and keto diets. 

See how I break down these diets and show you which, if any, are the cleanest diets for weight loss and longevity. The answer may surprise you. 


Let’s start with the Paleo Diet. First discussed and brought to the mainstream via book by Loren Coradain, PhD., the paleo diet attempts to mimic how our ancestors ate in the paleolithic era before agriculture. This means that the diet does not contain beans, nuts,  dairy, or refined oils (even olive oil, coconut oil, or ghee) and instead focuses on fish, whole foods, vegetables, fruits, and some seeds. This diet is higher in protein with a moderate amount of fat and carbs. 

According to an article by the Harvard School of Public Health, “Some randomized controlled trials have shown the Paleo diet to produce greater short-term benefits than diets based on national nutrition guidelines, including greater weight loss, reduced waist circumference, decreased blood pressure increased insulin sensitivity, and improved cholesterol. However, these studies were of short duration (6 months or less) with a small number of participants (less than 40). 

One larger randomized controlled trial followed 70 post-menopausal Swedish women with obesity for two years, who were placed on either a Paleo diet or a Nordic Nutrition Recommendations (NNR) diet. [7] The Paleo diet provided 30% of total calories from protein, 40% fat (from mostly monounsaturated and polyunsaturated fats), and 30%  carbohydrates. It included lean meats, fish, eggs, vegetables, fruits, berries, nuts,  avocado, and olive oil. The NNR diet provided less protein and fat but more carbohydrates with 15% protein, 25-30% fat, and 55-60% carbohydrates, including foods similar to the Paleo diet but also low-fat dairy products and high-fiber grains. Both groups significantly decreased fat mass and weight circumference at 6 and 24 months,  with the Paleo diet producing greater fat loss at 6 months but not at 24 months.  Triglyceride levels decreased more significantly with the Paleo diet at 6 and 24 months  than the NNR diet.”1

Low Carb

When we look at the low carb diet, let’s break down what “low carb” actually means as many people use the term but can be referring to many different things. Technically speaking, the RDA (recommended daily allowance) for calories is 2000 and the RDA of carbs is between 45-65%. If we convert this to actual grams this would be between 225-325 grams of carbohydrates per day. As you can see, what constitutes “low” can vary widely depending on where you fall. Some diets even claim the “low carb” title is eating below 50-100grams per day. However, technically speaking a “low carb diet” is one in which daily carbohydrates are below 225 grams or 75 grams per meal if eating 3 meals per day.

Does the low carb diet work? And if so, what are the benefits and potential consequences? 

According to the Mayo Clinic, “Low-carb diets may help prevent or improve serious health conditions, such as metabolic syndrome, diabetes, high blood pressure and cardiovascular disease. In fact, almost any diet that helps you shed excess weight can reduce or even reverse risk factors for cardiovascular disease and diabetes. Most weight-loss diets — not just low-carb diets — may improve blood cholesterol or blood sugar  levels, at least temporarily.” 

But when looking at the risks associated with low-carb diets, it appears that short-term use of such a diet is more beneficial than long term use. Mayo Clinic goes on to say, …some diets restrict carbohydrate intake so much that in the long term they can result 

in vitamin or mineral deficiencies, bone loss, and gastrointestinal disturbances and may  increase risks of various chronic diseases.”2


When we look at the keto diet, we are looking at an ultra low carb diet meant to switch the body’s fuel source from glucose to ketones. In order to “get into” keto, one usually uses prolonged fasting or making your diet 70-80% fat based only.

Protein intake is fairly low as too much protein can actually throw you out of ketosis. If you’re in ketosis for too long or not doing it correctly, it will start to breakdown your own muscle tissue. This will have a total of 5-10% carbohydrates which will be about 25-50grams per day. This is the diet with the lowest amount of carbs. In order to ensure you are in ketosis, you actually need to measure this and you can do so with easy at-home testing strips. After 6 weeks of this, it can start to change the gut microbiome and it can change the cell membrane structure.

According to the University of Chicago, “The keto diet could cause low blood pressure,  kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease.  Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid, or  gallbladder.”3

Which one is the healthiest?

It depends on the person and it depends on the goal. If regulating blood sugar and maintaining a healthy weight, short term ketosis can be very helpful. But we would want to limit this to 3-4 weeks. Then, it’s important to start including more carbohydrates. 

Start slow and then start adding in carbohydrates with the first meal of the day. Follow paleo-style that is overall lower in carbs and full of fruits and vegetables. Adding a little oatmeal in the morning with a smoothie or your multivitamin for the day. Low glycemic fruit is ideal. Then eventually, increase to getting about 80-160 grams of carbs per day spread out throughout the day. You can incorporate starchy vegetables or not (yams, sweet potatoes, squash). If you are larger and looking to lose weight these will be limited and will instead favor less starchy vegetables.

In order to reach your specific goals, it is important to work one on one with a  professional trained in nutrition who can make specific dietary recommendations that are unique to your physical and medical situation. Need help finding one? Check out to search for help.


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