Dr. Roach: Modern thoughts on the Paleo diet

Keith Roach
To Your Health

Dear Dr. Roach: After a few months of stress eating, I have gained a lot of weight. People swear that the Paleo diet would help me lose weight and feel better. Do you recommend it?


Dear H.C.: Most diets have good points and bad points, and work better or worse for different people. The Paleo diet is no exception. The theory behind Paleo is that humans are best adapted to the diet that Paleolithic man ate 10,000 or more years ago, which was high in meat, with relatively large amounts of fruits and vegetables, and no grains or dairy.

I disagree with the theory on several points, especially that I think it is a fundamental misunderstanding of adaptation, in that there’s no guarantee that evolution produces a “best” adaptation, merely one that’s good enough. Paleolithic man ate what he had to to survive, not necessarily what was optimal for his health.

The part about the Paleo diet that I do like is its recommendation against highly refined grains and other processed foods. I don’t agree with the usual recommendation to eat so much meat. It’s important to remember that the meat Paleolithic man ate, until just before being eaten, was busily running away from him and did not have remotely the fat content of today’s supermarket meat. The nuts and vegetables available to modern man are vastly different from those available to Paleolithic man, according to a great talk from Christina Warriner. Finally, there is abundant evidence that preagricultural man, from many different societies, had atherosclerosis in the unlikely event he lived into his 40s.

Dear Dr. Roach: My dental hygienist recommends rinsing your mouth with hydrogen peroxide to kill germs after flossing. Lately I have heard the using too much hydrogen peroxide can be harmful. What are your thoughts?


Dear T.W.: Hydrogen peroxide is a powerful antiseptic that has some usefulness for household objects; however, I don’t recommend it as an oral rinse. It is too toxic to tissues.

In a 1993 study, even hydrogen peroxide solutions diluted to half and quarter strengths caused damage to mucous membranes and caused “overwhelmingly negative subjective reactions.” Thus they were not recommended for oral care. A regular mouthwash is a much better choice, and your dentist can prescribe a medicated mouthwash if needed.

Incidentally, I don’t recommend hydrogen peroxide for cleaning cuts and abrasions, either. It isn’t effective at inhibiting bacterial growth.

I recommend careful cleaning with mild soap and water or saline and an antibiotic ointment like Bacitracin.

Email questions to ToYourGoodHealth@med.cornell.edu.