Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle

Reviewed by Jess, a Suppers member

I became interested in the Paleo lifestyle a few years ago because my lifelong digestive woes had taken a turn for the worse. My son, who was in elementary school at the time, made an innocent (but still hurtful) comment that brought the issue acutely to my mind. Around this same time, I read that people who eliminate dairy, legumes, grains, and processed foods including sugars from their diet can have a marked improvement in digestive symptoms. I already suspected I was lactose (dairy) intolerant so I decided to give it a try. Within several days my digestive problems had almost completely dissipated. 

Some people who do an elimination diet such as I did will eventually try to reintroduce foods to test for intolerances/sensitivities. However, I felt so great (wonderful energy, no more gas/bloating/irregular poo) that I decided to continue to avoid dairy, legumes, grains, and processed foods. It wasn’t until later that I realized I was eating what has been called a "Paleo" (or "Paleolithic" or "Ancestral") diet.

Once I realized there was a name for it, I started seeking out more resources. Practical Paleo by Diane Sanfilippo is a great place to start for those who are interested in learning more -- or for those who are somewhat familiar with the Paleo lifestyle but want to modify it to address certain health goals or medical issues. The author asserts:

  • Your health requires that you help yourself.
  • There is no one cookie-cutter “Paleo diet.” People are at different starting points on the journey, have different diseases/ailments, and have different needs (those who want direction for healthy food choices vs. those in need of a comprehensive “plan”).
  • “You can find extraordinary health in beautifully simple, unprocessed, whole foods.”

In the first section of the book, Sanfillippo gives a thorough and easy-to-understand explanation of the Paleo diet, what it entails, and the rationale (although not always the supporting research/data) behind the recommendations. There is a mini-health assessment to alert readers to symptoms that might be improved by adopting the Paleo lifestyle. She explains how irritating foods may impact the integrity of the digestive system (“leaky gut”) leading to changes in the immune system, which may increase inflammation throughout the body. She also discusses how eating different amounts of macronutrients (fats/proteins/carbohydrates) can impact satiety, blood sugar, insulin and related metabolic processes. All of this is contrasted against conventional wisdom (i.e., USDA recommendations) for a “healthy diet.” In the first section and throughout, the book contains a number of summary charts (Guide to Stocking a Paleo Pantry, Guide to Cooking Oils, etc.) that I found useful and still reference today! 

The second section of Practical Paleo contains meal plans to help readers customize for their individual needs. I found it was most useful to consider several meals plans that I thought applied to my situation (and different plans have appealed to me at different points). Sanfilippo encourages readers to find a plan that will help them reach their own personal health goals (“You are unique").

For each specific meal plan, she offers:

  • Diet and lifestyle recommendations: add (+) and avoid (-)
  • Nutritional supplements to consider
  • Supportive nutrients and the foods that contain them
  • Quick list of “yes” foods
  • 30-day meal plan (linked by page number to recipes in the back section)

Her meal plans consider these health challenges:

  • Autoimmune conditions
  • Blood sugar regulation
  • Digestive health
  • Thyroid health
  • MS, Fibromyalgia and chronic fatigue
  • Neurological health
  • Heart health
  • Cancer recovery
  • Athletic performance
  • Fat Loss
  • “Squeaky Clean” or “strict” Paleo

The third section of the book is a cooking section which contains:

  • Kitchen basics
  • Herb and spice blends
  • Clarifying butter/broth/fermentation
  • Recipes which offer prep and cooking times; how to “change it up”; and a quick check for foods that are frequently avoided on some of the meal plans (nuts, eggs, nightshades, FODMAPS) and some (but not always) options for modification

I’ve found the recipes to be simple and easy to follow, with relatively short ingredient lists. In addition, they are cross-referenced with the meal plans, making it easy to navigate if you have special needs (such as avoidance of allergens like eggs or nuts).

Overall, however, this is a great book for people new to Paleo who want to learn more about it, or for people familiar with Paleo who want suggestions on how to tailor the diet toward their particular health issues. But, I do have a few criticisms. The author suggests that Paleo is not a diet but a lifestyle. Although she recommends certain lifestyle modifications (decreasing stress, increasing quality and quantity of sleep) she doesn’t offer much in the way of practical suggestions on how to attain these lifestyle changes. Other Paleo authors and bloggers offer more extensive resources on stress management, sleep, exercise, play, etc. This is primarily a book on food (and supplements).

I have become aware that, in general, there is a lot of “lore” in nutrition literature that has not been validated by research studies. It is not uncommon for nutrition writers to cite data to support their arguments while omitting data in conflict with their arguments. In trying to make her guide “user friendly,” I think that Sanfilippo has given up some of the scientific validation. In addition, one might look at the list of specialized meal plans and think that Paleo is the cure-all for disease. Readers may want to maintain a healthy level of skepticism and curiosity while going through the first part of the book –- and may want to explore other sources for more information.

This is of specific concern to me when it comes to supplements. Nutritional supplements can have pharmacologic effects, which means they can provide benefits but can have side effects. Scientific testing is much less rigorous for supplements so it is not always clear how much one should take to get the desired effect OR what might happen from taking the supplement. When one gets a prescription from a health care provider, ideally the provider would have weighed the risks and benefits, and discussed them with the patient. So readers of this book may want to do more research into the various suggested supplements, maybe even discussing with a health care provider, as to why they might be recommended for a given condition, how much should be taken, and what side effects might be expected. And then there is the oft-unacknowledged cost. Supplements can be expensive! 

The last criticism comes on behalf of the vegetarians: With the exclusion of dairy and legumes (and sometimes eggs), it may be difficult to eat a Paleo vegetarian diet. Sanfilippo offers a short section for vegetarians on how to reintroduce meats but otherwise does not “speak” to the needs of vegetarians. Vegetarians who wish to explore the Paleo model without reintroducing meat might want to look for other resources.

More details from the book

Mini health assessment - ask:

  • How do you feel most of the time?
  • How is your fitness or athletic performance?
  • What is your body composition?
  • How are your moods?
  • Does your energy level fluctuate throughout the day?
  • How is your appetite?
  • Do you have food cravings?
  • How is your skin? Vision? Dental health? Bowel movements?
  • Have you been diagnosed with a specific health condition?

List of charts:

  • Guide to Paleo Foods (p 29)
  • Guide to stocking a Paleo Pantry (p 30)
  • Guide to Food Quality (p 31)
  • Guide to Fats and Oils (p 44)
  • Guide to Cooking Fats (p 45)
  • Guide to Digestion (p 74)
  • Guide to Your Poop (p 75)
  • Guide to Healing a Leaky Gut (p 88)
  • Guide to Gluten (p 89)
  • Guide to Dense Sources of Paleo Carbs (p 110)
  • Guide to Sweeteners (p 111)

My family’s eating habits changed somewhat as a result of mine (I am the main shopper and cook) although I didn’t impose my habits on them or on the kitchen or shopping cart. Eating this way helped us as a family. We became more conscious of where our food was coming from, trying to eat more locally grown, grass-fed/pastured, and organic products. We also became much more aware of the natural seasonality of both meat and produce –- one year we did a totally local and seasonal Thanksgiving dinner! 

About a year after I started, I convinced my husband to try a similar elimination diet for a month and he found a new appreciation for the ways in which sugar and concentrated carbohydrates make him feel. While I try to stick to a stricter, more limited version of the Paleo diet due to my digestive issues, my husband is more flexible, eating Paleo 80% of the time. My kitchen is mostly Paleo, but there are other options available, especially for my teenaged son who, I think, needs to learn to make his own choices. Hopefully he is learning by example.

In my opinion, there is no one right path or nutritional plan for everyone. There are plenty of arguments on the web about what Paleo is and isn’t (no dairy vs. only pastured, grass-fed dairy) but I think the Paleo movement has a lot to offer people with different goals and needs. Practical Paleo is just a start. Other resources that I’ve found useful in my journey are and

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