Researchers tested two different ways to measure how closely people follow a Stone Age (Paleolithic) diet in a 2-year weight loss study. They found that both scoring methods gave similar results when tracking what people ate. However, neither score predicted whether participants would lose belly fat or improve their heart health markers. This suggests that simply measuring how ‘paleo’ someone’s diet is may not be the best way to predict health improvements, at least in the short term.

The Quick Take

  • What they studied: How well two different scoring systems track Stone Age diet eating patterns and whether these scores predict health improvements
  • Who participated: 57 adults (36 women, 21 men) aged 31-79 with large waist measurements and heart disease risk factors who completed a 2-year diet study
  • Key finding: Both scoring methods tracked paleo eating similarly, but neither predicted changes in belly fat or heart health markers over 2 years
  • What it means for you: Following paleo diet principles may still be healthy, but these particular scoring methods might not be the best way to track your progress toward better health

The Research Details

This was a follow-up analysis of a 2-year weight loss study. Participants were randomly assigned to different diet groups - some followed current healthy eating guidelines, others avoided grains, and some added exercise. Researchers tracked what people ate using detailed 4-day food diaries at the start, after 1 year, and after 2 years. They calculated two different scores to measure how closely each person’s diet matched a Stone Age eating pattern.

This study design is important because it directly compared two scoring methods in the same group of people over a long period. Previous studies had only looked at these scores separately, so this gives us the first direct comparison of how well they work together.

The study followed people for 2 full years and used detailed food diaries, which are strengths. However, the small number of participants (57) and the fact that people didn’t change their diets dramatically limits how much we can conclude from the results.

What the Results Show

Both scoring methods showed moderate to strong agreement with each other throughout the study, meaning they generally identified the same people as following more or less paleo-style eating. Participants started with about 36% of their calories coming from paleo-approved foods, which increased to 44% after one year and settled at 42% after two years. However, when researchers looked at whether higher paleo scores predicted better health outcomes, they found no significant connections. People with higher paleo scores weren’t more likely to lose belly fat or improve their cholesterol, blood sugar, or blood pressure compared to those with lower scores.

The study found that the correlation between the two scoring methods ranged from moderate to strong (0.38 to 0.75) at different time points, suggesting both capture similar dietary patterns. The changes in diet were relatively modest overall, which may have limited the researchers’ ability to detect health benefits.

This finding contrasts with previous large population studies that found paleo diet scores were linked to lower rates of death, heart disease, and cancer. However, those studies looked at much larger groups over longer periods, while this study focused on a smaller group for a shorter time.

The study was small with only 57 people completing it, which makes it harder to detect real effects. Participants didn’t make dramatic changes to their diets, so there may not have been enough difference to see health benefits. The 2-year timeframe might also be too short to see some health improvements that take longer to develop.

The Bottom Line

While this study didn’t find connections between paleo scores and health improvements, it doesn’t mean paleo eating is ineffective. The evidence suggests focusing on the quality of your overall eating pattern rather than trying to achieve a specific paleo score. Emphasize whole foods, vegetables, and lean proteins regardless of whether they fit strict paleo guidelines.

People interested in paleo diets should know that scoring systems may not predict individual success. Those with heart disease risk factors should focus on proven dietary changes rather than specific diet scores. Healthcare providers might want to consider other measures of diet quality beyond paleo scoring.

Based on this study, don’t expect paleo diet scores to predict health changes within 2 years. Longer-term studies suggest benefits may take more time to appear, and individual results will vary significantly.

Want to Apply This Research?

  • Track whole food intake percentage rather than specific paleo scores - aim for 80% minimally processed foods including vegetables, fruits, lean proteins, and healthy fats
  • Focus on gradually increasing whole food choices and reducing processed foods rather than strictly following paleo rules or achieving specific scores
  • Monitor overall diet quality trends over months rather than daily paleo scores, and track how you feel and your energy levels alongside basic health markers

This information is for educational purposes only and should not replace professional medical advice. Consult with a healthcare provider before making significant dietary changes, especially if you have existing health conditions or risk factors.