Paleo Diet Q & A - 2 February 2010 - The Paleo Diet and Children

Dear Readers,

Today's Paleo Diet Q & A focuses on use of the diet for children.

---

Q: Thanks for all of the hard work your team puts into this. I've been receiving the e-mail blog for quite some time, have read both Paleo Diet and Paleo Diet for Athletes books, and subscribe to a Yahoo Paleo blog as well. I thoroughly enjoy reading the information sent to me every few days including the archives.

One concern I do have is that the bulk of the information seems to be targeted toward adults. More specifically adults with health problems that have already occurred and are in many cases not being addressed or cured by "traditional" medical practices. As the kids grow I feel it is important to develop proper dietary habits now, not when they are older and dealing with the after effects of poor health.

In my personal case I have a young son who has had issues with asthma. We have sought medical help but my mind keeps coming back to the Paleo Diet. Is there more detailed information available to address the issues of babies, young children and some of the issues they deal with as they mature?

Again, thanks for the great job.
Murray

A: Hi Murray,

The subject of pregnancy, young children, and The Paleo Diet was discussed in Volume 5 Issue 24 of our newsletter, The Paleo Diet Update. Here is the full text of that article:

Pregnancy, Young Children, and the Paleo Diet
by Loren Cordain, Ph.D.

With the growing popularity of the Paleo Diet, we've received questions about adapting this diet for pregnancy, particularly with regard to the low fat aspect of the diet. Others are also asking for more information about adapting the Paleo Diet to the growth and nutritional needs of infants and young children. With a little modification, the Paleo Diet can meet these needs, help children escape the growing childhood obesity problem, build life-long eating habits to lower the risk of disease, and generate healthful, vital longevity. Here are some recommendations for using the Paleo Diet to optimize nutrition during pregnancy, infancy and childhood.

What about pregnancy?

Due to the metabolic changes that occur in the liver during pregnancy, women cannot tolerate protein levels as high as they normally could. This has been documented in both the anthropological and clinical literature. To accommodate this, higher fat meats, higher fat vegetables, and more carbs can be included in the Paleo Diet during pregnancy than most people eating the typical Paleo Diet will need.

Numerous studies have shown that fetal and infant cognitive development requires sufficient omega-3 fatty acids during pregnancy and nursing. Our ancestors got most of their dietary fat from leaner meat, which was a richer source of monounsaturated and omega-3 polyunsaturated fatty acids, than the meat from feedlot animals today. The Paleo Diet is high in mono-unsaturated fats, such as olive oil, and omega-3 polyunsaturated fats from fish. It also avoids feedlot meat to increase the omega-3 in our diet, and enhance the omega-6/omega-3 ratio to more closely resemble the healthful diet of our ancestors.

What about infancy (the first two years of a child's life)?

Hunter-gatherer children were typically introduced to solid food later than what is considered normal in the Western world. Studies of five hunter-gatherer societies (Kung, Ache, Inuit, Australian Aborigines, and Hadza) have revealed the average age of weaning to be 2.9 years. Hence, the early nutrition of hunter-gatherer infants is highly dependent upon mother's milk. Because hunter-gatherers typically consumed a diet higher in omega-3 fatty acids, mother's milk likely would also have been higher in omega-3 fatty acids than milk from the typical nursing Western mother. This difference is important in light of the studies indicating the importance of sufficient omega-3 fatty acids during pregnancy and nursing for cognitive development. For the Western mother, weaning at age 3 is impractical, but weaning should be delayed as long as possible (preferrably at least 1-1.5 years). After weaning, I recommend that infants be given a formula th at is enriched with both docosahexaenoic acid (DHA) and arachidonic acid (AA). Infants should not be given eicosapentaenoic acid (EPA) in the form of fish oil because it competes with AA metabolism and can result in impaired motor development and growth.

Human milk contains very little iron, but infants are born with iron stores sufficient to last 9-12 months. Pediatricians typically recommend that infants' first solid foods be iron-fortified cereals. Commercial baby foods, such as beef, pork, or chicken, are a better alternative to this. Hunter-gatherer mothers introduced their infants to solid foods by thoroughly chewing meat, marrow, nuts, seeds, fruits, etc. If you do give cereal to your infant, I recommend rice and not either wheat or oats.

Virtually all pediatricians recommend that cow's milk and other dairy products, such as yogurt, cheese, etc., be excluded from infant diets during their first year. Early exposure to dairy products has been implicated in increased risk of a number of autoimmune diseases, particularly type 1 diabetes.

What about when solid foods are introduced?

When switching to solid foods, I recommend focusing upon the same basic food types that I recommend for adults, such as fresh fruits and vegetables, fresh meats and seafood. There is evidence that the children's livers are less able to deal with high levels of protein (~30-40 % total energy). Hence, higher fat meats and fish should not necessarily be restricted to the same extent as with adults because this will help balance the protein levels. Higher fat plant foods, such as nuts and avocados, and healthful oils are also useful, but monitor for nut allergies. Omega-3 enriched eggs should be the egg of choice, and they are a source of DHA.

I don't advocate completely restricting processed food from children because eating involves behavioral issues. The best way to get a child to eat junk food is to completely forbid it. In our house, we serve typical Paleo foods in every meal. We stock very little processed food, so if our children are hungry, their choices are primarily healthy foods. We don't allow unlimited access to TV, computers or electronic games, but we do encourage outdoor play. For active children, I don't think that certain high glycemic load foods may be harmful. We do not restrict dried fruit, such as raisins and dates, and we encourage them to eat bananas, yams and sweet potatoes.

Finally, while societies often view being tall positively, it has a downside. It increases the adult risk for a number of cancers, particularly breast cancer in women. The nature of this relationship remains obscure, but our research group thinks that the relationship between stature and cancer risk involves the consumption of high glycemic load carbohydrates during childhood, along with an otherwise healthy diet that is high in protein. I fully explain how high glycemic load carbohydrates can increase height and risk of numerous chronic diseases in my published research article # 24. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization: more than just syndrome X.

Please visit our web site to obtain a copy of Volume 5 Issue 24 of The Paleo Diet Update for a complete list of the references cited in this article.

---

Dr. Cordain has also written the following comments:

The American Pediatric Society recommends that cow’s milk not be given in the first year ,and a number of studies indicate that it increases the risk for type I diabetes and other autoimmune diseases later in life. I have 3 boys (17, 15, 11) and none of them have ever consumed milk on a regular basis – In fact they rarely or never drink it. They eat cheese and ice cream occasionally, but certainly not daily or even once a week. The 17 yr old is a lean, high level high school swimmer and is 5’10”, 138 lbs. The 15 year old is 6’1” and 145 lbs and plays competitive ice hockey; the 11 year old is 5’4” about 95 lbs and plays all sports. None of them wears glasses, or have ever had acne & among them all there have only been 2 dental caries. We are not strict with the Paleo diet for them, but we never have stocked our house with bread, crackers, milk, candy, soda or processed foods. At every meal we provide a variety of fresh fruits, vegetables, meats, seafood and omega 3 enriched eggs. They eat potatoes, sweet potatoes, and some rice & some processed foods like sushi, beef jerky, fruit popsicles, tacos and other minimally processed foods. All parents want to give their children the best start possible. Our anecdotal successes may not be right for everyone, but they have worked for us.

Loren Cordain, Ph.D.

---

In addition, Pedro has the following commentary:

During the first year of life, you should give a child human milk or a completely hydrolyzed infant formula (one study used a casein-based commercially available formula in children with high risk for Type 1 Diabetes).

Milk and dairy not only increase the risk for Type 1 Diabetes when consumed early in life, but they are also associated with various auto-immune diseases. Moreover, milk elevates insulin as much as white bread (having been shown to induce insulin resistance in boys) and it increases IGF-1 and decreases IGFBP-3, which is a hormonal pattern implicated in various cancers (prostate, breast, kidney, liver, etc.), myopia and acne.

Finally, milk proteins (especially alpha casein s1 and beta-lactoglobulin, which do not exist in human milk) are common food allergens, and milk is a source of various hormones (commercial milk from pregnant cows and cows who have mastitis and/or are intensively fed to gain weight rapidly have an even higher concentration of some of these hormones). This is another possible mechanism linking milk with hormonal dependent cancers. There various other reasons why I think non-human milk is not ideal for humans, but I tried to present the most important ones.

I know this may sound overly alarming and exaggerated, but given what I know about milk, I have a hard time recommending it, even though it has some positive effects.

In my opinion, the main benefit of milk is that it is a cheap source of high quality protein and various micronutrients. So, for those who are fortunate and have access to good food, milk is not necessary.

Instead of milk, I would continue using a completely hydrolysed formula (like the one used in the Type 1 Diabetes study – make sure it contains DHA and arachidonic acid [AA], or supplement your child's diet with DHA and give them egg yolks to get AA).

If you don’t have a choice and feel like you have to give them milk, I would opt for non-homogenized fermented goat milk (or goat yoghurt), which has much less alpha casein s1 than cow’s milk, and it may contain smaller concentrations of various steroid and peptide hormones. This is because it is fermented, the animal is smaller, and they aren’t typically treated like a cow.

Nevertheless, it most certainly will elevate insulin as much as cow’s milk does, and it will have an impact on the IGF-1 system. Moreover, apart from alpha casein s1, the protein profile of goat milk is similar to cow milk, so the possibility exists that it may also elicit an autoimmune response in some people. Also, there are reports in the medical literature of selective allergy to goat milk. Finally, both milks have a high calcium/magnesium ratio, and may contribute to some micronutrient imbalances.

Pedro