Paleo Diet: Food List, What the Trials Show and Nutrient Gaps

The paleo diet is an eating pattern built around foods thought to resemble what humans ate before farming: meat, fish, eggs, vegetables, fruit, nuts and seeds, with grains, legumes, dairy, added sugar and most processed foods removed. Small randomized trials found short-term improvements in waist size, triglycerides and blood pressure compared with standard diets, but the advantage faded in the longest trial, and cutting dairy and table salt left some participants short on iodine. Below is what the paleo diet includes, what the research measured, and the nutrient gaps worth planning for.

Peptide Labs does not sell diet programs or foods. This article is general nutrition information, not medical advice.

What is the paleo diet?

The idea gained medical attention in 1985, when physician S. Boyd Eaton and anthropologist Melvin Konner published “Paleolithic nutrition” in the New England Journal of Medicine, arguing that modern diets differ from those humans evolved on. Today’s paleolithic diet is a modern interpretation, not a historical recipe: researchers describe it as lean meat, fish, vegetables, fruits and nuts while avoiding grains, dairy products, processed foods, and added sugar and salt. A 2015 review in the American Journal of Clinical Nutrition noted that this pattern “differs radically” from national guidelines, mainly because it excludes grains and dairy.

Versions differ from book to book and program to program, so check which rules a plan uses before assuming a food is in or out.

Paleo diet food list: what is in and what is out

Most plans share the same basic paleo diet food list:

• Included: meat, poultry, fish and seafood, eggs, vegetables, fruits, nuts, seeds, and oils such as olive or avocado oil.
• Excluded: grains (wheat, oats, rice, corn) and grain products such as bread and pasta.
• Excluded: legumes, including beans, lentils, peas, peanuts and soy.
• Excluded: dairy products such as milk, yogurt and cheese.
• Excluded: added sugar, many processed foods, and in strict versions added salt.

Pseudo-grains such as quinoa fall in a gray area; strict plans exclude them, and our quinoa guide covers its nutrition. Because grains and legumes are out, a paleo plate is often lower in carbohydrate than a typical diet, although paleo is not automatically very low carb. For carb counts of individual foods, see our guide to low carb foods.

Nutrients you give up when grains, legumes and dairy go

The table compares common excluded foods with common paleo foods, using USDA FoodData Central SR Legacy data (FDC IDs shown). Percent Daily Value (%DV) uses the FDA Daily Values from Nutrition Facts labels.

Two patterns stand out. Legumes are among the richest fiber sources in the American diet, and a cup of lentils also supplies about 90% of the Daily Value for folate. Dairy is the easiest calcium source for most people. A paleo plan can still reach fiber goals through plenty of vegetables, berries, avocado, nuts and seeds; our high fiber foods list and fiber intake guide show which plant foods carry the most. Calcium is harder: leafy greens such as kale help, and nuts like almonds add some, but a clinician or dietitian may suggest checking intake. Our calcium supplement guide explains the label basics if a professional recommends one.

What paleolithic diet trials show

Paleo trials are small, short and usually compare paleo with an ad libitum diet based on national guidelines. The main findings:

• Manheimer and colleagues, 2015 (American Journal of Clinical Nutrition): four randomized trials with 159 people who had at least one feature of metabolic syndrome. Over periods of up to 6 months, paleo produced greater improvements in waist circumference, triglycerides and blood pressure than guideline-based control diets. The evidence was rated moderate quality, and no trial measured quality of life.
• Mellberg and colleagues, 2014 (European Journal of Clinical Nutrition): 70 postmenopausal women with obesity followed a paleo-type diet or a Nordic Nutrition Recommendations diet for 2 years. Both groups lost fat. The paleo group lost more at 6 months, but the difference was no longer statistically significant at 24 months. Triglycerides fell more on paleo at both time points, and the paleo group did not stick closely to its protein target.
• Ghaedi and colleagues, 2019 (Advances in Nutrition): a meta-analysis of eight trials reported lower weight, waist size, blood pressure and some blood lipids on paleo, but results shifted when single studies were removed, and the authors called the evidence not conclusive. Other researchers later published a comment pointing out errors, and a corrected item followed in 2020.
• Bahrami and colleagues, 2026 (Critical Reviews in Food Science and Nutrition): pooled 19 trials and 12 cohort studies. Trials showed small improvements in fasting insulin, cholesterol, triglycerides, body weight and diastolic blood pressure. The cohort findings, such as lower death rates among people who ate in a more paleo-like way, are observational and cannot show cause and effect.

Put plainly, paleo looks at least as good as standard advice over the short term, possibly because it cuts out added sugar and ultra-processed foods. Whether it beats other well-planned diets over years, or affects heart attacks and strokes, has not been tested in long trials.

Is the paleo diet healthy? The concerns

Saturated fat and LDL cholesterol

Research versions of paleo stress lean meat and fish, but popular versions can lean heavily on fatty red meat, bacon and tropical oils. The 2025-2030 Dietary Guidelines for Americans say saturated fat should generally not exceed 10% of daily calories, the same limit as the 2020-2025 edition. A 2017 American Heart Association advisory concluded that replacing saturated fat with unsaturated fats lowers LDL cholesterol, which it called a cause of cardiovascular disease. If a paleo plan relies on butter, ghee or coconut oil for cooking, it can drift above that limit; olive oil, nuts, avocado and fish keep it closer to the research versions.

Whole grains, legumes and fiber

The Dietary Guidelines name dietary fiber, calcium, potassium and vitamin D as nutrients most Americans already underconsume. The 2025-2030 edition also tells people to prioritize fiber-rich whole grains and includes beans, peas and lentils among recommended protein foods. Paleo removes both groups, so it depends on large amounts of vegetables and fruit to make up the difference.

Iodine and calcium

In the Swedish 2-year trial, researchers measured iodine because the diet removed two of the largest iodine sources in that population: dairy and table salt. Urinary iodine fell by about half at 6 months in the paleo group and stayed steady in the comparison group, and the authors concluded paleo raised the risk of iodine deficiency. Seafood and eggs supply some iodine; our iodine guide covers sources and why too much is also a problem. Ask a clinician before adding a supplement.

Who should talk to a clinician first

• People with high LDL cholesterol or heart disease, so lipids can be rechecked after the change.
• Anyone taking diabetes medicines, because cutting starchy foods can change blood sugar.
• People who are pregnant or breastfeeding, who have higher iodine and calcium needs.
• Anyone with kidney disease or a history of disordered eating.
• Children and teens, whose growth needs call for planning with a pediatric dietitian.

If you want an even stricter animal-based approach, read our sibling guide to the carnivore diet, which removes the vegetables, fruit and nuts that make paleo workable.

Frequently Asked Questions

Questions about a label? Contact us or read our Buyer’s Guide. Food comes first; ask a healthcare provider or registered dietitian before a major diet change or a new supplement, especially if you take medicines, are pregnant or have a health condition. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Last reviewed October 2026.

Related guides: Carnivore Diet: Food List, Research, Risks and LDL Concerns, Whole30: Rules, Reintroduction, Research and Cautions, Mediterranean Diet: What It Is, Food List and What the Research Shows.