From Bamm-Bamm Rubble to "Yum Yum": Is the Paleo Diet OK for Children?
In mid-March 2015, a controversial baby book from Australia was pulled before its release. The reason? The book, called Bubba Yum Yum: The Paleo Way, advised parents of how to feed their children a Paleo diet, and featured a DIY infant formula made from bone broth, oils and probiotics that could have a toxic cocktail of vitamin A.
The three authors of this book are Charlotte Carr, an actress and voice artist; Pete Evans, a chef and health coach; and Helen Pandarin, who calls herself a “naturopath, nutritionist and medical herbalist.” None of them report any background credentials in pediatric nutrition. For those of us who do have pediatric nutrition specialties, we know that infants, toddlers and children have unique nutrition needs that are quite different from those of adults.
This controversy has led many to wonder: Can children go Paleo? If so, at what age and what are the considerations?
What Is the Paleo Diet?
In the 1970s Walter Voegtlin, a gastroenterologist, wrote The Stone Age Diet, a book which claimed that because humans are carnivorous beings with roots in the Paleolithic period, modern humans' diets should primarily consist of meat and fat with very little carbohydrate. Dr. Voegtlin treated many of his patients that had inflammatory bowel disease and irritable bowel syndrome with good results using this dietary approach.
Flash forward to year 2002, when Loren Cordain, PhD, revived the diet in The Paleo Diet, a book that mimics some of Dr. Voegtlin's opinions on the way humans should eat. Dr. Cordain is an advocate for leaner meat and less fat than Dr. Voegtlin, and Dr. Cordain seems to promote fruits and vegetables more with a total carbohydrate amount varying between 22 to 40 percent. Dr. Cordain's diet also promotes eating whole foods and prohibits dairy, soy, refined sugars, legumes (including peanuts), potatoes, grains, refined vegetable oils, processed foods and added salt.
The Paleo Diet for Infants and Children
Bubba Yum Yum was not published, so I can't tell you exactly what's in the book. However, one of the authors, Charlotte Carr, has an active website and blog where she publishes recipes and advice for mothers. I do not recommend parents utilize this website for any advice. She may be a great actress and loving mother with the best intentions, but she is no nutrition expert.
So, who are the authorities on Paleo and what do they say? Dr. Cordain does have some respectable education credentials, but his background is primarily in exercise physiology and he bases most of his recommendations on adult weight management and wellness. He is not a pediatric expert and certainly not a pediatric nutrition expert.
Even still, I opened my mind, visited ThePaleoDiet.com and downloaded a newsletter that discussed child nutrition. In the recommendations in "The Paleo Diet's Insider," he recommends:
- Waiting to wean from breast-feeding as long as possible – at least until a baby is a 1-year-old and even better if he or she is weaned at 18 months.
- Baby foods should be mainly beef, pork and chicken. He acknowledges that a baby’s liver has trouble with a protein level of greater than 30 to 40 percent, so he advises higher-fat meats to balance the protein amounts in their diets.
- If grains are given, he recommends rice over oats or wheat.
- He does not advise “completely restricting processed food from children because eating involves behavioral issues.” I think Dr. Cordain is onto something there (more on that later).
Overall, Dr. Cordain’s guidance was fairly vague, so it makes it somewhat difficult to assess objectively.
Nutrition Adequacy for Children
In order to meet the vitamin and mineral needs on a Paleo diet, according to Dr. Cordain, one must consume a large amount of plant-based foods. Those foods must be varied and eaten in adequate quantities in efforts to achieve those needs. You can intellectualize that with willing adults, but it’s not as easy with children. I am a mother and practitioner who sees children in my practice daily. I know we must have options and carry those food options out with appropriate structure and guidance.
Even if we can get our young children to consume a high plant-based diet, it brings up another issue of excessive fiber’s risk of achieving adequate total energy requirements along with the bioavailability of vital minerals such as calcium, iron and zinc (see Special Considerations for Infant Feeding, USDA, p. 137).
Children also utilize carbohydrates for growth. According to the Institute of Medicine's Adequate Intake recommendations, infants from 6 to 12 months of age increase their carbohydrate needs up to 60 percent of their calories from carbohydrate foods, including a varied amount of grain-based foods to meet those needs — along with adequate calories. This is all assuming that the mother is producing enough breast milk and is able to breast-feed for at least one year. But according to the latest data from the CDC, only 49 percent of infants are breast-fed at 6 months, and only 27 percent at 1 year old. This statistic alone disqualifies most babies from going Paleo. For those successfully breast-feeding mothers, I still caution parents very strongly about following Paleo for kids as it seriously restricts carbohydrates in the diet, which are needed to promote adequate growth for children.
Behavioral Aspects of Paleo
Food restrictions of any kind for children cause social ramifications. How do you deal with children at school? At birthday parties? In my practice, we teach families how to eliminate certain foods after a medical diagnosis of a food allergy or intolerance. If you ask any of those families, they would give anything to avoid the social and logistical challenges of their required eliminations. And that happens when even just one food is eliminated. The Paleo diet is extremely restrictive and the social and behavioral aspects can have serious psychological implications for your child. Even Lorrie Cordain, MEd, of “The Paleo Team” (a.k.a., Dr. Cordain’s wife) talks about the effects of over-restriction and rigidity with children’s diet and its ramifications.
The Paleo approach continues to be a very popular way of eating for many adults, and its popularity does not seem to be waning anytime soon. But its restrictive treatment of carbohydrates and promotion of protein make it behaviorally and nutritionally challenging. I do not advise parents to put their children on a Paleo diet.
Angela Lemond, RDN, CSP, LD, is a Spokesperson for the Academy of Nutrition and Dietetics and registered dietitian in private practice. Read her blog, Mommy Dietitian and follow her on Facebook, Twitter, LinkedIn, Pinterest and Google+.