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Paleo vegetarian - how to make it work

26 replies

Paleovege · 28/11/2025 12:39

Help, just been told by a Dr to switch to a paleo diet to reduce inflammation. Have a serious illness that required steroids, so have gained a stone and a bit and am at the top of normal/border of overweight.

Can the paleo diet work as a vegetarian?

I don't understand why pulses are not included. Most seem like they are a good source of protein and anti-inflammatory.

Completely cutting daisy also feels wrong. Will cut down a lot though.

Out does brown rice and wholemeal pasta. My diet really isn't bad and I eat small portions/am not snacking. Hoping the weight will go as I cut down the steroids.

I intend to switch to primarily paleo (at least three quarters of the plate), plus at least one meal a day that is pure paleo. Just a bit worried about excluding so many food groups.

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Cornflakegirl7 · 28/11/2025 12:42

I do low-carb vegan which isn't so dissimilar. I would say it is doable. Nuts, seeds and unrefined fats are all permitted as far as I understand. You just have to get creative!
Pulses are excluded due to the carb factor I assume-I am not an expert?

Deanefan · 28/11/2025 12:44

Excuse my ignorance but what is a paleo diet? Is the doctor actually medically qualified or do they use doxtor because they have a PhD or are a nutritionist maybe?
Did they offer any evidence to back up their claim that this change in diet would improve your sypmtoms?

Paleovege · 28/11/2025 12:58

Very qualified @Deanefan Consultant at a major hospital. I wouldn't be following this is they were not.

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Paleovege · 28/11/2025 13:01

Thank you @Cornflakegirl7 I did not realise how carb heavy some are. Just looked up chick peas and they are at 60g per 100g. Others are fairly low carb. Will reduce amounts, but I eat a lot of them and don't want to cut them completely.

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Summerhillsquare · 28/11/2025 13:23

I'd be amazed if this was agreed policy. 'paleo' is not an agreed definition, and Doctors are not actually dieticians. Could they refer you to the dietician?

Deanefan · 28/11/2025 13:33

That’s reassuring @Paleovege but I would still want to know what evidence there is before making such a massive dietary change. What about potential unintended effects like reduction in bone density with calcium reduction - this will have already taken a hit from the steroids

Paleovege · 29/11/2025 07:02

@Summerhillsquare @Deanefan I very much agree and probably won't cut dairy or beans/lentils. I was thinking about making most of my plate paleo, but not wiping out food groups like dairy. Particularly when the dairy I eat is primarily unsweetened yoghurt with live cultures.

Cholesterol is an issue with the steroids, but I hope as I reduce them levels will normalise again. I really cannot see anything in my diet that would give me the cholesterol profile I now have. I know from the start of this, pre-steroids, my cholesterol profile was really good. Same with weight - I would understand if I was obese, but even with years of steroids and peri my BMI is borderline normal (was in the middle of normal before). I do have fat around the middle for the first time in my life The illness was horrific and meant exercise was not possible, which was a complete turnaround to running , etc., before. I am making an effort to walk more (used to walk everywhere, but have been too ill) and be consistent with yoga/pilates. By the way, no ED history so I am not worried about disordered eating.

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MotherOfCrocodiles · 29/11/2025 07:30

Does the doctor know you are vegetarian? If possible ask him which aspect is important- no dairy, no gluten, high protein, low carb, low UPF…. I don’t think you can achieve all of those as a vegetarian and still get essential nutrients

RedToothBrush · 29/11/2025 07:55

Help, just been told by a Dr to switch to a paleo diet to reduce inflammation.

Well your doctor is talking bollocks to start with. I don't care if he's a senior consultant. Go and Google this. There's no scientific evidence to prove it's better than other diets - it's just that it's not ultra processed so it should help improve health from that point alone anyway. It's a fad diet in effect.

I know it's banded about as a treatment for MS but there's little actual proper science behind this so I'd be cautious about a doctor who tells you this.

I have a friend who has MS and lives by a paleo diet. He got to a point where he struggles to maintain weight now - he's fit and very slim. It's a difficult diet to maintain. For starters it's gluten free, which means eating out becomes difficult. And it's even more difficult because he can't have pulses and he can't have dairy. He lives a lot off grilled meat and vegetables or simple oven tray bakes of meat and veg. Even his wife calls it miserable as a diet and she's supportive.

Another friend has an another auto immune condition and he is carb /starch free but eats a lot of meat and dairy to make up for it. He needs the diary because he has to have steroid medication and this affects his bone density. There is evidence that starches can be problematic for his condition. He's an otherwise very healthy bloke.

Being vegetarian on top of being paleo sounds like a massive stretch tbh - it's a really challenging diet without that additional factor. I've catered for my first friend in the past and without pulses and legumes and wheat it's extremely difficult as it is and the second friend has a challenge to eat well generally by his own admission because everything has carbs/starch in.

Plus you are already talking about eating dairy and pulses so you aren't interested in following the doctors advice and going paleo anyway, despite saying you wouldn't be doing it without your doctors advice! If you were following his advice, you would be doing a proper paleo diet! So in essence you are picking and choosing what you want to do anyway!

As I say, going gluten free / looking at your starch consumption and going ultra processed free is probably enough of a health benefit without calling yourself paleo because if you are eating pulses and dairy but not meat you aren't following a paleo diet anyway!

You should get enough benefits from that. There IS research saying there's a link between gluten consumption and autoimmune conditions so this is probably what I'd focus on. One of the things about ultra processed foods is precisely because they tend to be packed full of gluten / starch products. There is a growing body of evidence about non-celiac gluten sensitivity and autoimmune conditions and concerns about starch consumption.

I think setting yourself up to do an exceptionally hard diet is generally setting yourself up to fail as it's so hard to maintain long term.

If you start with ultra processed free and gluten free, its challenging enough. If that makes a difference that might be enough without going further. Eliminate and test - if it doesn't work, move onto eliminating the next thing. Plus calling yourself paleo when you aren't only serves to confuse.

So whilst I think your doctor is talking bollocks I also think there's something in what he says to an extent - just not necessarily how he's framed it to you. Go away and really look up the scientific evidence on this and your condition not the fad diet evangelists - there's a difference between the two - don't fall into the trap of getting them confused.

TheNinkyNonkyIsATardis · 29/11/2025 08:02

Doctors don't have dietary specialisms, not really the time to deliver specific advice.

I have seen my GP twice about gallstones recently. The first said "limit fat" the second said "limit carbs".

A dietician is what you need for tailored personal advice. If you can't get a referral, an online one should be relatively inexpensive.

Shedmistress · 29/11/2025 09:50

I'd be interested in what anyone thinks Paleo Vegetarian is because it seems like two completely opposing dietry plans.

TappaMcFeety · 29/11/2025 10:03

Paleovege · 28/11/2025 12:58

Very qualified @Deanefan Consultant at a major hospital. I wouldn't be following this is they were not.

You need a healthy diet, not a restrictive one like Paleo and I’m surprised that your consultant recommended it, although I do give them points for at least being aware of how important diet is.

I’m a vegetarian with a rare autoimmune disease, also on steroids and I eat a Mediterranean style diet, with lots of pulses, whole grains, beans, nuts, huge variety of fruit and veg and a small amount of dairy. My weight is healthy and I have energy.

You need to do your own research and I would recommend watching some Zoe podcasts on YouTube and the Doctors Kitchen who have some good podcasts on what to eat for chronic inflammation.

Westfacing · 29/11/2025 10:16

Did you tell the doctor that you're vegetarian?

I can't imagine how you can safely follow this advice.

mamagogo1 · 29/11/2025 10:23

The aim is to eat unrefined foods so whilst do listen to your doctor also you know your own body, natural yogurt for instance may be a good compromise. Eggs are encouraged but generally it’s a meat and veg type diet which doesn’t really work for vegetarians. Consult a proper dietician experienced in managing your condition and vegetarians

SerendipityJane · 29/11/2025 11:36

I have zero intention of changing anything, but isn't it accepted that generally we eat much more meat than we used to in our evolution ? (I mean I accept it, although that could be to annoy vegans 😎).

BillieWiper · 29/11/2025 11:40

Did the doctor actually give you a diet? As just saying 'eat paleo' seems extremely vague and unhelpful. Especially If he's not a dietician. And you're vegetarian.

I guess tofu, soy etc are not allowed? I honestly thought paleo diets were mainly meat and low carb veg.

SerendipityJane · 29/11/2025 11:41

I guess tofu, soy etc are not allowed? I honestly thought paleo diets were mainly meat and low carb veg.

I thought the meat was the least part. Most hunter gatherers were sustained by the gathering.

Paleovege · 29/11/2025 13:47

Thank you all. There was not clear guidance and I did say I was vegetarian. An ultra strict paleo diet just does not seem to be able to work sustainably/sensibly as a vegetarian. Plus cutting dairy when on steroids goes against a lot of advice.

To clarify, I do want to follow his guidance, but to a sensible extent. I do eat tofu, which would need to be cut for a paleo diet. It is highly confusing as I had been told by another consultant to eat tofu and to try to get calcium via dairy.

My diet is pretty good anyway. UPFs rare. Very few white carbs - less than once a week. I mainly drink water, no alcohol.

To switch towards paleo, I will reduce/eliminate gluten, reduce starch, get rid of any excess sugar, keep dairy consumption in check (not the best timing with Christmas). I will try to make sure at least one meal a day is purely paleo, and others have a plate that is mainly paleo. Also looking for some things to replace pasta/rice, so will eat more sweet potatoes and cauliflower rice. Any advice on good things to eat gratefully accepted!

I will know from blood work in a few months whether that has made a difference. At the same time I will be tapering steroids and pain meds, which I hope will make a big difference to the problem areas (which seem to be cholesterol, problems processing glucose and some liver inflammation - no physical symptoms of the latter and I have not seen the blood work).

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RedToothBrush · 29/11/2025 13:54

Paleovege · 29/11/2025 13:47

Thank you all. There was not clear guidance and I did say I was vegetarian. An ultra strict paleo diet just does not seem to be able to work sustainably/sensibly as a vegetarian. Plus cutting dairy when on steroids goes against a lot of advice.

To clarify, I do want to follow his guidance, but to a sensible extent. I do eat tofu, which would need to be cut for a paleo diet. It is highly confusing as I had been told by another consultant to eat tofu and to try to get calcium via dairy.

My diet is pretty good anyway. UPFs rare. Very few white carbs - less than once a week. I mainly drink water, no alcohol.

To switch towards paleo, I will reduce/eliminate gluten, reduce starch, get rid of any excess sugar, keep dairy consumption in check (not the best timing with Christmas). I will try to make sure at least one meal a day is purely paleo, and others have a plate that is mainly paleo. Also looking for some things to replace pasta/rice, so will eat more sweet potatoes and cauliflower rice. Any advice on good things to eat gratefully accepted!

I will know from blood work in a few months whether that has made a difference. At the same time I will be tapering steroids and pain meds, which I hope will make a big difference to the problem areas (which seem to be cholesterol, problems processing glucose and some liver inflammation - no physical symptoms of the latter and I have not seen the blood work).

Edited

I'd have a good look at Korean recipes online and invest in some gluten free soy. When I was looking for recipes for my friend there were quite a few good recipes that looked doable and generally stuck to the rules or were adaptable fairly easily.

strongermummy · 29/11/2025 14:05

No. Paleo does not work as a vegetarian.

Westfacing · 29/11/2025 14:30

To clarify, I do want to follow his guidance, but to a sensible extent

But if you will be eating pulses, dairy and tofu then it's not a 'Paleo' diet. Paleo is basically meat and veg - cutting out UPF doesn't make it Paleo.

I think your chap has this wrong!

SerendipityJane · 29/11/2025 14:43

Westfacing · 29/11/2025 14:30

To clarify, I do want to follow his guidance, but to a sensible extent

But if you will be eating pulses, dairy and tofu then it's not a 'Paleo' diet. Paleo is basically meat and veg - cutting out UPF doesn't make it Paleo.

I think your chap has this wrong!

Also, humans cannot exist on a 100% unprocessed diet. Cooking is processing, of course.

Badslipperluck · 29/11/2025 15:30

Have you tried fasting? Even just an overnight 14 hour one?

Paleovege · 30/11/2025 14:44

I will try fasting. Was on heavy meds am/pm and really wanted to avoid stomach damage at all costs. @Badslipperluck

I can't see how to do a fully paleo diet @Westfacing . I will make my diet more paleo, cut the non-essentials and reduce non paleo groups.

The main goal is getting cholesterol down, then reducing inflammation. I cannot see why cutting wholemeal organic oats made with water, (to be pure paleo), would help, given the role they play in reducing cholesterol.. Most of the appointment was concerned with other things and the paleo advice thrown in fairly quickly and without much discussion. It isn't that I am choosing to ignore it off my own back - a different consultant specifically recommended protecting my stomach with yoghurt, eating probiotic foods, eating tofu and getting calcium from diet.

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Paleovege · 30/11/2025 14:45

Please let me know if there are any good vegetarian paleo recipes.

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