No matter your health goals, the Paleo template is the best place to start. With its focus on nutrient density, hormone regulation, and lifestyle modification, there’s no question that standard, out-of-the-box Paleo is powerful. However, if you have specific goals (like weight loss or athletic performance) or are dealing with a chronic illness, there are likely ways that you can tweak your implementation of the Paleo template to better meet your specific needs.
During my 2019 workshop, one of the most popular program sessions was one in which I discussed the leading chronic illnesses and how prevention and treatment relate to specific nutrient deficiencies, dietary patterns, and lifestyle factors. This post summarizes much of the same information, however, if you’re interested in a deeper dive, I highly recommend getting access to my workshop here.
And without further adieu, let’s dig into what research tells us about modifying Paleo for specific health conditions and goals!
Modifying Paleo for Weight Loss
Thanks to the Paleo diet’s focus on consuming nutrient-dense, satiating foods (along with removing many hunger-stimulating foods, like refined grains and sugars), many people lose weight when they first adopt the Paleo framework—even if they’re not trying! The elimination of Standard American Diet (SAD) staples, along with an increase in bulky plant foods that are high in fiber and water, generally results in a spontaneous decreased caloric intake and a subsequent reduction in body fat.
But for some of us, simply switching to a Paleo diet doesn’t lead to our desired weight loss. As long as our goals are reasonable (and keeping in mind that there are protective benefits to a little adipose body fat, see Healthy Weight Loss with Paleo, Part 4: Using the Obesity Paradox to Inform Our Goals), there are a few modifications we can make to yield increased weight loss.
- Focus on portion control. Read more in Portion Control: The Weight Loss Magic Bullet
- Eat more vegetables. Their fiber, phytochemicals, and relatively low caloric load make them essential to weight loss with Paleo.
- Instead of focusing on low-carb or low fat, aim for a balanced macronutrient ratio and make sure to get enough protein to support muscle metabolism.
- Remember that slow-and-steady weight loss wins the race. Aim for a moderate caloric deficit of 10-20%.
- Counting calories is not a good long-term solution, but can be a useful short-term training tool.
- Eat these nutrients (for more, see 10 Nutrients that Can Help You Burn Fat):
- Vitamin A
- Vitamin B1
- Vitamin B3
- Vitamin B5
- Vitamin B6
- Vitamin D
- Get enough high-quality sleep. Not doing so can complicate, delay, or even prevent weight loss. See The Link Between Sleep and Your Weight, 10 Tips to Improve Sleep Quality, and 4 Biohacks for Better Sleep.
- Engage in both aerobic (cardio) and anaerobic (muscle-building) activity. See The Importance of Exercise
I’ve written extensively on this topic! To learn more, start at Paleo for Weight Loss.
I also dedicated an entire program session to healthy weight loss during my 2019 workshop, which you can access here.
Modifying Paleo for Cardiovascular Disease
Cardiovascular disease, including coronary heart disease, hypertensive heart disease, and stroke, is the number-one global killer and is unequivocally rooted in diet and lifestyle. Approximately 84 million Americans suffer from cardiovascular disease with approximately 610,000 deaths annually from heart disease alone.
The good news is that multiple clinical trials have demonstrated that a Paleo-style diet can reduce virtually every risk factor for cardiovascular disease, including high triglycerides, high LDL (“bad”) cholesterol and low HDL (“good”) cholesterol, high blood pressure, high insulin, high blood sugar, high C-reactive protein, and other markers of inflammation.
That being said, what can we do to fine-tune the Paleo template to offer the best possible protection against cardiovascular disease?
- Gene test for ApoE4. If you have one or two copies, lower your fat intake to about 20% of total calories. See Genes to Know About: ApoE
- Eat moderate saturated fat. Yes, despite being vilified as the cause of cardiovascular disease, there are some legitimate reasons not to go nuts. See Saturated Fat: Healthful, Harmful, or Somewhere In Between?
- Focus on these nutrients:
- vitamin D. Get vitamin D levels tested and supplement accordingly.
- fiber. See The Fiber Manifesto-Part 4 of 5: Fiber, Cholesterol and Bile Salts
- phytochemicals. See The Amazing World of Plant Phytochemicals: Why a diet rich in veggies is so important! and Polyphenols: Magic Bullet or Health Hype?
- If you smoke, quit!
- Get plenty of sleep. Inadequate sleep is one of the biggest risk factors for cardiovascular disease!
- Manage stress. Stress is a bigger predictor of cardiovascular disease than any other diet or lifestyle factor.
- Engage in gentle movement throughout the day and get some exercise during the week. See The Benefits of Gentle Movement and Why is Exercise so Important?)
Modifying Paleo for Cancer
No diet or lifestyle protocol has ever been proven to cure cancer. (Despite claims made about Gerson therapy, the Gonzalez protocol, and other regimens, there is no peer-reviewed evidence demonstrating that these programs can treat existing cancer.) Likewise, the Paleo diet has not been evaluated for treating cancer patients and should not be viewed as a cure for this disease.
However, there is ample evidence that Paleo can help reduce cancer risk (keeping in mind that reducing cancer risk is different from treating cancer).
- Whole, fresh plant foods are rich in a massive spectrum of phytochemicals with proven anti-cancer properties, such as cyanidins and resveratrol in grapes, curcumin in turmeric, crocetin in saffron, apigenin in parsley, indole-3-carbinol in Brassica vegetables, lycopene in tomatoes, fisetin in strawberries and apples, gingerol in ginger, kaempferol in broccoli and grapefruit, and isothiocyanates and sulforaphanes in cruciferous vegetables. See The Amazing World of Plant Phytochemicals: Why a diet rich in veggies is so important! and Polyphenols: Magic Bullet or Health Hype?
- Maintaining sufficient levels of vitamin D (through sun exposure, supplementation, and/or food sources like salmon) helps protect against a wide range of cancers. See Vitamin D
- There is emerging evidence that deficiency in important immune system nutrients like zinc, omega-3 fatty acids, and vitamin D may increase cancer risk.
- Some types of fiber appear to protect against colorectal cancer. See The Fiber Manifesto–Part 3 of 5: Soluble vs. Insoluble Fiber
- Getting enough sleep and managing stress are also associated with reduced cancer risk.
If you have a family history of cancer or know via genetic testing that you have cancer genes like specific mutations in the BRCA1 or BRCA2 gene, your best bet is an even greater focus on vegetables and high-antioxidant fruits in addition to tracking micronutrients to ensure nutrient sufficiency. See also
Modifying Paleo for Diabetes
Over the past few decades, type 2 diabetes has reached epidemic proportions, skyrocketing from 108 million people worldwide in 1980 to over 422 million people today (according to the most recent World Health Organization data)!
Although Paleo can help many people manage type 2 diabetes without any special modifications, a few changes can make the diet even more powerfully therapeutic for this disease.
Those changes include:
- Limiting or avoiding higher-glycemic fruit, including dried fruit (raisins, dried figs, dried apricots, etc.), watermelon, pineapple, and mango.
- Swapping out freshly-cooked potatoes for potatoes that have been cooked and then cooled down; the cooling process increases their resistant starch content and lowers their glycemic index. (See Resistant Starch: It’s Not All Sunshine and Roses)
- Consuming foods high in naturally occurring sugar or starch with an acidic ingredient (like vinegar, lemon, or salsa) or with higher-fiber foods (like a salad of leafy greens), which lowers the glycemic response.
- Avoiding the less refined, “gray zone” sweeteners like maple syrup, sucanat, Muscovado/Barbados sugar, and molasses (or at least, using them very sparingly).
- If you do use a sweetener, choose honey! See Honey: The Sweet Truth About a Functional Food!
- Emphasizing fiber-rich foods, protein, and nutrient-dense sources of fat to help prevent blood sugar and insulin spikes and keep blood sugar levels at an even keel throughout the day. (See The Fiber Manifesto, Part 1 of 5: What Is Fiber and Why Is it Good?)
- Focusing on other components of the Paleo framework that help improve insulin sensitivity, such as getting adequate sleep, managing stress, and engaging in gentle frequent movement throughout the day (see 3 Ways to Regulate Insulin that Have Nothing to Do With Food).
Modifying Paleo for Autoimmune Disease
There are more than one hundred confirmed autoimmune diseases and many more diseases that are suspected of having autoimmune origins. The root cause of all autoimmune diseases is the same: our immune system, which is supposed to protect us from invading microorganisms, turns against us and attacks our proteins, cells, and tissues instead.
Modifying Paleo for autoimmune conditions using the Autoimmune Protocol, abbreviated AIP, is a powerful strategy that uses diet and lifestyle to regulate the immune system, putting an end to these attacks and giving the body the opportunity to heal.
The Paleo Autoimmune Protocol works by addressing nutrient density, gut health, hormone regulation, and immune system regulation. Following the AIP diet involves increasing your intake of nutrient-dense, health-promoting foods while avoiding foods that may be triggers for your disease.
- Focus on eating
- organ meat and offal – read more here.
- fish and shellfish – read more here and here.
vegetables of all kinds
- green vegetables
- colorful vegetables and fruit (red, purple, blue, yellow, orange, white)
- cruciferous vegetables (broccoli, cabbage, kale, turnips, arugula, cauliflower, brussels sprouts, watercress, mustard greens, etc.)
- root veggies (carrots, beets, sweet potato, cassava, parsnip, etc.)
- sea vegetables (excluding algae like chlorella and spirulina which are immune stimulators)
- mushrooms and other edible fungi
- herbs and spices
- quality meats
- healthy fats
- probiotic/fermented foods
- glycine-rich foods
- Source the best-quality ingredients you can.
- Eat as much variety as possible.
- Focus on avoiding
- refined and processed sugars and oils
- eggs (especially the whites)
- nuts (including nut butters, flours and oils)
- seeds (including seed oil, cocoa, coffee and seed-based spices)
- potential gluten cross-reactive foods
- NSAIDS (like aspirin or ibuprofen)
- non-nutritive sweeteners (yes, all of them, even monk fruit and stevia)
- emulsifiers, thickeners, and other food additives
- Moderate your intake of the following:
- fructose (from fruits and starchy vegetables, aiming for between 10 and 40 grams per day, around 20 grams is probably ideal)
- salt (using only unrefined salt such as Himalayan pink salt or Celtic gray salt.
- moderate- and high-glycemic-load fruits and vegetables (such as dried fruit, plantain, and taro root)
- omega-6 polyunsaturated fatty acid–rich foods (such as poultry and fatty cuts of industrially produced meat)
- black and green tea
- natural sugars like blackstrap molasses, maple syrup and honey
- In addition, lifestyle factors are extremely important in the management of autoimmune disease.
- get enough sleep (at least 8-10 hours every night),
- manage stress
- protect circadian rhythms
- nurture social connection, have fun, make time for hobbies, and relax
- get outside and commune with nature
- get lots of mild to moderately intense activity (while avoiding intense/strenuous activity). See The Benefits of Gentle Movement and Why is Exercise so Important?)
For a deep into the science behind the Autoimmune Protocol, sign up for the next session of the AIP Lecture Series.
Modifying Paleo for Kidney Disease
Chronic kidney disease is a condition in which there is gradual and progressive loss of kidney function. It affects about 10% of the American population, with older people at much greater risk. Modifying Paleo for kidney disease involves focusing on hydration, which is necessary for kidney function, as well as making some crucial lifestyle modifications.
- Aim for 8-15 cups of vegetables per day. High veggie consumption improves kidney function, reduces risk of kidney stones and reduces risk factors for chronic conditions that cause kidney disease (see The Importance of Vegetables). Recent studies show it may also protect the kidneys from further deterioration and improve kidney function.
- Maintain a healthy weight.
- Drink enough water. The latest research suggests that men should consume about 13 cups (or 3 liters) of fluid per day, and women should consume about 9 cups (74 ounce, or 2.2 liters)—but this includes all beverages, as well as the water content of the food we eat.
- Add mineral drops to water before drinking (Read more about the effect of sodium on kidney health in Is Salt Paleo?.)
- Make choices that mitigate diabetes and normalize blood pressure. This may help reduce risk of chronic kidney disease. See Modifying Paleo for Diabetes.
- Eat plenty of fiber. High fiber diets, high vegetable and fruit consumption, a daily serving of nuts, and proper hydration have all been shown to decrease risk of kidney disease (see The Importance of Vegetables). Avoiding excess sodium consumption is also important for kidney health.
- Focus on these nutrients:
- Vitamin D. Vitamin D deficiency increases risk of chronic kidney disease as well as all-cause mortality in chronic kidney disease sufferers (see Vitamin D).
- Omega-3s. Fish oil supplementation has been shown to reduce markers of inflammation and cardiovascular disease risk factors in patients with chronic kidney disease.
Modifying Paleo for Gout
Gout occurs when hyperuricemia, too much uric acid in the blood, causes sharp needle-like crystals of urate (uric acid salts) to form and deposit in joints. Gout affects about 2% of people in Western countries at some point in their lives with an estimated 3 million new cases annually in the USA.
- Eat more vegetables, which seems to decrease the risk of developing gout and the risk of flares once diagnosed (see The Importance of Vegetables, The Amazing World of Plant Phytochemicals: Why a diet rich in veggies is so important! and Why Fruit is a Good Source of Carbohydrates).
- Approach a low-purine diet with caution. Low-purine diets have traditionally been recommended for those with gout and hyperuricaemia (high blood levels of uric acid); however, more recent scientific research shows that refined sugar, and especially fructose, is the more likely culprit. While acutely high purine intake does increase probability of a gout flare, the overall effectiveness of low-purine diets has not been proven. In addition, limiting fructose and alcohol intake,
- Reduce sugar intake, especially fructose. Fructose seems to be a bigger player in the development of gout and the common denominator between gout and its comorbidities. See also Is Fructose a Key Player in the Rise of Chronic Health Problems?, Why is High Fructose Corn Syrup Bad For Us?, Fructose and Vitamin D Deficiency: The Perfect Storm?, and Is It Paleo? Fructose and Fructose-Based Sweeteners (I’m looking at you, Agave!).
- Limit alcohol intake. Drinking one alcoholic beverage per day increases risk of gout by 10 percent but drinking two per day doubles risk;
- Maintain a healthy body weight. having a BMI over 27.5 increases risk of gout by a whopping 16 times! See Paleo for Weight Loss.
- Live an active lifestyle. See The Benefits of Gentle Movement and Why is Exercise so Important?).
For more, see The Paleo Diet for Gout.
Modifying Paleo for Asthma and Allergies
Asthma and allergies affect huge portions of the population (about 8% of Americans have asthma, and allergies affect as many as 30% of adults and 40% of children!). Dietary changes that reduce inflammation and regulate the body’s immune response can improve asthma and allergies without harmful side effects. We can use the available evidence to modify the Paleo diet in ways that give asthma and allergy sufferers some relief!
- Focus on dietary fiber.
- The short-chain fatty acids produced when our gut microbes metabolize fiber may suppress airway inflammation, leading to improvements in asthma symptoms.
- The immune-regulating effects of short-chain fatty acids appear to benefit both food allergies and environmental allergies.
- Vitamin D. Low vitamin D levels have been convincingly linked to increased risk of asthma attacks in both children and adults.
- Omega-3 Fats. Due to their role in regulating inflammation, omega-3 fats (and the overall omega-3/omega-6 ratio of the diet) may influence the occurrence and severity of asthma and allergies.
- Focus on nutrition during pregnancy. Vitamin D supplements, Brazil nuts, low-mercury fatty fish, and organ meats and shellfish. When eaten during pregnancy, these foods may reduce a child’s risk of asthma.
Modifying Paleo for Skeletal Health
Keeping our bones healthy can greatly improve our health in old age, but it comes in handy at any time of life! Our bones provide structure to our bodies, anchor our muscles for movement, protect our organs, and store calcium and other minerals for us.
The good news is that it’s relatively easy to support our skeletal health by providing the right nutrients and the stimulus of activity! Paleo is a perfect place to start! In addition:
- Eat plenty of fruits and vegetables, especially cruciferous vegetables, to get crucial minerals.
- Focus on these nutrients:
- Magnesium, from seafood, nuts and seeds, leafy dark green vegetables, and cruciferous vegetables.
- Potassium, found in leafy dark green vegetables, cruciferous vegetables, some fruit (such as bananas and cantaloupe) and orange veggies.
- Phosphorus, found richly in fish, shellfish, nuts, and seeds.
- Though important for bone health, dairy is not the only way to source this nutrient. In fact, fruits, vegetables, nuts, seeds, meat, and seafood all contain substantial quantities of calcium.
- Vitamin D. Vitamin D status influences calcium absorption. So, testing to make sure your serum vitamin D levels are in the functional range (50 to 70 ng/mL is probably optimal) and supplementing accordingly is essential. Read more in Vitamin D.
- Fat-soluble vitamins (A, D, and K2 in particular), which are essential regulators in bone mineralization. Where do we get these essential fat-soluble vitamins? Seafood, dairy fat from grass-fed cows (see Goat Milk: The Benefits of A2 Dairy), and the fat from grass-fed and pasture-raised meats.
- Incorporate weight-bearing exercise into your routine. That means exercise that involves moving your own body weight around, like walking.
Read more in Paleo for skeletal health.
Modifying Paleo for Pregnancy and Lactation
The Paleo diet’s focus on nutrient density makes it a great framework for ensuring that pregnant and lactating women receive the nutrition they need to support a healthy pregnancy and child. Not only do nutrient requirements increase for expecting and breastfeeding mothers, but the mother’s diet directly influences fetal brain development, birth weight, the risk of birth defects, and even the baby’s immune function (see also The Importance of Nutrient Density).
That being said, the Paleo framework can be adjusted to emphasize the nutrients that are in particularly high demand during pregnancy and lactation. Here’s how:
- A woman may need 200 to 300 additional calories per day during pregnancy.
- Breastfeeding burns up to 500 calories a day or more, and inadequate calorie intake can decrease the mother’s milk supply.
- Eating a balanced diet of protein, fat, and carbohydrates is essential during both stages.
- Drinking adequate water becomes even more important, as fluid needs increase.
- Focus on these nutrients:
- Vitamin B9 (Folate) – essential for early fetal development and found in leafy green vegetables, asparagus, broccoli, avocados, nuts, seeds, beets, cauliflower, and squash
- Vitamin A – essential for fetal development and found in both plant foods and animal foods like liver, eggs, and grass-fed dairy
- Vitamin D – facilitates calcium absorption and metabolism, plays a critical role in immune function can potentially help prevent pregnancy complications such as gestational diabetes, preeclampsia, low birth weight, and preterm birth, among other benefits. The best way to get vitamin D is from skin exposure to the sun, but the highest dietary sources are egg yolks, fatty fish (like salmon, herring, and mackerel), and cod liver oil.
- Calcium – Calcium is needed for skeletal development, blood pressure regulation, and proper muscle and nerve functioning, and it becomes particularly important for the fetus during third-trimester bone development. Pregnant or lactating women need 1,000 to 1,300 milligrams per day. The best Paleo-friendly sources are leafy green vegetables, broccoli, small bone-in fish like sardines, and grass-fed dairy. Blackstrap molasses is also a great source of calcium, iron and B-vitamins (see Blackstrap Molasses: The Sugar You Can Love!). See also Calcium
- Choline – Choline is important for the development of the fetal nervous system, neural tube, and brain. Pregnant women should consume at least 450 milligrams per day. The richest sources are egg yolks, liver, shrimp, and beef. See also Choline
- Iron – Iron is needed for a fetus’s rapidly developing blood supply and for the expanding blood supply of the mother. For pregnant women, 27 milligrams daily is recommended. The best sources are red meat, organ meat, and leafy green vegetables. See also Iron
- Zinc – is used for fetal cell growth, as well as supporting immunity, enzyme production, and insulin production in the mother. Pregnant women should aim for 11 milligrams per day from rich sources like beef, pork, poultry, seafood (especially oysters), nuts, and seeds. See also Zinc
- Omega-3 Fats, especially DHA and EPA – DHA has been consistently shown to support fetal brain, eye, and central nervous system development (it’s a major structural fat in the retina and brain), while EPA plays a role in transporting DHA across the placenta, as well as supporting DHA intracellular absorption. Inadequate omega-3 intake can negatively affect pregnancy outcomes and increase the risk of preterm labor and preeclampsia.The best sources of essential fatty acids are low-mercury fatty fish and other seafood, walnuts, and omega-3–enriched eggs. See also Why Grains Are Bad-Part 2, Omega 3 vs. 6 Fats.
Read more in Paleo for Pregnancy and Lactation.
Modifying Paleo for Babies and Toddlers
Paleo is a great choice for kids! In fact, children might benefit from Paleo even more than adults because the nutrient density of the Paleo diet readily supports the demands of growth and development.
However, making sure children get all the nutrients they need is important with any dietary framework, and Paleo is no exception (see also The Importance of Nutrient Density).
- Focus on meat and fat. Adding some of these foods is important, but specific macronutrient ratios aren’t that important.
- Present them with a variety of options like meat, fish, organ meat, healthy fats (such as avocados, olives, and coconut oil), green veggies, other colorful veggies, cruciferous veggies, starchy veggies, all kinds of fruit, and probiotic foods like sauerkraut.
- A few micronutrients are particularly critical due to the specific developmental processes that children are going through, including the following:
- Vitamin A is important for healthy vision, immunity, and gene expression (vitamin A deficiency is the leading cause of childhood blindness in developing nations and puts children at significantly increased risk of infection). The best sources of vitamin A in the form of retinol are liver, eggs, and full-fat dairy, and the best sources of vitamin A precursors are sweet potatoes, leafy green vegetables, squash, carrots, and many other orange and green fruits and vegetables.
- Vitamin B12 is used in many metabolic processes and is important for neurological health, including playing a role in myelination from early fetal development all the way through early adulthood. The best sources of B12 are animal products like red meat, fish, shellfish, poultry, and eggs.
- Vitamin C plays a role in synthesizing collagen and neurotransmitters during childhood and beyond. It’s also critical for proper immune function, helping children fight off infections as they’re exposed to new pathogens. The best sources of vitamin C are citrus fruits, melons, berries, kiwis, papayas, mangoes, and pineapple.
- Vitamin D supports growing bones and teeth through its role in facilitating calcium metabolism (vitamin D deficiency is a major cause of rickets, which occurs when bones fail to mineralize and results in bowed legs and arms). The best sources of naturally occurring vitamin D (apart from what the body produces during sun exposure) are fatty fish, liver, eggs, and full-fat dairy.
- Calcium is used to build bones and teeth. An adequate intake during childhood and adolescence is necessary to attain strong peak bone mass and reduce the risk of osteoporosis later in life. Make sure to include plenty of calcium-rich foods, see The Paleo Diet for Skeletal Health and Why Don’t I Need to Worry About Calcium?
- Iodine is needed for brain development in infancy, is used to synthesize thyroid hormones, and helps control a number of bodily processes, such as growth, metabolism, and development. Because some Paleo diets omit iodized salt and processed foods made with iodized salt—the most common sources of iodine in the modern diet—dietary sources of iodine are extremely important for young children: sea vegetables, fish, eggs, and dairy.
- Zinc plays a role in growth, development, neurological function, immune function, and cell metabolism. Zinc deficiency can impair a child’s physical growth and increase the susceptibility to infection, so adequate intake is important for preventing “failure to thrive.” The best sources of zinc are organ meat, shellfish, nuts, and seeds.
- Omega-3 fats are critical for healthy brain development, vision, gene expression, nervous system function, and building cell membranes. The best sources are fatty fish such as salmon, mackerel, tuna, and sardines, as well as walnuts.
- Pay attention to the Recommended Dietary Allowances (RDAs) as established for a variety of demographic groups by the Food and Nutrition Board of the Institute of Medicine.
Read more in Paleo for Babies and Toddlers.
Modifying Paleo for Athletic Performance
Can the Paleo diet work for athletes? Yes! Fortunately, Paleo supplies all the raw materials needed to support performance and help the body recover from physically demanding activities while also improving micronutrient status and removing dietary components that can undermine health over time.
Supporting performance really amounts to supporting metabolism and muscular health.
- Consume sufficient carbohydrates to support metabolism, restore muscle glycogen, and recover from exercise (see How Many Carbs Should You Eat?).
- Consume sufficient protein to maintain and build muscle, up to 20-30% of total calories.
- Get the nutrients required for metabolism of stored energy (see 10 Nutrients that Can Help You Burn Fat).
- Eat abundant vegetables and consider drinking coconut water to support healthy electrolyte balance.
- Support thyroid health (see The Case for More Carbs: Insulin’s Non-Metabolic Roles in the Human Body and What about the Goitrogens in Cruciferous Veggies?).
- Maintain insulin sensitivity (see The Paleo Diet for Diabetes, 3 Ways to Regulate Insulin that Have Nothing to Do With Food, Why Is Sugar Bad?, The Hormones of Hunger, and The Hormones of Fat: Leptin and Insulin).
- Get adequate sleep to support recovery.
- Incorporate appropriate recovery time in your exercise routine.
Read more in Modifying Paleo for performance.