Understanding the Rules of the Paleolithic Ketogenic Diet (PKD)

December 11, 2025 •

4 min read

The Paleolithic ketogenic diet (PKD), developed in the early 2010s, was designed to address underlying inflammatory conditions and promote ketosis by eating only evolutionarily-adapted foods. This highly restrictive dietary protocol focuses almost exclusively on animal-based foods while severely limiting or eliminating all plant-based material to reduce inflammatory food toxins.

Quick Summary

The Paleolithic ketogenic diet is a highly restrictive protocol based on consuming fatty, unprocessed animal products and animal fats, while strictly eliminating all grains, dairy, sugar, and most plant foods to induce ketosis and reduce inflammation.

Key Points

Animal-Based Focus: The diet is overwhelmingly composed of high-fat, unprocessed animal products, often comprising 70-100% of the food intake.
High Fat, Low Carb: Macronutrient ratios favor fat (70-80% of calories), with moderate protein (15-20%) and very few carbohydrates (5-10%).
No Grains, Legumes, or Dairy: All products from the agricultural era, including grains, beans, and dairy, are strictly prohibited to avoid inflammatory components.
Embrace Organ Meats: Nose-to-tail eating, particularly consuming organ meats like liver and bone marrow, is central to obtaining a wide array of vital nutrients.
Eliminate Processed Foods and Sugar: This rule cuts out all processed foods, refined sugars, artificial sweeteners, and most vegetable/seed oils.
Limited Plant Foods: Only a small amount of low-carb vegetables, berries, and specific nuts are permitted, and only in non-therapeutic versions of the diet.
Eat to Satiety: Calorie counting is generally not a focus; instead, followers are encouraged to eat until they are full, trusting the nutrient density to manage appetite.

The Foundational Principles of the Paleolithic Ketogenic Diet

The Paleolithic ketogenic diet (PKD) is a unique and strict eating plan that merges the principles of the Paleolithic (ancestral) and ketogenic diets. Its core philosophy revolves around consuming nutrient-dense foods that early humans would have had access to, while maintaining the body in a state of ketosis, where it burns fat for fuel instead of glucose. This approach is often pursued for therapeutic purposes, aiming to heal issues like intestinal hyperpermeability and address chronic disease.

Prioritizing Animal-Based Products

At its heart, PKD is an animal-based diet. Unlike a standard ketogenic diet that allows certain plant-based fats or a standard Paleo diet that includes a broader range of fruits and vegetables, PKD places immense emphasis on fatty animal products. These products are considered the cornerstone of human nutrition, providing all essential amino acids, fats, and micronutrients.

The Strict Macronutrient Ratio

For most followers, the diet consists of a minimum of 70% animal products, with some therapeutic versions requiring 100% animal-sourced food. The typical macronutrient breakdown is markedly different from other diets:

Fat: Approximately 70-80% of daily calories come from fat.
Protein: Protein intake is kept moderate, at around 15-20% of calories, to prevent the body from exiting ketosis through gluconeogenesis.
Carbohydrates: Carbohydrates are extremely low, often comprising less than 5-10% of total caloric intake, from limited plant sources.

A Closer Look at What to Eat and Avoid

Allowed Foods

Fatty Meats and Fish: Fatty cuts from grass-fed or pasture-raised animals like beef, lamb, and pork are staples. Wild-caught, fatty fish such as salmon, mackerel, and sardines are also included for their omega-3 fatty acid content.
Organ Meats: The diet strongly encourages nose-to-tail consumption. Liver, kidney, heart, and bone marrow are prized for their exceptional nutrient density, which provides critical vitamins and minerals often lacking in muscle meat.
Animal Fats: Rendered animal fats like lard, tallow, and duck fat are the primary cooking fats.
Eggs: Eggs from pasture-raised hens are considered a complete and nutrient-rich food source.
Limited Low-Carb Vegetables: For those not following the 100% animal-based version, a small amount of low-carb, non-starchy vegetables is permitted. This includes leafy greens like spinach and kale, cruciferous vegetables like broccoli and cauliflower, and herbs.
Moderated Nuts and Berries: Select nuts like macadamia nuts and pecans, and low-sugar berries like raspberries and strawberries can be consumed in very small, controlled portions.

Foods to Strictly Avoid

The list of prohibited foods on the Paleolithic ketogenic diet is extensive, targeting ingredients believed to cause inflammation and compromise intestinal health.

Grains and Cereals: All grains, including wheat, rice, corn, and oats, are eliminated.
Legumes: Beans, lentils, and peanuts are strictly forbidden due to their lectin and phytic acid content.
Dairy Products: With the exception of certain therapeutic versions that may allow clarified butter (ghee), all dairy is excluded based on Paleo principles.
Refined Sugars and Sweeteners: All forms of added sugar, artificial sweeteners, and honey are cut out.
Processed Vegetable and Seed Oils: Industrial oils like soybean, canola, and corn oil are eliminated in favor of animal fats.
High-Carb Fruits and Starchy Vegetables: High-sugar fruits (like bananas and grapes) and starchy vegetables (like potatoes and carrots) are not allowed.

Comparison of Diets: PKD vs. Standard Keto vs. Standard Paleo


Feature	Paleolithic Ketogenic Diet (PKD)	Standard Ketogenic Diet	Standard Paleolithic Diet
Carb Source	Very low, from limited low-carb plants	Very low, from non-starchy vegetables, nuts, seeds	Low to moderate, from fruits, vegetables, some tubers
Fat Source	Primarily animal fats, organ fats, some nut/seed oil	Animal fats, coconut oil, avocado oil, moderate dairy	Natural fats from meat, nuts, seeds, avocados, olives
Protein Focus	Moderate, fatty animal products, organ meats	Moderate, varied sources including lean/fatty meats	Lean meat, eggs, fish
Dairy	Strictly avoided (except for some ghee)	Often permitted (e.g., butter, cheese, cream)	Strictly avoided
Grains & Legumes	Strictly avoided	Strictly avoided	Strictly avoided
Processed Foods	Strictly avoided	Avoided	Strictly avoided

Practical Rules for Following the PKD

Listen to your body: The diet is designed around the concept of eating to satiety and drinking only when thirsty. Calorie counting and meticulous measurement are not typically required unless for a specific therapeutic purpose.
Focus on food quality: Prioritize grass-fed, pasture-raised, and wild-caught animal products to ensure the highest nutrient content and omega-3 to omega-6 fatty acid balance.
Prioritize organ meats: Make a conscious effort to include organ meats regularly. They are nutritional powerhouses and a key component of the diet's health benefits.
Hydrate with plain water: The main beverage should be water. Bone broth is also encouraged, but sugary drinks, fruit juices, and even most herbal teas should be avoided.

Conclusion: A Restrictive but Focused Approach

The Paleolithic ketogenic diet is a highly restrictive, yet profoundly focused nutritional strategy. By emphasizing nutrient-dense animal products and eliminating all known dietary inflammatory factors and sugars, it aims to provide the body with optimal fuel and the building blocks for healing. While challenging, proponents believe its adherence can lead to significant improvements in health markers and metabolic function. Because of its restrictive nature, individuals considering the Paleolithic ketogenic diet for therapeutic purposes should consult with a healthcare professional or registered dietitian specializing in this area. A prominent resource for this approach is the Paleomedicina protocol, which provides a detailed framework for implementation.

Final Thoughts on the PKD

The rules of the Paleolithic ketogenic diet are clear: favor high-fat, high-quality animal products, embrace nose-to-tail eating, and completely eliminate grains, legumes, dairy, sugar, and most processed foods. For healthy individuals, a limited amount of low-carb plants might be tolerated, but the strictest version is 100% animal-based. This diet is more than just a low-carb diet; it’s a radical and targeted dietary shift that prioritizes ancestral food and aims for deep metabolic and anti-inflammatory effects.

The PKD emphasizes an evolutionary approach to diet, rooted in the belief that human biology is best suited for pre-agricultural foods.

Frequently Asked Questions

The Paleolithic ketogenic diet is far more restrictive. While both are low-carb, PKD strictly eliminates all dairy, legumes, and grains based on ancestral principles. A standard keto diet typically allows dairy products like cheese and cream.

The amount of vegetables depends on the specific protocol followed. The strictest version is 100% animal-based, but a lighter version allows up to 30% of daily calories from a list of the less 'toxic' plants, such as certain low-carb vegetables.

Primary fat sources should be animal-based, including lard, tallow, and fat from grass-fed meat and fatty fish. Extra virgin olive oil, coconut oil, and avocado oil are often included in moderation, while processed seed oils are completely avoided.

Grains and legumes contain 'anti-nutrients' such as lectins and phytic acid, which are thought to cause inflammation and interfere with nutrient absorption. The PKD excludes them completely to promote healing of the gut barrier.

The long-term safety and nutritional adequacy of this highly restrictive diet are subjects of ongoing debate within the medical and nutritional communities. Given the strict limitations, consulting with a healthcare professional or dietitian is strongly advised before starting.

Organ meats are highly prized for their exceptional concentration of vitamins and minerals. They are considered crucial for providing comprehensive nutrition that muscle meat alone may lack.

No, calorie counting is generally not a central rule. The diet's emphasis on high-fat, nutrient-dense foods is intended to promote satiety, allowing individuals to eat intuitively until full.