Another diet, another debate about its effectiveness.

The Paleo Diet, dubbed the caveman diet, promotes simple eating – lean meats, fish, poultry, fruits, vegetables and nuts. Processed foods are out, as are refined sugars, excessive salt, grains and dairy. Eat like our ancestors did 10,000 years ago, goes the Paleo mantra.

“Generally, it’s a healthy diet,” says Dr. Theresa Amerson, with Wake Specialty Physicians City Center Medical Group in Raleigh. “Any diet that focuses on whole foods is a healthy start.”

Among the diet’s claims: grains, dairy, legumes and processed foods contribute to Type 2 diabetes, heart disease, high blood pressure, gout, acne and other chronic ailments. Eliminate them and you’ve taken a big step on the road to recovery.

Yet in a recent evaluation of 29 current popular diets, U.S. News & World Report ranked Paleo 28th, saying its experts “took issue with the diet on every measure.”

Their main beef: replicating man’s simple diet of 10,000 years ago is difficult today, if not impossible. For starters, the meat we eat today is nothing like meat consumed in ancient times. You need to eat lean, grass-fed beef that’s far more expensive than feedlot-raised beef sold at grocery stores.

And many of the vegetables we eat differ genetically from what our ancestors ate. Plus, their selection would have been limited to what grew wild in their immediate surroundings; we have ready access to produce from around the world.

Alicia Fogarty, a nutritionist with Carolinas Medical Center in Charlotte, agrees that the diet has a solid “basic, core concept.” She cautions, though, that practitioners need to be aware of what the diet omits. “Calcium, for example, by eliminating dairy,” she says. “But you can supplement that with green leafy vegetables. It’s also low on Vitamin D, but you can make that up with fatty fish.”

The Paleo Diet – short for Paleolithic – was introduced in 2002 by exercise physiology professor Loren Cordain in his book by the same name.

It didn’t gain wide attention until Robb Wolf, a student of Cordain’s, published “The Paleo Solution” in 2010. Since then, it has attracted considerable buzz, both positive and not so.

Some love it

Until 4 1/2 years ago Amber and Carter Lewis of Charlotte lived on what Amber describes as “the standard American diet,” including fatty foods, beer and a little overindulgence on the weekend.

Carter was having trouble with high blood pressure, Amber suffered chronic digestive issues and was plagued by skin problems.

“Seven days after we started Paleo was the first time I could ever remember not having heartburn,” says Amber Lewis.

Carter Lewis’ blood pressure soon dropped to the point his doctor took him off his medication.

As Amber Lewis shared her story with friends, they wanted to eat the way she was eating.

Lewis, 37, started making meals for friends, so many that in January 2012 she launched Mod Paleo, a catering service that supplies fresh, pre-cooked Paleo meals.

“I’ve got about 190 to 200 customers from Spartanburg to Asheville to Hickory,” says Lewis, who has tapped into a market of customers who can afford to eat Paleo, but don’t have time to be their own hunters, gatherers and chefs.

Joy Dvorak of Gilroy, Calif., chronicles the impact Paleo has had on her family’s health in the blog PeaceLovePaleo.net. She says the diet may seem expensive at first. But at least in their case, the added food expense is offset by fewer trips to the doctor and fewer meds.

Because the diet is relatively new, few studies have tested Cordain’s assertions, such as “very few chronic diseases don’t respond positively to this diet.”

The ultimate diet question

That gives rise to critics such as Colin Pistell of Chapel Hill. Pistell is the owner of Fifth Ape, a fitness program that embraces an ethic similar to the overall Paleo lifestyle: Eat whole foods, work out like we did 10,000 years ago. He believes that simple message should suffice. However, “Unfortunately, that’s not enough to put into an ebook, so everyone tries to complicate it or dogmatize it. I think Paleo is a foolish term. It has its uses as a marketing term … but that’s about it.”

The U.S. News & World Report rating also criticized the diet for being restrictive – a common criticism of many diets. That prompts Fogarty to offer the advice she offers anyone contemplating any diet.

“You have to ask yourself, ‘Will it be hard to follow? Is it something I can stick with?’ ” says Fogarty. “I encourage lifestyle changes for the long term.”

Adds Amerson with Wake Specialty Physicians, “People get mired in following a diet to the letter. Rather, don’t be upset if you can’t follow a diet exactly as written.”

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There’s agreement that the Paleo diet is based on sound principles. Here are five:

•  Avoid processed foods. “The fewer chemicals the better,” advises Dr. Theresa Amerson with Wake Specialty Physicians City Center Medical Group in Raleigh. As a rule, if the nutritional label lists more than five ingredients, pass.

•  Load up on vegetables and fruits. Fresh is preferable, frozen a close second. Avoid canned fruits packed in syrup, and limit consumption of dried fruits, “as they can contain as much concentrated sugar as a candy bar,” according to “The Paleo Diet.” Potatoes are off-limits as they “maintain high glycemic loads that may adversely affect your blood sugar and insulin levels.”

•  Be wary of grains. “This is a bigger issue than we may realize,” says Amerson. “More and more information is coming out about what grains are doing to our system.” She notes the growing link between grains and inflammation to the intestines.

•  Eat at home. Preparing your own meals gives you greater control over your diet, says Joy Dvorak, author of the blog PeaceLovePaleo.net. It offers another big advantage: “For the last three years (since going on the Paleo Diet) we hardly spend money eating out.”

•  It’s not all about losing weight. Though the science is yet to weigh in, anecdotal evidence suggests there’s some truth to Paleo’s claims that the diet can resolve a host of chronic ailments, from intestinal inflammation to high blood pressure to acne.