A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease

Abstract

Aims/hypothesis Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones. Methods Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic ('Old Stone Age') diet (n=14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n=15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose 0-120 ) and plasma insulin AUC (AUC Insulin 0-120 ) in OGTTs. Results Over 12 weeks, there was a 26% decrease of AUC Glucose 0-120 (p=0.0001) in the Palaeolithic group and a 7% decrease (p=0.08) in the Consensus group. The larger (p= 0.001) improvement in the Palaeolithic group was independent (p=0.0008) of change in waist circumference (−5.6 cm in the Palaeolithic group, −2.9 cm in the Consensus group; p=0.03). In the study population as a whole, there was no relationship between change in AUC Glucose 0-120 and changes in weight (r=−0.06, p=0.9) or waist circumference (r=0.01, p=1.0). There was a tendency for a larger decrease of AUC Insulin 0-120 in the Palaeolithic group, but because of the strong association between change in AUC Insulin 0-120 and change in waist circumference (r=0.64, p=0.0003), this did not remain after multivariate analysis. Conclusions/interpretation A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.

Nutrition, Genes and Modern Disease: A Current Dilemma or a Legacy of our Past

“…Equally, in a randomized cross-over study of three months duration, diabetic patients receiving a Paleolithic diet (lean meat, fish, fruit, vegetables, root vegetables, eggs, and nuts) showed a reduction in body weight, BMI and waist circumference, lower HbA1c, TAG and diastolic blood pressure, and an improvement in glycaemic control [12]. These studies are further supported by Lindeberg et al [13] who reported that patients with ischemic heart disease concomitant with glucose intolerance or type 2 diabetes had a large improvement in insulin sensitivity and glucose tolerance when receiving a Paleolithic diet. Even in non-human studies the Paleolithic diet has been successfully used as a model to explain modern disease.…”

Mediterranean diet and diabetes prevention: Myth or fact?

“…On the other hand, a Paleolithic diet (i.e. a diet consisting of lean meat, fish, shellfish, fruits and vegetables, roots, eggs and nuts, but not grains, dairy products, salt or refined fats and sugar) was associated with marked improvement of glucose tolerance while control subjects who were advised to follow a Mediterranean-like diet did not significantly improve their glucose tolerance despite decreases in weight and waist circumference [13] .…”

Dietary Refinement And The Upper Gut Microbiota: The Starting Point For Obesity And Non-Communicable Diseases?

“…Consensus dietary advice places considerable emphasis on the inclusion of breads and baked goods, and it is arguable that this retention of flour-derived foods may be responsible for the poor consensus performance versus paleolithic diets in the clinical trials carried out to date (17)(18)(19)(20)(21)58,59). The omnipresence of flour, breads and baked goods in most nutrition research has prevented the proper investigation of the concentration-health relationship for refined foods in 'sensitized' populations, which anecdotal observations from those eating no refined foods indicate may be non-linear.…”