Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial

Abstract

(1) Background: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns; (2) Methods: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m2) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention; (3) Results: Significantly greater weight loss occurred in the Paleolithic group (−1.99 kg, 95% CI −2.9, −1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (−14.63% of energy (E), 95% CI −19.5, −9.7), sodium (−1055 mg/day, 95% CI −1593, −518), calcium (−292 mg/day 95% CI −486.0, −99.0) and iodine (−47.9 μg/day, 95% CI −79.2, −16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01); (4) Conclusions: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations.

Feasibility of a Web-Based Cross-Over Paleolithic Diet Intervention in the General Population

“…Drop-out rates were comparable to other Paleolithic-like diet interventions in the normal population (Frassetto, Schloetter, Mietus-Synder, Morris, & Sebastian, 2009;Genoni et al, 2016;Osterdahl, Kocturk, Koochek, & Wandell, 2008). Reasons for discontinuing participation were unknown for most drop-outs, most did not respond to requests to fill-out questionnaires, nor did they reply to personal e-mails inquiring about their reasons for discontinuation.…”

“…The reason that we choose these two diets is that results from a meta-analysis suggest that Paleolithic-like diets improved risk factors for chronic diseases more than any of the control diets in people meeting one or more criteria for metabolic syndrome at inclusion (Manheimer, van Zuuren, Fedorowicz, & Pijl, 2015). Today, only one published randomized-controlled trial investigated health effects of a Paleolithic-like diet in the general population (Genoni, Lyons-Wall, Lo, & Devine, 2016).The major limitation of all these trials is the small sample size, ranging from 13 in a cross-over trial (Jonsson et al, 2009) to 70 in a parallel groups trial (Mellberg et al, 2014). Using web-based study designs could be one way to increase sample sizes.…”

Impacts of carbohydrate‐restricted diets on micronutrient intakes and status: A systematic review

“…For other vitamins, different advice between specific CHO‐restricted diets regarding fruits and vegetables intake probably explains the variable effects on some micronutrients. Reductions in carotenoid intakes and plasma concentrations were reported after an Atkins diet, while there were increases in carotenoid intakes and plasma concentrations after a “Paleolithic” diet . The “Paleolithic” diet also showed an increase in vitamin C intake, reflecting advice to consume more fruits than typical Atkins diets, which mostly showed reductions in vitamin C intakes (Figure ).…”

“…Although iodine is not a nutrient acquired from CHO‐rich foods, both Atkins and “Paleolithic” diets exclude milk/dairy from the diets leading to lower iodine intake. Our systematic review showed that both iodine intake and iodine status (urinary biomarker) were reduced after following a “Paleolithic” diet . In the United Kingdom, bread and fortified breakfast cereals, milk and milk products, and vegetable including potatoes are the top three food groups as sources of the vitamins and minerals, which are reported to be reduced on CHO‐restricted diets.…”

Compliance, Palatability and Feasibility of PALEOLITHIC and Australian Guide to Healthy Eating Diets in Healthy Women: A 4-Week Dietary Intervention

“…Sample size calculations were performed α-priori and based on expected reductions in total plasma cholesterol, as reported in our previous publication [11]. The study was approved by the Edith Cowan University Human Research Ethics Committee (Project 10176) and registered on the Australia and New Zealand Register of Clinical Trials (ACTRN12615000246583).…”