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Carrera-Bastos P, Rydhög B, Fontes-Villalba M, Arvidsson D, Granfeldt Y, Sundquist K, Jönsson T. Randomised controlled trial of lifestyle interventions for abdominal obesity in primary health care. Prim Health Care Res Dev 2024; 25:e19. [PMID: 38639002 DOI: 10.1017/s1463423624000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
AIM Assess effects on waist circumference from diet with or without cereal grains and with or without long-term physical exercise. BACKGROUND Elevated waist circumference is an indicator of increased abdominal fat storage and is accordingly associated with increased cardiovascular mortality. This is likely due to the association between lifestyle-induced changes in waist circumference and cardiovascular risk factors. Reductions in waist circumference may be facilitated by diet without cereal grains combined with long-term physical exercise. METHODS Two-year randomised controlled trial with factorial trial design in individuals at increased risk of cardiovascular disease with increased waist circumference. Participants were allocated diet based on current Swedish dietary guidelines with or without cereal grains (baseline diet information supported by monthly group sessions) and with or without physical exercise (pedometers and two initial months of weekly structured exercise followed by written prescription of physical activity) or control group. The primary outcome was the change in waist circumference. FINDINGS The greatest mean intervention group difference in the change in waist circumference among the 73 participants (47 women and 26 men aged 23-79 years) was at one year between participants allocated a diet without cereal grains and no exercise and participants allocated a diet with cereal grains and no exercise [M = -5.3 cm and -0.9 cm, respectively; mean difference = 4.4 cm, 4.0%, 95% CI (0.0%, 8.0%), P = 0.051, Cohen's d = 0.75]. All group comparisons in the change in waist circumference were non-significant despite the greatest group difference being more than double that estimated in the pre-study power calculation. The non-significance was likely caused by too few participants and a greater than expected variability in the change in waist circumference. The greatest mean intervention group difference strengthens the possibility that dietary exclusion of cereal grains could be related to greater reduction in waist circumference.
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Affiliation(s)
- Pedro Carrera-Bastos
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Björn Rydhög
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Maelán Fontes-Villalba
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Daniel Arvidsson
- Center for Health and Performance, Department of Food and Nutrition, University of Gothenburg, Gothenburg, Sweden
- Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Yvonne Granfeldt
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Tommy Jönsson
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Rydhög B, Carrera-Bastos P, Granfeldt Y, Sundquist K, Sonestedt E, Nilsson PM, Jönsson T. Inverse association between Paleolithic Diet Fraction and mortality and incidence of cardiometabolic disease in the prospective Malmö Diet and Cancer Study. Eur J Nutr 2024; 63:501-512. [PMID: 38078965 PMCID: PMC10899283 DOI: 10.1007/s00394-023-03279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/08/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE Paleolithic Diet Fraction (PDF) estimates how large a portion of the absolute dietary intake stems from food groups included in the Paleolithic diet. In randomized controlled trials higher PDFs have been associated with healthier levels of cardiometabolic risk markers. Our aim was to build upon these findings by examining associations between PDF and mortality and incidence of cardiometabolic disease in the prospective Malmö Diet and Cancer Study. METHODS PDF was calculated from an interview-based, modified diet history method, and associations were estimated by using multivariable Cox proportional hazards regression. The examined cohort consisted of 24,104 individuals (44-74 years, 63% women) without previous coronary events, diabetes, or stroke at baseline (1992-1996). A total of 10,092 individuals died during a median follow-up of 18 years. RESULTS Median PDF was 40% (0-90%). The adjusted hazard ratios (HR) for PDF as a continuous variable (from 0 to 100%) were for risk of death from all causes 0.55 [95% CI 0.45, 0.66], tumor 0.68 [95% CI 0.49, 0.93], cardiovascular 0.55 [95% CI 0.39, 0.78], respiratory 0.44 [95% CI 0.21, 0.90], neurological 0.26 [95% CI 0.11, 0.60], digestive, 0.10 [95% CI 0.03, 0.30], and other diseases 0.64 [95% CI 0.41, 1.00]. The corresponding HR for risk of coronary event was 0.61 [95% 0.43, 0.86], for ischemic stroke it was 0.73 [95% 0.48, 1.09] and for type 2 diabetes it was 0.82 [95% 0.61, 1.10]. CONCLUSION Observational data suggest an inverse association between PDF and all-cause as well as cause-specific mortality and incidence of cardiometabolic disease.
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Affiliation(s)
- Björn Rydhög
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden.
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden
| | - Yvonne Granfeldt
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Peter M Nilsson
- Internal Medicine-Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Tommy Jönsson
- Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden
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3
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Bonekamp NE, Cruijsen E, Geleijnse JM, Winkels RM, Visseren FLJ, Morris PB, Koopal C. Diet in secondary prevention: the effect of dietary patterns on cardiovascular risk factors in patients with cardiovascular disease: a systematic review and network meta-analysis. Nutr J 2024; 23:18. [PMID: 38331867 PMCID: PMC10851459 DOI: 10.1186/s12937-024-00922-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Improving dietary habits is a first-line recommendation for patients with cardiovascular disease (CVD). It is unclear which dietary pattern most effectively lowers cardiovascular risk factors and what the short- and long-term effects are. Therefore, this network meta-analysis compared the effects of popular dietary patterns on cardiovascular risk factors in patients with established CVD. METHODS A systematic search of PubMed, Embase, the Cochrane library, SCOPUS and Web of Science was conducted up to 1 April 2023. Randomized controlled trials (RCTs) comparing the effect of popular dietary patterns (Mediterranean, moderate carbohydrate, low glycemic index, low-fat and minimal dietary intervention) on cardiovascular risk factors (body weight, systolic blood pressure, lipids) in CVD populations were selected. A random-effects network meta-analysis was performed. RESULTS Seventeen RCTs comprising 6,331 participants were included. The moderate carbohydrate diet had the most beneficial effect on body weight (-4.6 kg, 95%CrI -25.1; 15.8) and systolic blood pressure (-7.0 mmHg 95%CrI -16.8; 2.7) compared to minimal intervention. None of the included dietary patterns had a favorable effect on low-density lipoprotein cholesterol. After 12 months, the effects were attenuated compared to those at < 6 months. CONCLUSIONS In this network meta-analysis of 17 randomized trials, potentially clinically relevant effects of dietary interventions on CV risk factors were observed, but there was considerable uncertainty due to study heterogeneity, low adherence, or actual diminished effects in the medically treated CVD population. It was not possible to select optimal dietary patterns for secondary CVD prevention. Given recent clinical trials demonstrating the potential of dietary patterns to significantly reduce cardiovascular event risk, it is likely that these effects are effectuated through alternative physiological pathways.
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Affiliation(s)
- N E Bonekamp
- Department of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, the Netherlands
| | - E Cruijsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - J M Geleijnse
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - R M Winkels
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - F L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, the Netherlands.
| | - P B Morris
- Department of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - C Koopal
- Department of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, the Netherlands
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Pięta A, Frączek B, Wiecek M, Mazur-Kurach P. Impact of Paleo Diet on Body Composition, Carbohydrate and Fat Metabolism of Professional Handball Players. Nutrients 2023; 15:4155. [PMID: 37836439 PMCID: PMC10574054 DOI: 10.3390/nu15194155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
The Paleo diet (PD) involves a restriction of carbohydrates and increased fat content (35% energy from carbohydrates, 35% energy from fats and 30% energy from protein). The aim of this study was to examine the effect of the PD on body composition, concentration of carbohydrates and lipids, as well as insulin, irisin, adiponectin and leptin in the blood. A total of 25 handball players were assigned to two groups: 14 in the experimental group (PD) and 11 in the control group (CD), using a PD and a rational diet, respectively. Analysis of body mass and body composition (body mass index, fat mass, lean body mass, fat-free mass, muscle mass, bone mineral content and bone mineral density), as well as blood concentration of metabolism markers (glucose, insulin, total cholesterol, HDL-cholesterol, non-HDL-cholesterol, LDL-cholesterol, triglycerides, free fatty acids, β-hydroxybutyrate, irisin, adiponectin and leptin), were determined at the beginning and after 4 and 8 weeks of nutritional intervention. Body mass was lower (p < 0.01), and adiponectin blood concentration was higher (p = 0.03) in the PD group at the end of the intervention. There were no changes (p ≥ 0.05) in body composition and blood levels of other biochemical markers in either group.
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Affiliation(s)
- Aleksandra Pięta
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (B.F.); (P.M.-K.)
| | - Barbara Frączek
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (B.F.); (P.M.-K.)
| | - Magdalena Wiecek
- Department of Physiology and Biochemistry, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland;
| | - Paulina Mazur-Kurach
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (B.F.); (P.M.-K.)
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Konner M, Eaton SB. Hunter-gatherer diets and activity as a model for health promotion: Challenges, responses, and confirmations. Evol Anthropol 2023; 32:206-222. [PMID: 37417918 DOI: 10.1002/evan.21987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 07/27/2022] [Accepted: 04/17/2023] [Indexed: 07/08/2023]
Abstract
Beginning in 1985, we and others presented estimates of hunter-gatherer (and ultimately ancestral) diet and physical activity, hoping to provide a model for health promotion. The Hunter-Gatherer Model was designed to offset the apparent mismatch between our genes and the current Western-type lifestyle, a mismatch that arguably affects prevalence of many chronic degenerative diseases. The effort has always been controversial and subject to both scientific and popular critiques. The present article (1) addresses eight such challenges, presenting for each how the model has been modified in response, or how the criticism can be rebutted; (2) reviews new epidemiological and experimental evidence (including especially randomized controlled clinical trials); and (3) shows how official recommendations put forth by governments and health authorities have converged toward the model. Such convergence suggests that evolutionary anthropology can make significant contributions to human health.
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Affiliation(s)
- Melvin Konner
- Department of Anthropology, Program in Anthropology and Human Biology, Emory University, Atlanta, Georgia, USA
| | - S Boyd Eaton
- Department of Radiology, Emory University School of Medicine (Emeritus), Adjunct Lecturer, Department of Anthropology, Emory University, Atlanta, Georgia, USA
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Sandhu SA, Angel CA, Campbell KL, Hickman IJ, MacLaughlin HL. Standardised Outcome Reporting for the Nutrition Management of Complex Chronic Disease: A Rapid Review. Nutrients 2021; 13:3388. [PMID: 34684389 PMCID: PMC8538850 DOI: 10.3390/nu13103388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/05/2022] Open
Abstract
Individuals with coexisting chronic diseases or with complex chronic disease are among the most challenging and costly patients to treat, placing a growing demand on healthcare systems. Recommending effective treatments, including nutrition interventions, relies on standardised outcome reporting from randomised controlled trials (RCTs) to enable data synthesis. This rapid review sought to determine how the scope and consistency of the outcomes reported by RCTs investigating nutrition interventions for the management of complex chronic disease compared to what is recommended by the core outcome sets (COS) for individual disease states. Peer-reviewed RCTs published between January 2010 and July 2020 were systematically sourced from PubMed, CINAHL and Embase, and COS were sourced from the International Consortium for Health Outcomes Measurements (ICHOM) and the Core Outcome Measures in Effectiveness Trials (COMET) database. A total of 45 RCTs (43 studies) and 7 COS were identified. Outcomes were extracted from both the RCTs and COS and were organised using COMET Taxonomy Core Areas. A total of 66 outcomes and 439 outcome measures were reported by the RCTs. The RCTs demonstrated extensive outcome heterogeneity, with only five outcomes (5/66, 8%) being reported with relative consistency (cited by ≥50% of publications). Furthermore, the scope of the outcomes reported by studies was limited, with a notable paucity of patient-reported outcomes. Poor agreement (25%) was observed between the outcomes reported in the RCTs and those recommended by the COS. This review urges greater uptake of the existing COS and the development of a COS for complex chronic disease to be considered so that evidence can be better synthesised regarding effective nutrition interventions.
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Affiliation(s)
- Savita A Sandhu
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
| | - Chloe A Angel
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
| | - Katrina L Campbell
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane 4029, Australia;
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane 4102, Australia;
- Faculty of Medicine, University of Queensland, Brisbane 4006, Australia
| | - Helen L MacLaughlin
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
- Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
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Sukkar SG, Muscaritoli M. A Clinical Perspective of Low Carbohydrate Ketogenic Diets: A Narrative Review. Front Nutr 2021; 8:642628. [PMID: 34322508 PMCID: PMC8310928 DOI: 10.3389/fnut.2021.642628] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/28/2021] [Indexed: 01/23/2023] Open
Abstract
Low carbohydrates diets (LCDs), which provide 20–120 g of carbohydrates per day, have long been used as therapeutic options in the treatment of severe obesity, type 2 diabetes mellitus and other morbid conditions, with good results in terms of weight loss and control of the main metabolic parameters, at least in the short and medium term. According to the caloric content and the macronutrient composition, we can classify LCDs in hypocaloric, normoproteic diets [such as the Very Low-Calorie Ketogenic Diet (VLCKD) or the protein-sparing modified fasting (PSMF)], hypocaloric, hyperproteic and hyperlipidic diets (e.g., Atkins, Paleo diets…) and normocaloric, normo-/hyperproteic diets (eucaloric KD), the latter mainly used in patients with brain tumors (gliomas) and refractory epilepsy. In addition to LCD diets, another interesting dietary approach which gained attention in the last few decades is fasting and its beneficial effects in terms of modulation of metabolic pathways, cellular processes and hormonal secretions. Due to the impossibility of using fasting regimens for long periods of time, several alternative strategies have been proposed that can mimic the effects, including calorie restriction, intermittent or alternating fasting, and the so-called fasting mimicking diets (FMDs). Recent preclinical studies have shown positive effects of FMDs in various experimental models of tumors, diabetes, Alzheimer Disease, and other morbid conditions, but to date, the scientific evidence in humans is limited to some opens studies and case reports. The purpose of our narrative review is to offer an overview of the characteristics of the main dietary regimens applied in the treatment of different clinical conditions as well as of the scientific evidence that justifies their use, focusing on low and zero-carb diets and on the different types of fasting.
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Affiliation(s)
- Samir Giuseppe Sukkar
- Unità Operativa Dipartimentale Dietetica e Nutrizione Clinica, Dipartimento Medicina Interna, Policlinico San Martino di Genova Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia e la Neurologia, Genova, Italy
| | - Maurizio Muscaritoli
- Unità Operativa Complessa di Medicina Interna e Nutrizione Clinica, Dipartimento ad Attività Integrata di Medicina Interna Scienze Endocrino-Metaboliche e Malattie Infettive, Azienda Ospedaliera Universitaria Policlinico Umberto I, Rome, Italy
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Klement RJ, Koebrunner PS, Krage K, Weigel MM, Sweeney RA. Short-term effects of a Paleolithic lifestyle intervention in breast cancer patients undergoing radiotherapy: a pilot and feasibility study. Med Oncol 2020; 38:1. [PMID: 33247817 DOI: 10.1007/s12032-020-01443-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/14/2020] [Indexed: 12/24/2022]
Abstract
Evolutionary principles are rarely considered in clinical oncology. We here aimed to test the feasibility and effects of a dietary and physical activity intervention based on evolutionary considerations in an oncological setting. A total of 13 breast cancer patients referred to our clinic for curative radiotherapy were recruited for this pilot study. The women were supposed to undertake a "Paleolithic lifestyle" (PL) intervention consisting of a Paleolithic diet and daily outdoor activity of at least 30 min duration while undergoing radiotherapy. Body composition was measured weekly by bioimpedance analysis. Blood parameters were assessed before, during, and at the end of radiotherapy. A control group on an unspecified standard diet (SD) was assigned by propensity score matching. A total of eleven patients completed the study. The majority of patients (64%) reported feeling good or very good during the intervention. The intervention group experienced an average decrease of 0.4 kg body weight (p < 0.001) and 0.34 kg (p < 0.001) fat mass per week, but fat-free and skeletal muscle mass were not significantly affected. Vitamin D levels increased slightly from 23.8 (11-37.3) ng/ml to 25.1 (22.6-41.6) ng/ml (p = 0.053). β-hydroxybutyrate levels were significantly increased and triglycerides and free T3 hormone levels significantly reduced by the PL intervention. This pilot study shows that adoption of a PL intervention during curative radiotherapy of breast cancer patients is feasible and able to reduce fat mass. Daily outdoor activity could eliminate vitamin D deficiency (vitamin D < 20 ng/ml). Future studies are needed to confirm these findings.
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Affiliation(s)
- Rainer J Klement
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany.
| | - Petra S Koebrunner
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany
| | - Kelley Krage
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany
| | - Michael M Weigel
- Department of Obstetrics and Gynaecology, Leopoldina Hospital, Schweinfurt, Germany.,Breast Cancer Centre, Leopoldina Hospital, Schweinfurt, Germany
| | - Reinhart A Sweeney
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany.,Breast Cancer Centre, Leopoldina Hospital, Schweinfurt, Germany
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Abstract
The satiating efficiency of food has been increasingly quantified using the Satiety Quotient (SQ). The SQ integrates both the energy content of food ingested during a meal and the associated change in appetite sensations. This systematic review examines the available evidence regarding its methodological use and clinical utility. A literature search was conducted in six databases considering studies from 1900 to April 2020 that used SQ in adults, adolescents and children. All study designs were included. From the initial 495 references found, fifty-two were included. Of the studies included, thirty-three were acute studies (twenty-nine in adults and four in adolescents) and nineteen were longitudinal studies in adults. A high methodological heterogeneity in the application of the SQ was observed between studies. Five main utilisations of the SQ were identified: its association with (i) energy intake; (ii) anthropometric variables; (iii) energy expenditure/physical activity; (iv) sleep quality and quantity and (v) to classify individuals by their satiety responsiveness (i.e. low and high satiety phenotypes). Altogether, the studies suggest the SQ as an interesting clinical tool regarding the satiety responsiveness to a meal and its changes in responses to weight loss in adults. The SQ might be a reliable clinical indicator in adults when it comes to both obesity prevention and treatment. There is a need for more standardised use of the SQ in addition to further studies to investigate its validity in different contexts and populations, especially among children and adolescents.
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Parente NDA, Sampaio HADC, Carioca AAF, Brito FO. The effects of the Paleolithic Diet on obesity anthropometric measurements. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2020. [DOI: 10.1590/1980-0037.2020v22e69957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Comparing the effects of Paleolithic Diet (PD) and of a Guidelines Substantiated Diet (GSD) on anthropometric indicators of obese individuals. Randomized clinical trial. Obese patients were divided into two groups based on dietary prescription: PD and GSD. These diets encompassed 82 and 73 patients, respectively, who were followed-up for 60 days. Anthropometric measurements were taken before the beginning of the trial, at the 30th day of it and at the end of the experimental period. At the 60th experimental day, there was 26.8% treatment abandonment by individuals in group PD and 19.2% by the ones in group GSD; there was not difference between groups (p = 0.684). Weight and height measurements were taken in order to determine body mass index (BMI), waist circumference (WC) and hip circumference (HC), which allowed determining the waist/hip ratio (WHR). There was no initial difference between groups in demographic, socioeconomic, exercising and anthropometric variables (p > 0.05). Group PD recorded the highest weight (p = 0.003), BMI (p = 0.002) and WC (p = 0.033) values at the 30th experimental day. Group PD kept the highest weight loss at the 60th day (p < 0,001), as well as the highest BMI (p < 0.001), WC (p = 0.002) and WHR (p = 0.002) reduction. PD is a feasible option to treat obesity, it led to reduced anthropometric markers. Other studies are necessary to assure the safety of its use for longer periods of time.
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11
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Gupta L, Khandelwal D, Lal PR, Kalra S, Dutta D. Palaeolithic Diet in Diabesity and Endocrinopathies - A Vegan's Perspective. EUROPEAN ENDOCRINOLOGY 2019; 15:77-82. [PMID: 31616497 PMCID: PMC6785956 DOI: 10.17925/ee.2019.15.2.77] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/15/2019] [Indexed: 12/17/2022]
Abstract
Introduction: The Palaeolithic diet is designed to resemble that of human hunter-gatherer ancestors thousands to millions of years ago. This review summarises the evidence and clinical application of this diet in various disorders. An empiric vegan variant of it has been provided, keeping in mind vegan food habits. Review of the literature: different types of Palaeolithic diets in vogue include the 80/20, the autoimmune, the lacto, the Palaeolithic vegan and the Palaeolithic ketogenic. We have developed an Indian variant of the Palaeolithic vegan diet, which excludes all animal-based foods. The Palaeolithic diet typically has low carbohydrate and lean protein of 30–35% daily caloric intake in addition to a fibre diet from non-cereal, plant-based sources, up to 45–100 g daily. In different observational studies, beneficial effects on metabolic syndrome, blood pressure, glucose tolerance, insulin secretion, lipid profiles and cardiovascular risk factors have been documented with the Palaeolithic diet. Short-term randomised controlled trials have documented weight loss, and improved glycaemia and adipo-cytokine profiles. Few concerns of micronutrient deficiency (e.g. calcium) have been raised. Conclusion: Initial data are encouraging with regard to the use of the Palaeolithic diet in managing diabesity. There is an urgent need for large randomised controlled trials to evaluate the role of the Palaeolithic diet with different anti-diabetes medications for glycaemic control and the reversal of type 2 diabetes.
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Affiliation(s)
- Lovely Gupta
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | - Deepak Khandelwal
- Department of Endocrinology, Maharaja Agrasen Hospital, New Delhi, India
| | - Priti Rishi Lal
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and Bharti Research Institute of Diabetes and Endocrinology, Karnal, Haryana, India
| | - Deep Dutta
- Department of Endocrinology, CEDAR Super-specialty Clinics New Delhi, India
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Abstract
PURPOSE OF REVIEW Obesity continues to be a growing concern globally due to association with a number of comorbidities and contributing significantly to increase in health care expenditures. Despite availability of a number of treatment modalities, lifestyle modification with dietary modification and exercise continues to be the foundation. However, the standard model of lifestyle modification is not efficacious or sustainable for many patients leading them to seek alternative approaches. We conducted a comprehensive literature review to present the data regarding efficacy and sustainability of many common dietary approaches. RECENT FINDINGS Building upon previous work, recent randomized controlled trials have compared many popular diets head to head in varying patient populations. Along with the weight changes, studies have investigated the changes in metabolic parameters, inflammatory markers, and cardiac risk factor reduction. Though the studies do not show superiority of one diet compared to the other, the preventive benefits and other favorable metabolic changes of the diets make them worthy of consideration.
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Markofski MM, Jennings K, Dolan C, Davies NA, LaVoy EC, Ryan EJ, Carrillo AE. Single-Arm 8-Week Ad Libitum Self-Prepared Paleo Diet Reduces Cardiometabolic Disease Risk Factors in Overweight Adults. Am J Lifestyle Med 2019; 15:690-700. [PMID: 34916890 DOI: 10.1177/1559827619866157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The paleo diet is popular among the general population due to promoted weight loss and disease prevention benefits. We examined the effectiveness of a self-administered paleo diet in improving cardiometabolic disease risk factors. Overweight, physically inactive but otherwise healthy adults (males = 4, females = 3, age 32.7 ± 4.9 years, body mass index [BMI] 29.4 ± 2.4 kg/m2) habitually eating a traditional Western diet (1853.4 ± 441.2 kcal; 34.0% carbohydrate; 41.4% fat; 19.2% protein) completed an ad libitum self-administered paleo diet for 8 weeks. Height, weight, blood pressure, and a fasting blood sample were collected pre- and post-paleo dietary intervention. Blood samples were analyzed for fasting cardiometabolic disease biomarkers-including brain-derived neurotropic factor (BDNF), fibroblast growth factor (FGF) 21, and leptin. After 8 weeks, body mass (-5.3 kg, P = .008), BMI (-1.7 kg/m2, P = .002), serum leptin (-56.2%, P = .012), serum FGF21 (-26.7%, P = .002), and serum BDNF (-25.8%, P = .045) significantly decreased. Systolic and diastolic blood pressure were unchanged following the paleo dietary intervention (P > .05). Average energy intake (-412.6 kcal, P = .016) significantly decreased with the paleo dietary intervention mostly due to a reduction in carbohydrate consumption (-69.2 g; P = .003). An 8-week self-administered paleo dietary intervention was effective in improving cardiometabolic disease risk factors in a healthy, physically inactive overweight adult population.
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Affiliation(s)
- Melissa M Markofski
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Kristofer Jennings
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Chad Dolan
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Natalie A Davies
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Emily C LaVoy
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Edward J Ryan
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
| | - Andres E Carrillo
- Laboratory of Integrative Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas (MMM, CD, ECL).,Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas (KJ).,Department of Exercise Science, Chatham University, Pittsburgh, Pennsylvania (NAD, EJR, AEC).,FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece (AEC)
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14
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de Menezes EVA, Sampaio HADC, Carioca AAF, Parente NA, Brito FO, Moreira TMM, de Souza ACC, Arruda SPM. Influence of Paleolithic diet on anthropometric markers in chronic diseases: systematic review and meta-analysis. Nutr J 2019; 18:41. [PMID: 31337389 PMCID: PMC6647066 DOI: 10.1186/s12937-019-0457-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 06/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Paleolithic diet has been studied in the scope of prevention and control of chronic noncommunicable diseases (CNCD). The objective of this study was to analyze the influence of the Paleolithic diet on the prevention and control of CNCD in humans, specifically on anthropometric markers, through a systematic review with meta-analysis. METHODS What is the effect of the Paleolithic diet on anthropometric parameters (weight, body mass index and waist circumference) compared to other control diets based on recommendations in adults? We included only randomized studies with humans that used the Paleolithic Diet in the prevention and control of CNCD published in Portuguese, English or Spanish. The search period was until March 2019, in the LILACS, PubMed, Scielo, Science Direct, Medline, Web of Science and Scopus databases. The abstracts were evaluated by two researchers. We found 1224 articles, of which 24 were selected and 11 were included in the meta-analysis. The effect of dietary use on body weight, body mass index and waist circumference was evaluated. RESULTS The summary of the effect showed a loss of - 3.52 kg in the mean weight (CI 95%: - 5.26; - 1.79; p < 0,001; I2 = 24%) of people who adopted the Paleolithic diet compared to diets based on recommendations. The analysis showed a positive association of adopting the Paleolithic diet in relation to weight loss. The effect was significant on weight, body mass index and waist circumference. CONCLUSION The Paleolithic diet may assist in controlling weight and waist circumference and in the management of chronic diseases. However, more randomized clinical studies with larger populations and duration are necessary to prove health benefits. TRIAL REGISTRATION CRD42015027849 .
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Affiliation(s)
- Ehrika Vanessa Almeida de Menezes
- Postgraduate Program in Colletive Health, Universidade Estadual do Ceará (UECE), Fortaleza, Brazil.,Nutrition course, Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil
| | | | - Antônio Augusto Ferreira Carioca
- Nutrition course, Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil.,Nutrition in Public Health, Faculdade Saúde Pública, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Nara Andrade Parente
- Postgraduate Program in Colletive Health, Universidade Estadual do Ceará (UECE), Fortaleza, Brazil. .,Nutrition course, Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil.
| | - Filipe Oliveira Brito
- Postgraduate Program in Colletive Health, Universidade Estadual do Ceará (UECE), Fortaleza, Brazil.,Nutrition course, Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil
| | - Thereza Maria Magalhães Moreira
- Postgraduate Program in Colletive Health, Universidade Estadual do Ceará (UECE), Fortaleza, Brazil.,Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ana Célia Caetano de Souza
- Clinical Care in Health, Universidade Federal do Ceará (UFC), Fortaleza, Brazil.,Nucleus of Research and Development of Medications, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Soraia Pinheiro Machado Arruda
- Collective Health, Universidade Federal do Maranhão, São Luís, Brazil.,Postgraduate Program in Collective Health and Academic Master's in Nutrition and Health, Universidade Estadual do Ceará, Fortaleza, Brazil
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15
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Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition 2019; 69:110549. [PMID: 31525701 DOI: 10.1016/j.nut.2019.07.001] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
New dietary strategies have been created to treat overweight and obesity and have become popular and widely adopted. Nonetheless, they are mainly based on personal impressions and reports published in books and magazines, rather than on scientific evidence. Animal models and human clinical trials have been employed to study changes in body composition and metabolic outcomes to determine the most effective diet. However, the studies present many limitations and should be carefully analyzed. The aim of this review was to discuss the scientific evidence of three categories of diets for weight loss. There is no one most effective diet to promote weight loss. In the short term, high-protein, low-carbohydrate diets and intermittent fasting are suggested to promote greater weight loss and could be adopted as a jumpstart. However, owing to adverse effects, caution is required. In the long term, current evidence indicates that different diets promoted similar weight loss and adherence to diets will predict their success. Finally, it is fundamental to adopt a diet that creates a negative energy balance and focuses on good food quality to promote health.
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16
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Ghaedi E, Mohammadi M, Mohammadi H, Ramezani-Jolfaie N, Malekzadeh J, Hosseinzadeh M, Salehi-Abargouei A. Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2019; 10:634-646. [PMID: 31041449 PMCID: PMC6628854 DOI: 10.1093/advances/nmz007] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/28/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022] Open
Abstract
There is some evidence supporting the beneficial effects of a Paleolithic Diet (PD) on cardiovascular disease risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on cardiovascular disease risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August, 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = -2.17 kg; 95% CI: -3.48, -0.87 kg], waist circumference (WMD = -2.90 cm; 95% CI: -4.51, -1.28 cm), body mass index (in kg/m2) (WMD = -1.15; 95% CI: -1.68, -0.62), body fat percentage (WMD = -1.38%; 95% CI: -2.08%, -0.67%), systolic (WMD = -4.24 mm Hg; 95% CI: -7.11, -1.38 mm Hg) and diastolic (WMD = -2.95 mm Hg; 95% CI: -4.72, -1.18 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = -0.22 mg/dL; 95% CI: -0.42, -0.03 mg/dL), TGs (WMD = -0.23 mg/dL; 95% CI: -0.46, -0.01 mg/dL), LDL cholesterol (WMD = -0.13 mg/dL; 95% CI: -0.25, -0.01 mg/dL), and C-reactive protein (CRP) (WMD = -0.41 mg/L; 95% CI: -0.81, -0.008 mg/L) and also significantly increased HDL cholesterol (WMD = 0.05 mg/dL; 95% CI: 0.005, 0.10 mg/dL). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, blood pressure, and circulating CRP concentrations were significantly influenced by removing some studies, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on cardiovascular disease risk factors, the evidence is not conclusive and more well-designed trials are still needed.
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Affiliation(s)
- Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamed Mohammadi
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Janmohamad Malekzadeh
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Address correspondence to MH (e-mail: )
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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17
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Assessing compliance with Paleolithic diet by calculating Paleolithic Diet Fraction as the fraction of intake from Paleolithic food groups. CLINICAL NUTRITION EXPERIMENTAL 2019. [DOI: 10.1016/j.yclnex.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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18
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Chenard CA, Rubenstein LM, Snetselaar LG, Wahls TL. Nutrient Composition Comparison between a Modified Paleolithic Diet for Multiple Sclerosis and the Recommended Healthy U.S.-Style Eating Pattern. Nutrients 2019; 11:E537. [PMID: 30832289 PMCID: PMC6470485 DOI: 10.3390/nu11030537] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/17/2019] [Accepted: 02/20/2019] [Indexed: 01/04/2023] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disease that attacks the central nervous system. Evidence-based dietary guidelines do not exist for MS; the default advice is to follow the Dietary Guidelines for Americans (DGA). A modified Paleolithic Wahls Elimination (WahlsElim) diet promoted for MS excludes grains and dairy and encourages 9+ cups fruits and vegetables (F/V) and saturated fat for cooking. This study evaluated the nutritional adequacy of seven-day menus and modeled them with varying amounts of F/V for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for ages 31⁻50 years. WahlsElim menus had low added sugar and glycemic index. Nutritional adequacy of the menus and modeled versions were similar to HEP for 17 vitamins and minerals (mean adequacy ratio ≥92%). Nutrient shortfalls for the modeled diet with 60% F/V were identical to HEP for vitamin D, iron (females), magnesium (marginally males), choline and potassium; this modeled diet was also low in dietary fiber and calcium but met vitamin E requirements while HEP did not. WahlsElim-prescribed supplements corrected vitamin D and magnesium shortfalls; careful selection of foods are needed to meet requirements of other shortfall nutrients and reduce saturated fat and sodium. Doctors should monitor nutritional status, supplement doses, and possible contraindications to high vitamin K intake in individuals following the WahlsElim diet.
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Affiliation(s)
- Catherine A Chenard
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Linda M Rubenstein
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
| | - Terry L Wahls
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
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19
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Wahls TL, Chenard CA, Snetselaar LG. Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic. Nutrients 2019; 11:E352. [PMID: 30736445 PMCID: PMC6412750 DOI: 10.3390/nu11020352] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 02/06/2023] Open
Abstract
The precise etiology of multiple sclerosis (MS) is unknown but epidemiologic evidence suggests this immune-mediated, neurodegenerative condition is the result of a complex interaction between genes and lifetime environmental exposures. Diet choices are modifiable environmental factors that may influence MS disease activity. Two diets promoted for MS, low saturated fat Swank and modified Paleolithic Wahls Elimination (WahlsElim), are currently being investigated for their effect on MS-related fatigue and quality of life (NCT02914964). Dr. Swank theorized restriction of saturated fat would reduce vascular dysfunction in the central nervous system (CNS). Dr. Wahls initially theorized that detailed guidance to increase intake of specific foodstuffs would facilitate increased intake of nutrients key to neuronal health (Wahls™ diet). Dr. Wahls further theorized restriction of lectins would reduce intestinal permeability and CNS inflammation (WahlsElim version). The purpose of this paper is to review the published research of the low saturated fat (Swank) and the modified Paleolithic (Wahls™) diets and the rationale for the structure of the Swank diet and low lectin version of the Wahls™ diet (WahlsElim) being investigated in the clinical trial.
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Affiliation(s)
- Terry L Wahls
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Catherine A Chenard
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
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20
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Olivieri C. Combating insulin resistance with the paleo diet. Nurse Pract 2019; 44:49-55. [PMID: 30672867 DOI: 10.1097/01.npr.0000552683.55684.f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Lifestyle changes that include adopting a healthy diet, such as the paleo diet, can help prevent prediabetes and T2DM. This article explores the potential benefits of replacing low-calorie diets with the paleo diet. As primary care providers, NPs are positioned to help inform patients, particularly those with prediabetes and T2DM, about healthy lifestyle choices and provide them with resources to achieve weight loss success.
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Affiliation(s)
- Chrystyne Olivieri
- Chrystyne Olivieri is an assistant professor of graduate nursing at Long Island University, Brookville, N.Y
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21
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A Paleolithic diet lowers resistant starch intake but does not affect serum trimethylamine-N-oxide concentrations in healthy women. Br J Nutr 2018; 121:322-329. [PMID: 30419974 PMCID: PMC6390390 DOI: 10.1017/s000711451800329x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The Paleolithic diet excludes two major sources of fibre, grains and legumes. However, it is not known whether this results in changes to resistant starch (RS) consumption. Serum trimethylamine-N-oxide (TMAO) is produced mainly from colonic fermentation and hepatic conversion of animal protein and is implicated in CVD, but changes in RS intake may alter concentrations. We aimed to determine whether intake of RS and serum concentrations of TMAO varied in response to either the Paleolithic or the Australian Guide to Healthy Eating (AGHE) diets and whether this was related to changes in food group consumption. A total of thirty-nine women (mean age 47 (sd 13) years, BMI 27 (sd 4) kg/m2) were randomised to AGHE (n 17) or Paleolithic diets (n 22) for 4 weeks. Serum TMAO concentrations were measured using liquid chromatography–MS; food groups, fibre and RS intake were estimated from weighed food records. The change in TMAO concentrations between groups (Paleolithic 3·39 μmv. AGHE 1·19 μm, P = 0·654) did not reach significance despite greater red meat and egg consumption in the Paleolithic group (0·65 serves/d; 95 % CI 0·2, 1·1; P <0·01, and 0·22 serves/d; 95 % CI 0·1, 0·4, P <0·05, respectively). RS intake was significantly lower on the Paleolithic diet (P <0·01) and was not associated with TMAO concentrations. However, the limited data for RS and the small sample size may have influenced these findings. While there were no significant changes in TMAO concentrations, increased meat consumption and reduced RS intake warrant further research to examine the markers of gastrointestinal health of Paleolithic diet followers and to update Australian food databases to include additional fibre components.
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22
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POPP COLLINJ, BOHAN BROWN MICHELLEM, BRIDGES WILLIAMC, JESCH ELLIOTD. The Effectiveness of MyPlate and Paleolithic-based Diet Recommendations, both with and without Exercise, on Aerobic Fitness, Muscular Strength and Anaerobic Power in Young Women: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2018; 11:921-933. [PMID: 30338015 PMCID: PMC6179430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of recommending a MyPlate or a Paleolithic-based diet, both with and without exercise, on aerobic fitness, strength, and anaerobic power over eight weeks. Participants (n=20) were randomized to one of four groups, (1) a MyPlate diet (MP), (2) Paleolithic-based diet (PD), (3) MyPlate and exercise (MP + Ex), and (4) Paleolithic-based diet and exercise (PD + Ex). The exercise included two days of unsupervised aerobic and resistance exercise. At baseline and final, absolute and relative peak oxygen consumption (absVO2peak and relVO2peak), anaerobic power, and upper and lower body strength were determined. Data were analyzed using repeated measures two-way analysis of variance (ANOVA). The ANOVA indicated that there was no significant interaction between time point (TP)*diet (D)*exercise (Ex) for all variables except relVO2peak (p = 0.016). The MP + Ex group (Δ+4.4 ml·kg-1·min-1) had a greater change from baseline compared to the MP group (Δ-2.7 ml·kg-1·min-1, p = 0.002), and PD + Ex group (Δ-0.3 ml·kg-1·min-1, p = 0.03). The results suggest recommending a MyPlate diet with both aerobic and resistance training are effective at improving aerobic fitness when compared to PD recommendations with exercise, although these conclusions may be confounded by low compliance to exercise recommendations.
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Affiliation(s)
- COLLIN J. POPP
- Department of Population Health, New York University, New York, NY, USA
| | | | - WILLIAM C. BRIDGES
- Department of Mathematical Sciences, Clemson University, Clemson, SC, USA
| | - ELLIOT D. JESCH
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
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Courie R, Gaillard M, Lainas P, Hansel B, Naveau S, Dagher I, Tranchart H. Weight outcome after 2 years of a diet that excludes six processed foods: exploratory study of the "1,2,3 diet" in a moderately obese population. Diabetes Metab Syndr Obes 2018; 11:345-355. [PMID: 30034246 PMCID: PMC6047626 DOI: 10.2147/dmso.s165598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The Paleolithic diet, a diet devoid of food-processing procedure, seems to produce a greater decrease in weight compared to healthy reference diets but its limited food choices make it difficult to implement in our modern times where refined food is dominant. OBJECTIVE To evaluate the effects of a 2-year diet that excludes only six refined foodstuffs implicated in obesity. Professional contact was kept minimal to approximate the approach used by most dieters. DESIGN Single-arm, open-label, exploratory study. SETTING One academic medical center, outpatient setting. PATIENTS One hundred and five subjects with a mean age of 50 (SD, 14 years) and mean body mass index of 30.5 kg/m2 (SD, 4 kg/m2). Thirty-nine percent had type 2 diabetes. INTERVENTION An ad libitum diet that excludes six refined foodstuffs (margarine, vegetable oils, butter, cream, processed meat, and sugary drinks) called the "1,2,3 diet". OUTCOMES Weight at 2 years was the primary outcome. Secondary outcomes included number of patients who lost more than 5% of initial body weight, glycated hemoglobin (HbA1c) level, and changes in dietary behavior. RESULTS Average weight loss was 4.8 kg (p<0.001), representing 5.6% of their initial body weight. Among completers (51%), the average weight loss was 5.5 kg (p<0.001), and 56% had a reduction of at least 5% of their initial body weight. Among diabetics, weight loss was similar to nondiabetics, and mean HbA1c level decreased by 1% (p=0.001) without modification in glucose-lowering medications. A higher intake of bread, dairy products, chocolate, and fresh fruits was the typical trend in dietary changes reported by completers. CONCLUSION In this exploratory study, there was a significant long-term weight loss with the "1,2,3 diet" despite minimal professional contact. Given the lack of a control group and high attrition rate, further evaluation of this diet is warranted.
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Affiliation(s)
- Rodi Courie
- Department of Hepato-Gastroenterology and Nutrition, Antoine Béclère Hospital (AP-HP), Clamart, France,
| | - Martin Gaillard
- Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital (AP-HP), Clamart, France
- Paris-Saclay University, INSERM U1193, Orsay, France
| | - Panagiotis Lainas
- Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital (AP-HP), Clamart, France
- Paris-Saclay University, INSERM U1193, Orsay, France
| | - Boris Hansel
- Department of Hepato-Gastroenterology and Nutrition, Antoine Béclère Hospital (AP-HP), Clamart, France,
| | - Sylvie Naveau
- Department of Hepato-Gastroenterology and Nutrition, Antoine Béclère Hospital (AP-HP), Clamart, France,
- Paris-Saclay University, INSERM U1193, Orsay, France
| | - Ibrahim Dagher
- Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital (AP-HP), Clamart, France
- Paris-Saclay University, INSERM U1193, Orsay, France
| | - Hadrien Tranchart
- Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital (AP-HP), Clamart, France
- Paris-Saclay University, INSERM U1193, Orsay, France
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Subhan FB, Chan CB. Review of Dietary Practices of the 21st Century: Facts and Fallacies. Can J Diabetes 2017; 40:348-54. [PMID: 27497150 DOI: 10.1016/j.jcjd.2016.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 04/11/2016] [Accepted: 05/09/2016] [Indexed: 01/15/2023]
Abstract
The prevalence of chronic metabolic diseases, such as diabetes, cardiovascular diseases and cancer, is increasing around the world. Nutritional interventions can reduce the prevalence and provide effective treatment, even when weight loss is not dramatic. The 2013 Canadian Diabetes Association Clinical Practice Guidelines concluded that certain dietary patterns and popular weight-loss diets had sufficient evidence to suggest their use by individuals with diabetes, but many other diet patterns and diets exist. Our specific objectives were to review the nutritional quality of various dietary patterns and diets, with emphasis on the evidence that they are efficacious for weight loss, glycemic control and cardiovascular risk factors.
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Affiliation(s)
- Fatheema B Subhan
- Department of Agricultural, Food and Nutritional Sciences (Division of Human Nutrition), University of Alberta, Edmonton, Alberta, Canada
| | - Catherine B Chan
- Department of Agricultural, Food and Nutritional Sciences (Division of Human Nutrition), University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.
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Otten J, Stomby A, Waling M, Isaksson A, Tellström A, Lundin-Olsson L, Brage S, Ryberg M, Svensson M, Olsson T. Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes. Diabetes Metab Res Rev 2017; 33:10.1002/dmrr.2828. [PMID: 27235022 PMCID: PMC5402870 DOI: 10.1002/dmrr.2828] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 05/06/2016] [Accepted: 05/10/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Means to reduce future risk for cardiovascular disease in subjects with type 2 diabetes are urgently needed. METHODS Thirty-two patients with type 2 diabetes (age 59 ± 8 years) followed a Paleolithic diet for 12 weeks. Participants were randomized to either standard care exercise recommendations (PD) or 1-h supervised exercise sessions (aerobic exercise and resistance training) three times per week (PD-EX). RESULTS For the within group analyses, fat mass decreased by 5.7 kg (IQR: -6.6, -4.1; p < 0.001) in the PD group and by 6.7 kg (-8.2, -5.3; p < 0.001) in the PD-EX group. Insulin sensitivity (HOMA-IR) improved by 45% in the PD (p < 0.001) and PD-EX (p < 0.001) groups. HbA1c decreased by 0.9% (-1.2, -0.6; p < 0.001) in the PD group and 1.1% (-1.7, -0.7; p < 0.01) in the PD-EX group. Leptin decreased by 62% (p < 0.001) in the PD group and 42% (p < 0.001) in the PD-EX group. Maximum oxygen uptake increased by 0.2 L/min (0.0, 0.3) in the PD-EX group, and remained unchanged in the PD group (p < 0.01 for the difference between intervention groups). Male participants decreased lean mass by 2.6 kg (-3.6, -1.3) in the PD group and by 1.2 kg (-1.3, 1.0) in the PD-EX group (p < 0.05 for the difference between intervention groups). CONCLUSIONS A Paleolithic diet improves fat mass and metabolic balance including insulin sensitivity, glycemic control, and leptin in subjects with type 2 diabetes. Supervised exercise training may not enhance the effects on these outcomes, but preserves lean mass in men and increases cardiovascular fitness. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Julia Otten
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Andreas Stomby
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Maria Waling
- Department of Food and Nutrition, Umeå University, Umeå, Sweden
| | - Andreas Isaksson
- Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, Umeå, Sweden
| | - Anna Tellström
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Lillemor Lundin-Olsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mats Ryberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Michael Svensson
- Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, Umeå, Sweden
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
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Hoffman R. Can the paleolithic diet meet the nutritional needs of older people? Maturitas 2016; 95:63-64. [PMID: 27666153 DOI: 10.1016/j.maturitas.2016.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Richard Hoffman
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, AL10 9AB, UK.
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Fontes-Villalba M, Lindeberg S, Granfeldt Y, Knop FK, Memon AA, Carrera-Bastos P, Picazo Ó, Chanrai M, Sunquist J, Sundquist K, Jönsson T. Palaeolithic diet decreases fasting plasma leptin concentrations more than a diabetes diet in patients with type 2 diabetes: a randomised cross-over trial. Cardiovasc Diabetol 2016; 15:80. [PMID: 27216013 PMCID: PMC4877952 DOI: 10.1186/s12933-016-0398-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/13/2016] [Indexed: 12/13/2022] Open
Abstract
Background We have previously shown that a Palaeolithic diet consisting of the typical food groups that our ancestors ate during the Palaeolithic era, improves cardiovascular disease risk factors and glucose control compared to the currently recommended diabetes diet in patients with type 2 diabetes. To elucidate the mechanisms behind these effects, we evaluated fasting plasma concentrations of glucagon, insulin, incretins, ghrelin, C-peptide and adipokines from the same study. Methods In a randomised, open-label, cross-over study, 13 patients with type 2 diabetes were randomly assigned to eat a Palaeolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, or a diabetes diet designed in accordance with current diabetes dietary guidelines during two consecutive 3-month periods. The patients were recruited from primary health-care units and included three women and 10 men [age (mean ± SD) 64 ± 6 years; BMI 30 ± 7 kg/m2; diabetes duration 8 ± 5 years; glycated haemoglobin 6.6 ± 0.6 % (57.3 ± 6 mmol/mol)] with unaltered diabetes treatment and stable body weight for 3 months prior to the start of the study. Outcome variables included fasting plasma concentrations of leptin, adiponectin, adipsin, visfatin, resistin, glucagon, insulin, C-peptide, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 and ghrelin. Dietary intake was evaluated by use of 4-day weighed food records. Results Seven participants started with the Palaeolithic diet and six with the diabetes diet. The Palaeolithic diet resulted in a large effect size (Cohen’s d = −1.26) at lowering fasting plasma leptin levels compared to the diabetes diet [mean difference (95 % CI), −2.3 (−5.1 to 0.4) ng/ml, p = 0.023]. No statistically significant differences between the diets for the other variables, analysed in this study, were observed. Conclusions Over a 3-month study period, a Palaeolithic diet resulted in reduced fasting plasma leptin levels, but did not change fasting levels of insulin, C-peptide, glucagon, incretins, ghrelin and adipokines compared to the currently recommended diabetes diet. Trial registration: ClinicalTrials.gov NCT00435240 Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0398-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maelán Fontes-Villalba
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden. .,, Calle José Betancort, 15, 35530, Teguise-Lanzarote, Spain.
| | - Staffan Lindeberg
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Yvonne Granfeldt
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Filip K Knop
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Ashfaque A Memon
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Pedro Carrera-Bastos
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Óscar Picazo
- NutriScience-Education and Consulting, Lda, Lisbon, Portugal
| | | | - Jan Sunquist
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Tommy Jönsson
- Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden
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Genoni A, Lyons-Wall P, Lo J, Devine A. Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial. Nutrients 2016; 8:E314. [PMID: 27223304 PMCID: PMC4882726 DOI: 10.3390/nu8050314] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023] Open
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.
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Affiliation(s)
- Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
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Abstract
Currently, there is widespread interest in many different diets. The best-known
diets include the New Atkins diet in the USA, the Dukan diet in France, and in
South Africa the Noakes diet. Two different approaches have emerged, one
focusing on a life-long healthy lifestyle and the other emphasising weight loss.
These are in fact complementary aims, as will be reviewed and reconciled.
Furthermore, besides the dietary approach, there is a valid case for added drug
therapy for selected lipid disorders with the use statins. In addition, new
drugs are emerging that in the future might eventually considerably reduce the
negative health impact of coronary artery disease.
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Affiliation(s)
- Lionel H Opie
- Hatter Institute for Cardiovascular Research in Africa, Groote Schuur Hospital and Medical School, University of Cape Town, Cape Town, South Africa.
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Pastore RL, Brooks JT, Carbone JW. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Nutr Res 2015; 35:474-9. [PMID: 26003334 DOI: 10.1016/j.nutres.2015.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/06/2015] [Accepted: 05/08/2015] [Indexed: 10/23/2022]
Abstract
Recent research suggests that traditional grain-based heart-healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol, HDL, LDL, and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male and 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months, followed by a Paleolithic diet for 4 months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated-measures analysis of variance. Four months of Paleolithic nutrition significantly lowered (P < .001) mean total cholesterol, LDL, and TG and increased (P < .001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart-healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations.
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Affiliation(s)
- Robert L Pastore
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI
| | - Judith T Brooks
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI
| | - John W Carbone
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI.
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Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Eur J Clin Nutr 2015; 69:944-8. [PMID: 25828624 DOI: 10.1038/ejcn.2015.39] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/18/2014] [Accepted: 12/08/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES The contemporary American diet figures centrally in the pathogenesis of numerous chronic diseases--'diseases of civilization'--such as obesity and diabetes. We investigated in type 2 diabetes whether a diet similar to that consumed by our pre-agricultural hunter-gatherer ancestors ('Paleolithic' type diet) confers health benefits. SUBJECTS/METHODS We performed an outpatient, metabolically controlled diet study in type 2 diabetes patients. We compared the findings in 14 participants consuming a Paleo diet comprising lean meat, fruits, vegetables and nuts, and excluding added salt, and non-Paleolithic-type foods comprising cereal grains, dairy or legumes, with 10 participants on a diet based on recommendations by the American Diabetes Association (ADA) containing moderate salt intake, low-fat dairy, whole grains and legumes. There were three ramp-up diets for 7 days, then 14 days of the test diet. Outcomes included the following: mean arterial blood pressure; 24-h urine electrolytes; hemoglobin A1c and fructosamine levels; insulin resistance by euglycemic hyperinsulinemic clamp and lipid levels. RESULTS Both groups had improvements in metabolic measures, but the Paleo diet group had greater benefits on glucose control and lipid profiles. Also, on the Paleo diet, the most insulin-resistant subjects had a significant improvement in insulin sensitivity (r = 0.40, P = 0.02), but no such effect was seen in the most insulin-resistant subjects on the ADA diet (r = 0.39, P = 0.3). CONCLUSIONS Even short-term consumption of a Paleolithic-type diet improved glucose control and lipid profiles in people with type 2 diabetes compared with a conventional diet containing moderate salt intake, low-fat dairy, whole grains and legumes.
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Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study. Br J Nutr 2015; 113:574-84. [PMID: 25661189 DOI: 10.1017/s0007114514004012] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
There is evidence for health benefits from 'Palaeolithic' diets; however, there are a few data on the acute effects of rationally designed Palaeolithic-type meals. In the present study, we used Palaeolithic diet principles to construct meals comprising readily available ingredients: fish and a variety of plants, selected to be rich in fibre and phyto-nutrients. We investigated the acute effects of two Palaeolithic-type meals (PAL 1 and PAL 2) and a reference meal based on WHO guidelines (REF), on blood glucose control, gut hormone responses and appetite regulation. Using a randomised cross-over trial design, healthy subjects were given three meals on separate occasions. PAL2 and REF were matched for energy, protein, fat and carbohydrates; PAL1 contained more protein and energy. Plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and peptide YY (PYY) concentrations were measured over a period of 180 min. Satiation was assessed using electronic visual analogue scale (EVAS) scores. GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 (P= 0·001 and P< 0·001) and PAL2 (P= 0·011 and P= 0·003) compared with the REF. Concomitant EVAS scores showed increased satiety. By contrast, GIP concentration was significantly suppressed. Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals. Consumption of meals based on Palaeolithic diet principles resulted in significant increases in incretin and anorectic gut hormones and increased perceived satiety. Surprisingly, this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity.
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Jönsson T, Memon AA, Sundquist K, Sundquist J, Olsson S, Nalla A, Bauer M, Linse S. Digested wheat gluten inhibits binding between leptin and its receptor. BMC BIOCHEMISTRY 2015; 16:3. [PMID: 25600821 PMCID: PMC4308898 DOI: 10.1186/s12858-015-0032-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/12/2015] [Indexed: 12/22/2022]
Abstract
Background Leptin resistance is considered a primary risk factor for obesity. It has been hypothesized that dietary cereal grain protein could cause leptin resistance by preventing leptin from binding to its receptor. Non-degraded dietary wheat protein has been found in human serum at a mean level of 41 ng/mL. Here, we report our findings from testing whether enzymatically digested gluten from wheat prevents leptin from binding to the leptin receptor in vitro. Gluten from wheat was digested with pepsin and trypsin under physiological conditions. Pepsin and trypsin activity was removed from the gluten digest with a 10 kDa spin-filter or by heat treatment at 100°C for 30 min. Binding to the leptin receptor of leptin mixed with gluten digest at a series of concentrations was measured using surface plasmon resonance technology. Results Binding of the gluten digest to the leptin receptor was not detected. Spin-filtered gluten digest inhibited binding of leptin to the leptin receptor, with 50% inhibition at a gluten digest concentration of ~10 ng/mL. Heat-treated gluten digest did not inhibit leptin binding. Conclusions Digested wheat gluten inhibits binding of leptin to the leptin receptor, with half-maximal inhibition at 10 ng/mL. The inhibition is significant at clinically relevant concentrations and could therefore serve as a novel pathway to investigate to understand the molecular basis of leptin resistance, obesity and associated disorders.
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Affiliation(s)
- Tommy Jönsson
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.
| | - Ashfaque A Memon
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.
| | - Stefan Olsson
- Department of Plant and Environmental Science, University of Copenhagen, DK-1871, Frederiksberg C, Denmark.
| | - Amarnadh Nalla
- Institute of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200, Copenhagen, Denmark. .,The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
| | - Mikael Bauer
- Department of Biochemistry and Structural Biology, Lund University, Lund, Sweden.
| | - Sara Linse
- Department of Biochemistry and Structural Biology, Lund University, Lund, Sweden.
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Bédard A, Hudon AM, Drapeau V, Corneau L, Dodin S, Lemieux S. Gender Differences in the Appetite Response to a Satiating Diet. J Obes 2015; 2015:140139. [PMID: 26442158 PMCID: PMC4579320 DOI: 10.1155/2015/140139] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/20/2015] [Accepted: 08/23/2015] [Indexed: 11/20/2022] Open
Abstract
We examined gender differences in appetite sensations when exposed to Mediterranean diet (MedDiet) meals and determined whether there are gender differences in the change in the satiating properties of the MedDiet over time. Thirty-eight men and 32 premenopausal women consumed a 4-week isoenergetic MedDiet under controlled conditions. Visual analogue scales were used to measure perceived appetite sensations before and immediately after each meal consumed over the course of one day (Wednesday) of the first and the fourth week of intervention. Women reported greater decreases for desire to eat, hunger, and appetite score than men in response to the consumption of the MedDiet meals (gender-by-meal interactions, resp., P = 0.04, P = 0.048, and P = 0.03). Fullness and prospective food consumption responses did not significantly differ between men and women. Between the first and the fourth week of intervention, premeal prospective food consumption increased with time in men (P = 0.0007) but not in women (P = 0.84; P for gender-by-time interaction = 0.04). These results indicate gender differences in appetite sensations when exposed to the MedDiet. These results may be useful in order to have a better understanding of gender issues for body weight management.
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Affiliation(s)
- Alexandra Bédard
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Pavillon des Services, Université Laval, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- École de Nutrition, Pavillon Paul-Comtois, Université Laval, 2425 rue de l'Agriculture, Québec, QC, Canada G1V 0A6
| | - Anne-Marie Hudon
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Pavillon des Services, Université Laval, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- École de Nutrition, Pavillon Paul-Comtois, Université Laval, 2425 rue de l'Agriculture, Québec, QC, Canada G1V 0A6
| | - Vicky Drapeau
- Département de l'Éducation Physique, Pavillon de l'Éducation Physique et des Sports, Université Laval, 2300 rue de la Terrasse, Québec, QC, Canada G1V 0A6
| | - Louise Corneau
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Pavillon des Services, Université Laval, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
| | - Sylvie Dodin
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Pavillon des Services, Université Laval, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- Département d'Obstétrique et Gynécologie, Pavillon Ferdinand-Vandry, Université Laval, 1050 Avenue de la Médecine, Québec, QC, Canada G1V 0A6
| | - Simone Lemieux
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Pavillon des Services, Université Laval, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- École de Nutrition, Pavillon Paul-Comtois, Université Laval, 2425 rue de l'Agriculture, Québec, QC, Canada G1V 0A6
- *Simone Lemieux:
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Abstract
Diet is established among the most important influences on health in modern societies. Injudicious diet figures among the leading causes of premature death and chronic disease. Optimal eating is associated with increased life expectancy, dramatic reduction in lifetime risk of all chronic disease, and amelioration of gene expression. In this context, claims abound for the competitive merits of various diets relative to one another. Whereas such claims, particularly when attached to commercial interests, emphasize distinctions, the fundamentals of virtually all eating patterns associated with meaningful evidence of health benefit overlap substantially. There have been no rigorous, long-term studies comparing contenders for best diet laurels using methodology that precludes bias and confounding, and for many reasons such studies are unlikely. In the absence of such direct comparisons, claims for the established superiority of any one specific diet over others are exaggerated. The weight of evidence strongly supports a theme of healthful eating while allowing for variations on that theme. A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention and is consistent with the salient components of seemingly distinct dietary approaches. Efforts to improve public health through diet are forestalled not for want of knowledge about the optimal feeding of Homo sapiens but for distractions associated with exaggerated claims, and our failure to convert what we reliably know into what we routinely do. Knowledge in this case is not, as of yet, power; would that it were so.
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Affiliation(s)
- D L Katz
- Prevention Research Center, Yale University School of Public Health, Griffin Hospital, Derby, Connecticut 06418;
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Moosheer SM, Waldschütz W, Itariu BK, Brath H, Stulnig TM. A protein-enriched low glycemic index diet with omega-3 polyunsaturated fatty acid supplementation exerts beneficial effects on metabolic control in type 2 diabetes. Prim Care Diabetes 2014; 8:308-314. [PMID: 24656509 DOI: 10.1016/j.pcd.2014.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/19/2014] [Accepted: 02/24/2014] [Indexed: 11/20/2022]
Abstract
AIMS The current study aims to investigate practicability and effects of a combined dietary intervention with increased relative protein content supplemented with omega-3 polyunsaturated fatty acids (PUFA) on metabolic control and inflammatory parameters in a real life situation in type 2 diabetes patients. METHODS In this observational study we advised thirty mostly obese patients with type 2 diabetes to follow a protein-enriched diet with carbohydrates of low glycemic index (low GI) and moderate fat reduction supplemented with omega-3 PUFA for 24 weeks. Primary efficacy parameter was the change in HbA1c; secondary parameters included changes in systemic inflammation (measured by ultrasensitive C-reactive protein, usCRP), body weight, waist circumference, fat mass. The study is registered at clinicaltrials.gov (NCT01474603). RESULTS The dietary intervention significantly reduced the primary efficacy variable HbA1c from a baseline value of 63±11mmol/mol to 59±14mmol/mol (P=0.033) and 56±12mmol/mol (P=0.001) after 12 and 24 weeks, respectively. In addition, usCRP decreased significantly at 24 weeks (P=0.039). Waist circumference, an important indicator for cardiometabolic-risk and silent inflammation, decreased from baseline 116.0±14.1cm to 114.9±13.5cm (P=0.019), 114.0±14.4cm (P=0.001), and 112.7±13.4cm (P=0.049), after 3, 12 and 24 weeks, respectively. CONCLUSION Counseling a protein enriched and low glycemic index diet supplemented with long-chain omega-3 PUFA in a real-life clinical setting improves glycemic control and also reduces waist circumference and silent inflammation in overweight or obese patients with type 2 diabetes.
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Affiliation(s)
- Simone M Moosheer
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria
| | | | - Bianca K Itariu
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria
| | - Helmut Brath
- Diabetes Outpatient Clinic, Health Center South, Vienna, Austria
| | - Thomas M Stulnig
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria.
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Red meats: Time for a paradigm shift in dietary advice. Meat Sci 2014; 98:445-51. [DOI: 10.1016/j.meatsci.2014.06.024] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/19/2014] [Accepted: 06/19/2014] [Indexed: 01/17/2023]
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Boers I, Muskiet FAJ, Berkelaar E, Schut E, Penders R, Hoenderdos K, Wichers HJ, Jong MC. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids Health Dis 2014; 13:160. [PMID: 25304296 PMCID: PMC4210559 DOI: 10.1186/1476-511x-13-160] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/29/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The main goal of this randomized controlled single-blinded pilot study was to study whether, independent of weight loss, a Palaeolithic-type diet alters characteristics of the metabolic syndrome. Next we searched for outcome variables that might become favourably influenced by a Paleolithic-type diet and may provide new insights in the pathophysiological mechanisms underlying the metabolic syndrome. In addition, more information on feasibility and designing an innovative dietary research program on the basis of a Palaeolithic-type diet was obtained. METHODS Thirty-four subjects, with at least two characteristics of the metabolic syndrome, were randomized to a two weeks Palaeolithic-type diet (n = 18) or an isoenergetic healthy reference diet, based on the guidelines of the Dutch Health Council (n = 14). Thirty-two subjects completed the study. Measures were taken to keep bodyweight stable. As primary outcomes oral glucose tolerance and characteristics of the metabolic syndrome (abdominal circumference, blood pressure, glucose, lipids) were measured. Secondary outcomes were intestinal permeability, inflammation and salivary cortisol. Data were collected at baseline and after the intervention. RESULTS Subjects were 53.5 (SD9.7) year old men (n = 9) and women (n = 25) with mean BMI of 31.8 (SD5.7) kg/m2. The Palaeolithic-type diet resulted in lower systolic blood pressure (-9.1 mmHg; P = 0.015), diastolic blood pressure (-5.2 mmHg; P = 0.038), total cholesterol (-0.52 mmol/l; P = 0.037), triglycerides (-0.89 mmol/l; P = 0.001) and higher HDL-cholesterol (+0.15 mmol/l; P = 0.013), compared to reference. The number of characteristics of the metabolic syndrome decreased with 1.07 (P = 0.010) upon the Palaeolithic-type diet, compared to reference. Despite efforts to keep bodyweight stable, it decreased in the Palaeolithic group compared to reference (-1.32 kg; P = 0.012). However, favourable effects remained after post-hoc adjustments for this unintended weight loss. No changes were observed for intestinal permeability, inflammation and salivary cortisol. CONCLUSIONS We conclude that consuming a Palaeolithic-type diet for two weeks improved several cardiovascular risk factors compared to a healthy reference diet in subjects with the metabolic syndrome. TRIAL REGISTRATION Nederlands Trial Register NTR3002.
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Affiliation(s)
- Inge Boers
- />Department Nutrition and Health, Louis Bolk Institute, Hoofdstraat 24, Driebergen, LA 3972 the Netherlands
- />Department of Clinical Psycho-Neuro-Immunology, University of Gerona, Gerona, Spain
| | - Frits AJ Muskiet
- />Department of Laboratory Medicine, University Medical Centre Groningen, Groningen, the Netherlands
| | - Evert Berkelaar
- />Department of Clinical Psycho-Neuro-Immunology, University of Gerona, Gerona, Spain
| | - Erik Schut
- />Department of Clinical Psycho-Neuro-Immunology, University of Gerona, Gerona, Spain
| | - Ria Penders
- />Department of Clinical Psycho-Neuro-Immunology, University of Gerona, Gerona, Spain
| | - Karine Hoenderdos
- />Scriptum Communication about Nutrition, IJsselstein, the Netherlands
| | - Harry J Wichers
- />Food and Biobased Research, Wageningen University & Research centre, Wageningen, the Netherlands
| | - Miek C Jong
- />Department Nutrition and Health, Louis Bolk Institute, Hoofdstraat 24, Driebergen, LA 3972 the Netherlands
- />Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
- />National Information and Knowledge Centre on Integrative Medicine (NIKIM), Amsterdam, the Netherlands
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Pizzorno L. Highlights From the Institute for Functional Medicine's 2014 Annual Conference: Functional Perspectives on Food and Nutrition: The Ultimate Upstream Medicine. Integr Med (Encinitas) 2014; 13:38-50. [PMID: 26770117 PMCID: PMC4684110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Muskiet FAJ, Carrera-Bastos P. Beyond the Paleolithic prescription: Commentary. Nutr Rev 2014; 72:285-6. [DOI: 10.1111/nure.12112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Frits AJ Muskiet
- Laboratory Medicine; University Medical Center Groningen; Groningen The Netherlands
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research; Faculty of Medicine at Lund University; Malmö Sweden
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Mellberg C, Sandberg S, Ryberg M, Eriksson M, Brage S, Larsson C, Olsson T, Lindahl B. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr 2014; 68:350-7. [PMID: 24473459 PMCID: PMC4216932 DOI: 10.1038/ejcn.2013.290] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVES Short-term studies have suggested beneficial effects of a Palaeolithic-type diet (PD) on body weight and metabolic balance. We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women, in comparison with a diet according to the Nordic Nutrition Recommendations (NNR). SUBJECTS/METHODS Seventy obese postmenopausal women (mean age 60 years, body mass index 33 kg/m(2)) were assigned to an ad libitum PD or NNR diet in a 2-year randomized controlled trial. The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry. RESULTS Both groups significantly decreased total fat mass at 6 months (-6.5 and-2.6 kg) and 24 months (-4.6 and-2.9 kg), with a more pronounced fat loss in the PD group at 6 months (P<0.001) but not at 24 months (P=0.095). Waist circumference and sagittal diameter also decreased in both the groups, with a more pronounced decrease in the PD group at 6 months (-11.1 vs-5.8 cm, P=0.001 and-3.7 vs-2.0 cm, P<0.001, respectively). Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group (P<0.001 and P=0.004). Nitrogen excretion did not differ between the groups. CONCLUSIONS A PD has greater beneficial effects vs an NNR diet regarding fat mass, abdominal obesity and triglyceride levels in obese postmenopausal women; effects not sustained for anthropometric measurements at 24 months. Adherence to protein intake was poor in the PD group. The long-term consequences of these changes remain to be studied.
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Affiliation(s)
- Caroline Mellberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Susanne Sandberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Mats Ryberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Marie Eriksson
- Department of Statistics, USBE, Umeå University, Umeå, Sweden
| | - Sören Brage
- MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Christel Larsson
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
- Department of Food and Nutrition, Umeå University, Umeå, Sweden
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
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Fontes-Villalba M, Jönsson T, Granfeldt Y, Frassetto LA, Sundquist J, Sundquist K, Carrera-Bastos P, Fika-Hernándo M, Picazo Ó, Lindeberg S. A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study--Alimentation and Diabetes in Lanzarote--ADILAN. Trials 2014; 15:2. [PMID: 24383431 PMCID: PMC3884016 DOI: 10.1186/1745-6215-15-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/16/2013] [Indexed: 11/21/2022] Open
Abstract
Background Research on the role of nutrition in type 2 diabetes has largely focused on macro/micronutrient composition and dietary fiber intake, while fewer studies have tested the effects of differing food choice. Some observational studies and short-term intervention studies suggest that a food pattern mimicking the diet with which humans evolved positively influences glucose control and associated endocrine systems. Such a food pattern mainly differs from other common healthy food patterns in its absence of cereal grains and dairy products. The primary aim of this pilot study is to determine the effect of two healthy diets with or without cereal grains and dairy products on glucose control, while keeping participants’ weight stable and other food parameters, such as macro/micronutrient composition, dietary fiber and glycemic load, the same in both diets. Methods/Design We intend to include 15 adult patients with a medical diagnosis of type 2 diabetes mellitus with or without medication and with an increased waist circumference (≥ 80 cm for women and ≥ 94 cm for men) in a random-order cross-over diet intervention study during two periods of four-weeks separated by a six-week washout period. Patients will be instructed to eat two healthy diets according to official dietary guidelines with respect to macro/micronutrient composition and fiber content, but differing in the type of food included, with one diet being without cereal grains and dairy products. Lunch will be served in a hospital kitchen for control of nutrient intake, while the rest of the meals will be eaten at home according to specific directions. The energy content of the diets will be individually adjusted to maintain a stable body weight during the two four-week intervention periods. Primary outcomes will be change in fasting plasma glucagon and fructosamine, while secondary outcomes include change in fasting glucose and glycated hemoglobin, glucose and glucagon response during oral glucose tolerance test, blood lipids, blood pressure, C-reactive protein, body composition, quality of life, subjective experience with the two diets, satiety scores and changes in medication. Discussion Using these results, we will assess the need to conduct larger and longer studies with similar design. Trial registration This trial was registered at clinicaltrials.gov as NCT01891955 and Spanish Agency of Medication and Sanitary Products (AEMPS) registration code: MFV-ADI-2013-01.
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Affiliation(s)
- Maelán Fontes-Villalba
- Department of Clinical Sciences, Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
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Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC. Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J 2013; 12:105. [PMID: 23890471 PMCID: PMC3727993 DOI: 10.1186/1475-2891-12-105] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/23/2013] [Indexed: 11/30/2022] Open
Abstract
Background We found marked improvement of glycemic control and several cardiovascular risk factors in patients with type 2 diabetes given advice to follow a Paleolithic diet, as compared to a diabetes diet. We now report findings on subjective ratings of satiety at meal times and participants’ other experiences of the two diets from the same study. Methods In a randomized cross-over study, 13 patients with type 2 diabetes (3 women and 10 men), were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, and a diabetes diet designed in accordance with dietary guidelines, during two consecutive 3-month periods. In parallel with a four-day weighed food record, the participants recorded their subjective rating of satiety. Satiety quotients were calculated as the intra-meal quotient of change in satiety during a meal and consumed energy or weight of food and drink for that specific meal. All participants answered the same three open-ended questions in a survey following each diet: “What thoughts do you have about this diet?”, “Describe your positive and negative experiences with this diet” and “How do you think this diet has affected your health?”. Results The participants were equally satiated on both diets. The Paleolithic diet resulted in greater satiety quotients for energy per meal (p = 0.004), energy density per meal (p = 0.01) and glycemic load per meal (p = 0.02). The distribution of positive and negative comments from the survey did not differ between the two diets, and the comments were mostly positive. Among comments relating to recurring topics, there was no difference in distribution between the two diets for comments relating to tastelessness, but there was a trend towards more comments on the Paleolithic diet being satiating and improving blood sugar values, and significantly more comments on weight loss and difficulty adhering to the Paleolithic diet. Conclusions A Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes. The Paleolithic diet was seen as instrumental in weight loss, albeit it was difficult to adhere to. Trial registration ClinicalTrials.gov: NCT00435240
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Affiliation(s)
- Tommy Jönsson
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.
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Spreadbury I, Samis AJW. Evolutionary Aspects of Obesity, Insulin Resistance, and Cardiovascular Risk. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0293-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lindeberg S. Dietary shifts and human health: cancer and cardiovascular disease in a sustainable world. J Gastrointest Cancer 2012; 43:8-12. [PMID: 22081408 DOI: 10.1007/s12029-011-9345-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Increasing evidence suggests that optimal food choice is critical for sizable prevention of western diseases such as cardiovascular disease and cancer. The Mediterranean diet is an important step in this direction. Moreover, substantially lower rates of Western disease, even compared to Mediterranean countries, have been observed among hunter-gatherers and other non-western populations (Lindeberg 2010). Observational studies and controlled trials support the notion that an evolutionary perspective is helpful when designing food models for optimal human health. DISCUSSION However, sustainable health for the individual patient is not enough: environmental sustainability must also be considered. Are fish and fruit sustainable for everyone? Are starchy root vegetables a better option than cereal grains? Is locally produced meat an underestimated wholesome food? These and other questions need to be addressed in order to cut greenhouse gases and the consumption of (blue) water and nonrenewable energy.
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Affiliation(s)
- S Lindeberg
- Center for Primary Health Care Research, Lund University, Lund, Sweden.
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Christophersen OA. Radiation protection following nuclear power accidents: a survey of putative mechanisms involved in the radioprotective actions of taurine during and after radiation exposure. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2012; 23:14787. [PMID: 23990836 PMCID: PMC3747764 DOI: 10.3402/mehd.v23i0.14787] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/18/2011] [Indexed: 12/28/2022]
Abstract
There are several animal experiments showing that high doses of ionizing radiation lead to strongly enhanced leakage of taurine from damaged cells into the extracellular fluid, followed by enhanced urinary excretion. This radiation-induced taurine depletion can itself have various harmful effects (as will also be the case when taurine depletion is due to other causes, such as alcohol abuse or cancer therapy with cytotoxic drugs), but taurine supplementation has been shown to have radioprotective effects apparently going beyond what might be expected just as a consequence of correcting the harmful consequences of taurine deficiency per se. The mechanisms accounting for the radioprotective effects of taurine are, however, very incompletely understood. In this article an attempt is made to survey various mechanisms that potentially might be involved as parts of the explanation for the overall beneficial effect of high levels of taurine that has been found in experiments with animals or isolated cells exposed to high doses of ionizing radiation. It is proposed that taurine may have radioprotective effects by a combination of several mechanisms: (1) during the exposure to ionizing radiation by functioning as an antioxidant, but perhaps more because it counteracts the prooxidant catalytic effect of iron rather than functioning as an important scavenger of harmful molecules itself, (2) after the ionizing radiation exposure by helping to reduce the intensity of the post-traumatic inflammatory response, and thus reducing the extent of tissue damage that develops because of severe inflammation rather than as a direct effect of the ionizing radiation per se, (3) by functioning as a growth factor helping to enhance the growth rate of leukocytes and leukocyte progenitor cells and perhaps also of other rapidly proliferating cell types, such as enterocyte progenitor cells, which may be important for immunological recovery and perhaps also for rapid repair of various damaged tissues, especially in the intestines, and (4) by functioning as an antifibrogenic agent. A detailed discussion is given of possible mechanisms involved both in the antioxidant effects of taurine, in its anti-inflammatory effects and in its role as a growth factor for leukocytes and nerve cells, which might be closely related to its role as an osmolyte important for cellular volume regulation because of the close connection between cell volume regulation and the regulation of protein synthesis as well as cellular protein degradation. While taurine supplementation alone would be expected to exert a therapeutic effect far better than negligible in patients that have been exposed to high doses of ionizing radiation, it may on theoretical grounds be expected that much better results may be obtained by using taurine as part of a multifactorial treatment strategy, where it may interact synergistically with several other nutrients, hormones or other drugs for optimizing antioxidant protection and minimizing harmful posttraumatic inflammatory reactions, while using other nutrients to optimize DNA and tissue repair processes, and using a combination of good diet, immunostimulatory hormones and perhaps other nontoxic immunostimulants (such as beta-glucans) for optimizing the recovery of antiviral and antibacterial immune functions. Similar multifactorial treatment strategies may presumably be helpful in several other disease situations (including severe infectious diseases and severe asthma) as well as for treatment of acute intoxications or acute injuries (both mechanical ones and severe burns) where severely enhanced oxidative and/or nitrative stress and/or too much secretion of vasodilatory neuropeptides from C-fibres are important parts of the pathogenetic mechanisms that may lead to the death of the patient. Some case histories (with discussion of some of those mechanisms that may have been responsible for the observed therapeutic outcome) are given for illustration of the likely validity of these concepts and their relevance both for treatment of severe infections and non-infectious inflammatory diseases such as asthma and rheumatoid arthritis.
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Effects of food pattern change and physical exercise on cafeteria diet-induced obesity in female rats. Br J Nutr 2012; 108:1511-8. [DOI: 10.1017/s0007114511006933] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obesity affects a large number of people around the world and appears to be the result of changes in food intake, eating habits and physical activity levels. Changes in dietary patterns and physical exercise are therefore strongly recommended to treat obesity and its complications. The present study tested the hypothesis that obesity and metabolic changes produced by a cafeteria diet can be prevented with dietary changes and/or physical exercise. A total of fifty-six female Wistar rats underwent one of five treatments: chow diet; cafeteria diet; cafeteria diet followed by a chow diet; cafeteria diet plus exercise; cafeteria diet followed by a chow diet plus exercise. The duration of the experiment was 34 weeks. The cafeteria diet resulted in higher energy intake, weight gain, increased visceral adipose tissue and liver weight, and insulin resistance. The cafeteria diet followed by the chow diet resulted in energy intake, body weight, visceral adipose tissue and liver weight and insulin sensitivity equal to that of the controls. Exercise increased total energy intake at week 34, but produced no changes in the animals' body weight or adipose tissue mass. However, insulin sensitivity in animals subjected to exercise and the diet was similar to that of the controls. The present study found that exposure to palatable food caused obesity and insulin resistance and a diet change was sufficient to prevent cafeteria diet-induced obesity and to maintain insulin sensitivity at normal levels. In addition, exercise resulted in normal insulin sensitivity in obese rats. These results may help to develop new approaches for the treatment of obesity and type 2 diabetes mellitus.
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Lindeberg S. Paleolithic diets as a model for prevention and treatment of Western disease. Am J Hum Biol 2012; 24:110-5. [PMID: 22262579 DOI: 10.1002/ajhb.22218] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 12/03/2011] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To explore the possibility that a paleolithic-like diet can be used in the prevention of age-related degenerative Western disease. METHODS Literature review of African Paleolithic foods in relation to recent evidence of healthy nutrition. RESULTS AND DISCUSSION Available evidence lends weak support in favor and little against the notion that lean meat, fish, vegetables, tubers, and fruit can be effective in the prevention and treatment of common Western diseases. There are no obvious risks with avoiding dairy products, margarine, oils, refined sugar, and cereal grains, which provide 70% or more of the dietary intake in northern European populations. If stroke, coronary heart disease, type 2 diabetes, and cancer are preventable by dietary changes, an ancestral-like diet may provide an appropriate template.
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Affiliation(s)
- Staffan Lindeberg
- Department of Primary Health Care Research, Lund University, Sweden.
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