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Blast from the past: a paleo solution for type-2 diabetes

The evidence continues to build for ancestrally-influenced diets

Study under review: Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes

Introduction

An estimated one out of eleven people in the United States has diabetes, and more than one third of adults have prediabetes. About 90 - 95% of diabetes cases are classified as type 2 diabetes (T2D), a metabolic disorder characterized by the body’s inability to regulate blood glucose due to insulin resistance. Although an unhealthy diet has long been regarded as a major contributor to the development of T2D, only in the last two decades has research supporting this hypothesis accumulated[1] from both observational and interventional studies.

The Paleolithic diet has been gaining considerable attention over the last decade. This diet’s goal is to emulate a pre-agricultural hunter-gatherer diet under the supposition that many of the foods humans began eating in the last 10,000 years have been harmful to our health. The father of this movement was the gastroenterologist Walter Voegtlin, who published The Stone Age Diet in 1975. Interest in the idea renewed with Loren Cordain’s 2002 publication, The Paleo Diet_. Two studies have evaluated the effects of a paleo diet in people with T2D. Both found significant improvements in blood glucose control with the Paleolithic diet when compared to a Mediterranean diet[2] and the European diabetes diet[3]. However, researchers conducting both studies only provided dietary advice and a rationale for eating a hunter-gatherer diet to the participants. Study participants were still free to choose the foods they ate.

This limitation was partly overcome by a paleo diet study[4] involving people with metabolic syndrome, a condition that involves obesity, high blood pressure, high cholesterol, and blood sugar problems that aren’t quite full-blown diabetes. In fact, individuals with metabolic syndrome are five times more likely to develop T2D, assuming it is not already present, and both conditions center on insulin resistance commonly brought about by a convergence of genetic and environmental factors. This study was discussed in depth in the sixth issue of the Examine Research Digest (April). Its findings were very impressive for the paleo diet intervention, which was superior to the reference diet (Dutch Health Council) in nearly every outcome. All food consumed by the participants was provided for them, so as to ensure dietary compliance and control energy intake.

However, the diets differed considerably in their macronutrient composition, with the paleo diet being higher in protein (24% vs 17%) and lower in carbohydrates (35 vs 53%) than the reference diet. Although these macronutrient ranges are more representative of what would likely be consumed by individuals who adopt a paleo diet, the differences between groups make it impossible to determine if the benefits were due to the differences in macronutrients or some other aspect of food choice.

The current study is an attempt to address some of the limitations of these previous trials in individuals diagnosed with T2D by providing all food for the participants and matching the macronutrient composition of the Paleo and reference diet.

Previous evidence suggests that the paleo diet is useful for people with type 2 diabetes (T2D). However, past studies either only suggested the paleo diet instead of controlling the participants’ diets directly, or didn’t control for macronutrient content. This study is an attempt to overcome this issues.

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Other Articles in Issue #08 (June 2015)