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Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.

Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S - Cardiovasc Diabetol (2009)

Bottom Line: Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test.Dietary intake was evaluated by use of 4-day weighed food records.Mean average dose of metformin was 1031 mg per day.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Sciences, Lund, Lund University, Box 117, 221 00 Lund, Sweden. Tommy.Jonsson@med.lu.se

ABSTRACT

Background: Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin.

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. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records.

Results: Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI = 50) than in the Diabetic diet (GI = 55).

Conclusion: Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes.

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Cardiovascular risk factors with significant effects from Paleolithic diet compared to Diabetes diet. Closed circles depicts individuals starting with Diabetes diet first and open circles depicts individuals starting with Paleolithic diet first. Values are group means and error bars depicts SD for group means.
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Figure 1: Cardiovascular risk factors with significant effects from Paleolithic diet compared to Diabetes diet. Closed circles depicts individuals starting with Diabetes diet first and open circles depicts individuals starting with Paleolithic diet first. Values are group means and error bars depicts SD for group means.

Mentions: Compared to the Diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c, TG, DBP, weight, BMI and waist circumference, while mean values for HDL were higher (Table 3, Figure 1). The larger decrease of fasting plasma glucose following the Paleolithic diet nearly reached significance, and SBP also tended to decrease more following the Paleolithic diet. Compared to baseline, the Paleolithic diet lowered mean values of HbA1c, TG, SBP, weight, BMI, waist circumference, fasting plasma glucose, fasting plasma insulin, AUC glucose, ISI0,120, HOMA2 %S and HOMA2 %IR (Table 3). Compared to baseline, the Diabetes diet lowered mean values of BMI, waist circumference and HOMA2 %S (Table 3). Period effects were seen in AUC insulin0–120, AUC insulin0–120 stimulated secretion and HOMA2 %B (Table 4). Carry over effects were seen in HbA1c (Table 2, Figure 1).


Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.

Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S - Cardiovasc Diabetol (2009)

Cardiovascular risk factors with significant effects from Paleolithic diet compared to Diabetes diet. Closed circles depicts individuals starting with Diabetes diet first and open circles depicts individuals starting with Paleolithic diet first. Values are group means and error bars depicts SD for group means.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2724493&req=5

Figure 1: Cardiovascular risk factors with significant effects from Paleolithic diet compared to Diabetes diet. Closed circles depicts individuals starting with Diabetes diet first and open circles depicts individuals starting with Paleolithic diet first. Values are group means and error bars depicts SD for group means.
Mentions: Compared to the Diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c, TG, DBP, weight, BMI and waist circumference, while mean values for HDL were higher (Table 3, Figure 1). The larger decrease of fasting plasma glucose following the Paleolithic diet nearly reached significance, and SBP also tended to decrease more following the Paleolithic diet. Compared to baseline, the Paleolithic diet lowered mean values of HbA1c, TG, SBP, weight, BMI, waist circumference, fasting plasma glucose, fasting plasma insulin, AUC glucose, ISI0,120, HOMA2 %S and HOMA2 %IR (Table 3). Compared to baseline, the Diabetes diet lowered mean values of BMI, waist circumference and HOMA2 %S (Table 3). Period effects were seen in AUC insulin0–120, AUC insulin0–120 stimulated secretion and HOMA2 %B (Table 4). Carry over effects were seen in HbA1c (Table 2, Figure 1).

Bottom Line: Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test.Dietary intake was evaluated by use of 4-day weighed food records.Mean average dose of metformin was 1031 mg per day.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Sciences, Lund, Lund University, Box 117, 221 00 Lund, Sweden. Tommy.Jonsson@med.lu.se

ABSTRACT

Background: Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin.

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. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75 g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records.

Results: Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI = 50) than in the Diabetic diet (GI = 55).

Conclusion: Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes.

Show MeSH
Related in: MedlinePlus