Full disclosure: I practice a Paleo lifestyle and am pretty biased. I have never felt better than when I’m following a Paleo diet. Despite this, I approached researching the Paleolithic Diet with an objective mind and have kept it grounded in statistical data. Compared to the Mediterranean Diet- which was heavily based on cohort and prospective studies- I was surprised to find a number of randomized controlled trials conducted on different populations of patients consuming a Paleolithic diet. The research has shown some promising results. Let’s dive in.
What is the Paleo Diet?
The concept of the Paleo (or Paleolithic) Diet is based on consuming a diet that mimics our ancestors.
Foods that are emphasized:
- Meat, seafood, and eggs
- Vegetables and fruit
- Nuts and seeds
- Healthy fats & oils (coconut / avocado / olive oil, ghee, butter etc.)
Foods that are avoided:
- Refined grains
- Whole grains
- Legumes (beans)
- Packaged snacks
- Dairy products
- Sweetened beverages
- Alcohol and caffeine
- Refined oils (vegetable / corn / sunflower oil etc.)
Paleolithic Effects on Health
Fortunately, there have been a few randomized controlled trials performed on participants consuming a Paleo diet. The total number of participants have been small in these studies (usually <100), but the results have been promising and suggestive of significant health improvements. Some of the outcomes include improvements in cardiovascular risk factors, diabetes, and overall weight.
A small study in the Netherlands was conducted on 34 participants with metabolic syndrome. The participants were both men and women between the ages of 18-70 years old. They had to have at least two of the following characteristics:
- Central obesity (waist circumference >40 inches in men and 34 inches in women),
- Elevated triglycerides
- Low HDL (“good cholesterol”)
- Elevated blood pressure (>130/85)
- Elevated fasting glucose levels.
They were randomized into two groups: 1) two weeks on a Paleolithic diet, and 2) continued on a conventional healthy reference diet (guidelines for a healthy diet of the Dutch Health Council).
Their goal was to compare metabolic outcomes independent of weight loss.
The study concluded that consuming a Paleolithic-type diet for 2 weeks improved several cardiovascular risk factors by lowering:
- Blood pressure (by 9 points on the top number, and 5 on the bottom)
- Total cholesterol
- Increasing HDL cholesterol (“good” cholesterol)
- Weight (by 3 lbs)
Paleolithic Effects on Diabetes
In one small randomized control trial (RCT), 32 type II diabetic patients (without other comorbidities) roughly 60 years of age with an average BMI of 31 were followed on a Paleolithic diet for 3 months.
They were additionally subdivided into 2 exercise groups according to 1) verbal recommendation to briskly walk at least 30 minutes a day (control group), or 2) three 1-hour supervised exercise session with aerobic and resistance training exercise sessions.
Surprisingly, the exercise component did not have a statistically significant effect on health markers (such as body fat or sugar control). As can be expected, it did improve participants’ cardiovascular fitness.
In patients with diabetes, blood sugar levels can be monitored with a blood test called a Hemoglobin A1C (HbA1c). This averages out their blood sugar levels over a span of 3 months. Participants in this study had a statistically significant reduction in their HbA1c by 0.9% points.
How big of a deal is this?
To put this in perspective, a dietary change toward a diabetic based diet (instead of a Paleo focused diet) was only found to lower HbA1c by 0.4% points. A prospective study in the UK found that a “1% improvement of HbA1c reduces microvascular [small blood vessel] complications by 37% and reduces diabetes‐related death by 21%.” Those are some serious numbers!
Overall, after 3 months of following a Paleo Diet, the type 2 diabetic patients in their study had:
- Improvements in fat mass
- An increase in insulin sensitivity
- Improvement in glycemic control
- A decrease in leptin levels*
*This finding is interesting. Leptin is traditionally thought of as the “I’m-full” signal in the body. However, leptin also plays a very important role in the up-regulating of the inflammatory immune response. Therefore, a decrease in leptin levels may help reduce inflammation in the body that can contribute to major complications of obesity!
Take Away Points
The Paleolithic Diet emphasizes eating whole foods rich in dense nutrients and avoidance of processed, refined, and nutrient poor foods manufactured in factories. There have been promising clinical trials (albeit small sample sizes) that have correlated Paleolithic diet modifications to improvements in insulin and sugar control, cardiovascular risk factors, and overall weight management.
If you’re interested in learning more about living a Paleo lifestyle, I encourage you to explore Diane Sanfilippo’s book: Practical Paleo.
Are there any small changes you could make to better align with the Paleo diet?
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- Boers, Inge, et al. “Favourable Effects of Consuming a Palaeolithic-Type Diet on Characteristics of the Metabolic Syndrome: a Randomized Controlled Pilot-Study.”Lipids in Health and Disease, BioMed Central, 11 Oct. 2014, lipidworld.biomedcentral.com/articles/10.1186/1476-511X-13-160.
- Loffreda S,Yang SQ, Lin HZ, et al. Leptin regulates proinflammatory immune responses. FASEB J 1998; 12(1): 57–65.
- “Netherlands.”org, FAO of the UN, www.fao.org/nutrition/education/food-based-dietary-guidelines/regions/countries/netherlands/en/.
- Otten, J, et al. “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.”Advances in Pediatrics., U.S. National Library of Medicine, May 2016, www.ncbi.nlm.nih.gov/pubmed/27235022.
- Stratton IM,Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321(7258): 405–12.