A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease
Open accessAbstract
Aims/hypothesis Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones.Methods Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic ('Old Stone Age') diet (n = 14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose(0-120)) and plasma insulin AUC (AUC Insulin(0-120)) in OGTTs.Results Over 12 weeks, there was a 26% decrease of AUC Glucose(0-120) (p = 0.0001) in the Palaeolithic group and a 7% decrease (p = 0.08) in the Consensus group. The larger (p = 0.001) improvement in the Palaeolithic group was independent (p = 0.0008) of change in waist circumference (-5.6 cm in the Palaeolithic group, -2.9 cm in the Consensus group; p = 0.03). In the study population as a whole, there was no relationship between change in AUC Glucose(0-120) and changes in weight (r = -0.06, p = 0.9) or waist circumference (r = 0.01, p = 1.0). There was a tendency for a larger decrease of AUC Insulin(0-120) in the Palaeolithic group, but because of the strong association between change in AUC Insulin(0-120) and change in waist circumference (r = 0.64, p = 0.0003), this did not remain after multivariate analysis.Conclusions/interpretation A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.
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Research studies focused on a paleo eating pattern in adults with type 2 diabetes are small and few, ranging from 13-29 participants, lasting no longer than 3 months, and finding mixed effects on A1C, weight, and lipids.
“Research studies focused on a paleo eating pattern in adults with type 2 diabetes are small and few, ranging from 13 -29participants,lastingnolongerthan 3 months, and fi nding mixed effects on A1C, weight, and lipids (120 -122).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [122]
The Participants section describes a 12-week trial with 29 adults, supporting the claim's sample-size and duration ranges. But participants had ischaemic heart disease plus either glucose intolerance or type 2 diabetes, not exclusively type 2 diabetes. The Results report weight and glucose-tolerance outcomes; this single study does not establish that studies are few or that their effects on A1C, weight, and lipids are mixed. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredStudies of various lengths have shown improvements in weight and measures of glycemia with Paleo and VLCD/ketogenic patterns.
“Studies of various lengths have shown improvements in weight and measures of glycemia with these patterns.46,[84][85][86][87]”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [46]
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- Authors
- Lindeberg, S., Jönsson, T., Granfeldt, Y., Borgstrand, E., Soffman, J., Sjöström, K., & Ahrén, B.
- Affiliations
- Lund University (SE)
- Corresponding author
- Lindeberg, S.
- Venue
- Diabetologia
- Published
- 2007-06-22
- Volume
- 50
- Issue
- 9
- Pages
- 1795-1807
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2132106453
- Cited by
- 273
- References
- 55
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 9 · 2021: 18 · 2020: 67 · 2019: 16 · 2018: 10 · 2017: 9 · 2016: 17 · 2015: 12 · 2014: 30 · 2013: 8 · 2012: 12
- FWCI
- 8.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- Funders
- Lunds Universitet
- Region Skåne
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- Paleolithic diet, Mediterranean diet, glucose tolerance, ischemic heart disease, type 2 diabetes, impaired glucose tolerance, waist circumference, insulin, plasma glucose, dietary intervention, human evolution
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diet, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Insulin, Middle Aged, Paleontology, Body Mass Index, Myocardial Ischemia, Area Under Curve, Diet, Mediterranean
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