Home Menopause Paleo diet consistently outperforms healthy eating guidelines: 7 studies

Paleo diet consistently outperforms healthy eating guidelines: 7 studies

July 5, 2018

The paleo diet compared to recommended healthy diets – which has the best results?

Many countries use experts to create healthy eating guidelines, here is a link to the information on how the US guidelines are created https://health.gov/dietaryguidelines/process.asp.

Some dietary guidelines have been designed specifically for people with cardiovascular disease or type 2 diabetes, such as the American Diabetes Association (ADA) guidelines.

Other healthy diets have been shown by epidemiological studies to reduce the risk of non-communicable diseases, for example, the Mediterranean diet pattern.

Over the last 12 years, a number of studies have tested a classic paleo protocol with a number of these healthy eating guidelines.

I’ve written about the paleo diet used in studies in a prior post: Paleo diet studies, weight loss and satiety, I also covered how a paleo diet achieved greater weight loss and satiety compared to other diet protocols.

In this post, I outline each study, the diet it was compared to and its results.

All studies apart from one were a maximum of 3 months on the intervention diet.

Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes, a randomized cross-over pilot study. Jonsson et al., 2009 Pubmed, Full text

Study type and length: Randomised open label crossover, 3 months on Paleo diet (PD) and 3 months on current dietary guideline for diabetes (DD)

Participants: 13 total, 7 started PD first, 6 started with DD. Type 2 diabetes duration average 9 years

Study length: 6 months (3 months each diet)

Results: Paleo diet resulted in lower HbA1c, triglycerides, BP, Weight, Waist circumference, higher HDL, compared to Diabetes diet

This graph is from the study:

2. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Lindeberg et al., 2007 Pubmed Fulltext

Type of study and length: 12 weeks, Randomised controlled dietary intervention. Mediterranean like diet (MD) compared to paleo diet (PD)

Participants: 29 male with ischemic heart disease (IHD) and with impaired glucose tolerance or type 2 diabetes. Increased OGTT. Waist >94cm. PD n=14, MD n=15

Results: PD, 20% decrease in the oral glucose tolerance test (OGTT) during the first 6 weeks and an 8% decrease between weeks 6 and 12. In the MD group, a 10% decrease of OGTT after the first 6 weeks with no further change at 12 weeks. After 12 weeks, all 14 subjects in the Palaeolithic group had normal 2-hour plasma glucose values, compared with 7 of 15 subjects.

Waist circumference decrease: PD 5.6cm, MD 2.9cm, Weight loss PD 5.1kg, MD 3.8kg

Here are graphs of oral glucose tolerance tests, (OGTT) and plasma insulin changes.

3. Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets. A 4-Week Randomised Trial. Genoni 2016 PubMed, Fulltext

Study design: Randomised, non blinded, Australian guide to healthy eating (AGHE) n=17 compared to PD n=22. Primary aim to compare PD with AGHE health effects and nutritional adequacy.

Participants: 39 healthy overweight women, Age 47 + 13y, BMI 27 + 4,

Study length: 4 weeks

Results:

PD significantly greater weight loss; 3.2 vs 1.2kg, decreased waist; 3.4 vs 1.6cm, fat loss, lowered systolic BP; 3.3 vs 0.7 mmHg.
There were no significant differences in fasting C-reactive protein, glucose, insulin, urinary sodium or creatinine.
Nutrients: PD had significantly lower calcium, iodine, thiamin and riboflavin. PD had significanlty higher intakes of vitamin C and betacarotene.
Women on paleo had 76% less desire for sugar foods vs 56% on AGHE

4. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Pastore, 2015 Pubmed,

Study type and length: 8 months, 2 phase intervention, own controls. AHA heart-healthy dietary guidelines for 4 months, (phase 1) followed by PD 4 months (phase 2). Variables measured at baseline to end AHA, then end PD phase.

Participants: 10 male, 10 female with hypercholesteremia

Results:

There were greater improvements in the PD phase compared to ADA phase in lipids, Total cholesterol -3% on AHA, -20% PD, LDL, -3% AHA, -36% PD, HDL AHA, no change, +35% PD.
Weight loss AHA 3.3kg, PD 10.4kg in men. AHA no change, PD 8.1kg

Lipid changes chart:

5. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Masharani, 2015 Pubmed

Study Type: Randomised, Non blinded. Outpatient, metabolically controlled study comparing Paleo diet (PD) with a standard diet based on nutrition recommendations of the American Diabetes Association (ADA diet). Same calories and PFC ratio. Completed: PD n=14 ADA n=10

Study length: Baseline: 3 days, ramp up diet: 7 days, intervention: 14 days.

Participants: 24 participants, T2D, controlled 50-69yrs, BMI <40.

Results:

Fructosamine, which is a shorter-term marker of glycemic control, declined by 34μmol/l in the Paleo group (P=0.01) and only by 3μmol/l in the ADA group
Weight changes – similar both groups
There were statistically signiﬁcant reductions in total cholesterol, HDL cholesterol and low-density lipoprotein (LDL) cholesterol on the Paleo diet.
Triglycerides trended downward to a greater degree on the Paleo diet than on the ADA diet.
No significant BP changes
Insulin sensitivity improved on paleo diet (see graph)

6. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome, a randomized controlled pilot-study. Boers, 2014 PubMed, Full text

Study Type: Randomised controlled single-blinded pilot, stratified (men/women) PD n= 18, compared to isogenic healthy reference diet: n=16 (14 completed) Dutch Health Council guidelines. Bodyweight kept stable throughout the intervention. 32 completed the study. All meals delivered, the goal to maintain weight so it was not a confounder

Study Length: 2 weeks

Participants: 34 subjects, with 2 characteristics of metabolic syndrome (Central obesity, elevated TG, Reduced HDL, raised BP, elevated plasma glucose). Mean age 53.5 (SD9.7), Male =9, Female = 25. BMI mean 31.8, Waist >102cm men, 88cm f, BP > 130/85, HDL <1, Fasting glucose >5.6

Results:

PD resulted in lower systolic BP -9.1mmHg, Dutch -5 mmHg, Total Cholesterol, triglycerides, higher HDL
Bodyweight reduced on PD, unintended
Tendency to larger decrease in AUC insulin in PD
Both groups: 3cm reduction in waist circumference
hsCRP and TNFa, cortisol, intestinal permeability did not change in either group
At end 89% PD and 64% Dutch group were motivated to continue

7. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women, a 2-year randomized trial. Melberg et al,.2014 Pubmed, Full text

Type of study and intervention: Randomly assigned to paleo Nordic Nutrition Recommendations (NNR) or paleo diet (PD); 35 in each group

(This group has 10 published studies comparing a range of different measures)

Participants: 70 women (61 analysed) – post menopause, non-smoking, obese (BMI >27), mean age 60yrs, (range 49 – 71) mean BMI 33. at 24 months 27 in PD, 22 in NNR completed

Study length: 24 months, with measures at 6, 12, 18 and 24 months

Results – these are some results from several study publications, listed at the end:

Both the diet groups decreased their total fat mass: PD: -6.5 and NNR: -2.6kg at 6 months; and PD: -4.6 and NNR: -2.9kg at 24 months
Waist PD group at 6 months -11.1 vs NNR -5.8cm; P=0.001
Hip circumference decreased with a signiﬁcant difference between the groups at 6 months (-6.8 with PD vs-2.7 cm with NNR at 6 months; P=0.001)
Triglyceride levels decreased signiﬁcantly in the PD group over time with a 0.26 and 0.22mmol/l difference between the diet groups at 6 and 24 months (P=0.001 and P=0.004)
Memory performance improved significantly from 16.7 ± 3.3 correctly remembered face-name pair, out of maximum 24, at baseline to 18.5 ± 2.0 after the dietary interventions, F (1, 18) = 8.3; p = 0.010; without difference between the PD or standard diet according to NNR.
Liver fat decreased after 6 months by 64% (95% confidence interval: 54-74%) in the PD group and by 43% (27-59%) in the LFDAfter 24 months, liver fat decreased 50% (25-75%) in the PD group and 49% (27-71%) in the LFD group.
Blood lipids and blood pressure,Triglycerides, total cholesterol and LDL improved significantly more in the PD group duringthe first 6 months of the study
Android fat decreased significantly more in the PD group (P50.009) during the first 6 months
Serum interleukin 6 (IL-6) and tumor necrosis factor a levels were decreased at 24 months in both groups (P<0.001) with a significant diet by-time interaction for serum IL-6 (P50.022). High-sensitivity C-reactive protein was decreased in the PD group at 24 months (P50.001).
Markers of insulin sensitivity improved in the PD group compared to NNR

Further papers from this 24-month study, paleo diet compared to Nordic nutrition recommendations in 70 post menopausal women:

Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task, Boraxbekk, 2015

Diet-induced weight loss has chronic tissue-specific effects on glucocorticoid metabolism in overweight postmenopausal women. Stomby A, 2015

Strong and persistent effect on liver fat with a Paleolithic diet during a two-year intervention. Otten J 2016

Left ventricular remodelling changes without concomitant loss of myocardial fat after long-term dietary intervention Andersson J 2016