Palaeolithic Diet References

Authors: Kowalski LM, Bujko J.

Mounting evidence suggests that foods that were regularly consumed during the Paleolithic era (more than 10,000 years ago) may prevent some chronic Western diseases.

It has been postulated that recent changes in our diet have been too rapid for the human genome to have completely adjusted.

In contemporary Western populations roughly 70% of the food intake comes from foods that were rarely consumed by Paleolithic hunter-gatherers – grains, dairy products, refined sugars and fats.

Observational studies of hunter-gatherers and other non-western populations lend support to the notion that a Paleolithic type diet may reduce the risk of cardiovascular disease, metabolic syndrome, type 2 diabetes, cancer, acne vulgaris and myopia.

Moreover, preliminary intervention studies using a contemporary diet based on Paleolithic food groups (meat, fish, shellfish, fresh fruits and vegetables, roots, tubers, eggs, and nuts), revealed promising results including favourable changes in risk factors, such as weight, waist circumference, C-reactive protein, glycated haemoglobin (HbAlc), blood pressure, glucose tolerance, insulin secretion, insulin sensitivity and lipid profiles.

Low calcium intake, which is often considered as a potential disadvantage of the Paleolithic diet model, should be weighed against the low content of phytates and the low content of sodium chloride, as well as the high amount of net base yielding vegetables and fruits.

Increasing evidence supports the view that intake of high glycemic foods and insulinotropic dairy products is involved in the pathogenesis and progression of acne vulgaris in Western countries.

In this context, diets that mimic the nutritional characteristics of diets found in hunter-gatherers and other non-western populations may have therapeutic value in treating acne vulgaris.

Additionally, more studies are needed to determine the impact of gliadin, specific lectins and saponins on intestinal permeability and the pathogenesis of autoimmune diseases.

Ian Spreadbury
Gastrointestinal Diseases Research Unit, Queen’s University, Kingston, Ontario, Canada
Diabetes Metab Syndr Obes. 2012; 5: 175–189.
Published online Jul 6, 2012. doi: 10.2147/DMSO.S33473
PMCID: PMC3402009

Abstract
A diet of grain-free whole foods with carbohydrate from cellular tubers, leaves, and fruits may produce a gastrointestinal microbiota consistent with our evolutionary condition, potentially explaining the exceptional macronutrient-independent metabolic health of non-Westernized populations, and the apparent efficacy of the modern “Paleolithic” diet on satiety and metabolism.

A novel hypothesis of obesity is suggested by consideration of diet-related inflammation and evolutionary medicine.

The obese homeostatically guard their elevated weight. In rodent models of high-fat diet-induced obesity, leptin resistance is seen initially at vagal afferents, blunting the actions of satiety mediators, then centrally, with gastrointestinal bacterial-triggered SOCS3 signaling implicated.

In humans, dietary fat and fructose elevate systemic lipopolysaccharide, while dietary glucose also strongly activates SOCS3 signaling. Crucially however, in humans, low-carbohydrate diets spontaneously decrease weight in a way that low-fat diets do not.

Furthermore, nutrition transition patterns and the health of those still eating diverse ancestral diets with abundant food suggest that neither glycemic index, altered fat, nor carbohydrate intake can be intrinsic causes of obesity, and that human energy homeostasis functions well without Westernized foods containing flours, sugar, and refined fats.

Due to being made up of cells, virtually all “ancestral foods” have markedly lower carbohydrate densities than flour- and sugar-containing foods, a property quite independent of glycemic index. Thus the “forgotten organ” of the gastrointestinal microbiota is a prime candidate to be influenced by evolutionarily unprecedented postprandial luminal carbohydrate concentrations.

The present hypothesis suggests that in parallel with the bacterial effects of sugars on dental and periodontal health, acellular flours, sugars, and processed foods produce an inflammatory microbiota via the upper gastrointestinal tract, with fat able to effect a “double hit” by increasing systemic absorption of lipopolysaccharide. This model is consistent with a broad spectrum of reported dietary phenomena.

Conclusion
A dietary pattern with carbohydrates exclusively from cellular low-density sources may remove the root cause of a range of our most prevalent diseases. The potential savings in health-care costs should be borne in mind, and the hypothesis tested.

The increased storage life and convenience of some of our oldest agricultural products may come with a hitherto unrecognized metabolic cost. The foods eaten by hunter-gatherers, non-cereal horticulturalists, and those following a modern Paleolithic or “primal” diet are sharply delineated from modern foods by their lower carbohydrate densities.

Consumption of exclusively low-density carbohydrates is suggested to produce a less inflammatory GI microbiota, and may explain the apparent absence of overweight and metabolic disease in two of these groups, and the promising early data from the third.

This hypothesis may also explain:
(1) Why obesity incidence scales with refined food intake, but has such confusing correlatory patterns with macronutrients.
(2) Why calorie-controlled diets of Westernized foods require a perpetual fight with homeostatic correction mechanisms.
(3) The link between periodontal disease and systemic atherosclerotic disease and obesity.
(4) Why the benefits of a diet of fruit and vegetables have not been replicated by supplements of the constituent antioxidants, vitamins, minerals, and fiber alongside a Western diet.
(5) Why low-carbohydrate diets produce ad libitum weight loss, but low-fat diets do not.
(6) The relative resistance of European people to obesity and diabetes from Westernized diets.

We should not settle for the meager improvements attainable from the consensus dietary advice when it is already clear that so much more might be achieved. Our sights should be set high, to see how close we can move levels of industrialized metabolic health toward those enjoyed by non-Westernized populations. While many will resist making dietary changes of such magnitude, official advice must nonetheless point in the correct direction, allowing individuals to make informed decisions.

The social and financial burden of the epidemic of obesity and metabolic syndrome threatens the long-term viability of our health-care systems and perniciously undermines the other benefits of modern civilization, including redirection of scarce financial resources. If this dietary pattern is confirmed to work, practical policy solutions must be sought. Some grain cultivars may be found to produce less inflammation, sprouting techniques may be found to be of benefit, or grain production may be replaced with root-vegetable cultivation where practical.

Over time, the interplay between market forces, attainable agricultural yields, and the practicalities of food-distribution networks may allow shifting demand from a newly informed populace to reshape global agribusiness.A dietary pattern with carbohydrates exclusively from cellular low-density sources may remove the root cause of a range of our most prevalent diseases. The potential savings in health-care costs should be borne in mind, and the hypothesis tested.

Jönsson T1, Olsson S, Ahrén B, Bøg-Hansen TC, Dole A, Lindeberg S.
Department of Clinical Sciences, Lund University, Lund, Sweden

Abstract
BACKGROUND:
The global pattern of varying prevalence of diseases of affluence, such as obesity, cardiovascular disease and diabetes, suggests that some environmental factor specific to agrarian societies could initiate these diseases.

PRESENTATION OF THE HYPOTHESIS:
We propose that a cereal-based diet could be such an environmental factor. Through previous studies in archaeology and molecular evolution we conclude that humans and the human leptin system are not specifically adapted to a cereal-based diet, and that leptin resistance associated with diseases of affluence could be a sign of insufficient adaptation to such a diet.

We further propose lectins as a cereal constituent with sufficient properties to cause leptin resistance, either through effects on metabolism central to the proper functions of the leptin system, and/or directly through binding to human leptin or human leptin receptor, thereby affecting the function.

TESTING THE HYPOTHESIS:
Dietary interventions should compare effects of agrarian and non-agrarian diets on incidence of diseases of affluence, related risk factors and leptin resistance. A non-significant (p = 0.10) increase of cardiovascular mortality was noted in patients advised to eat more whole-grain cereals.

Our lab conducted a study on 24 domestic pigs in which a cereal-free hunter-gatherer diet promoted significantly higher insulin sensitivity, lower diastolic blood pressure and lower C-reactive protein as compared to a cereal-based swine feed.

Testing should also evaluate the effects of grass lectins on the leptin system in vivo by diet interventions, and in vitro in various leptin and leptin receptor models.

Our group currently conducts such studies.

IMPLICATIONS OF THE HYPOTHESIS:
If an agrarian diet initiates diseases of affluence it should be possible to identify the responsible constituents and modify or remove them so as to make an agrarian diet healthier.

Eaton SB.
Department of Anthropology and Radiology, Emory University, Atlanta.
Abstract
Awareness of the ancestral human diet might advance traditional nutrition science. The human genome has hardly changed since the emergence of behaviourally-modern humans in East Africa 100-50 x 10(3) years ago; genetically, man remains adapted for the foods consumed then. The best available estimates suggest that those ancestors obtained about 35% of their dietary energy from fats, 35% from carbohydrates and 30% from protein. Saturated fats contributed approximately 7.5% total energy and harmful trans-fatty acids contributed negligible amounts. Polyunsaturated fat intake was high, with n-6:n-3 approaching 2:1 (v. 10:1 today). Cholesterol consumption was substantial, perhaps 480 mg/d. Carbohydrate came from uncultivated fruits and vegetables, approximately 50% energy intake as compared with the present level of 16% energy intake for Americans. High fruit and vegetable intake and minimal grain and dairy consumption made ancestral diets base-yielding, unlike today’s acid-producing pattern. Honey comprised 2-3% energy intake as compared with the 15% added sugars contribute currently. Fibre consumption was high, perhaps 100 g/d, but phytate content was minimal. Vitamin, mineral and (probably) phytochemical intake was typically 1.5 to eight times that of today except for that of Na, generally.

Cordain L1, Eaton SB, Miller JB, Mann N, Hill K.
Department of Health and Exercise Science, Colorado State University
Eur J Clin Nutr. 2002 Mar;56 Suppl 1:S42-52.
Abstract
OBJECTIVE:
Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). Consequently, the characterization of HG diets may have important implications in designing therapeutic diets that reduce the risk for CVD in Westernized societies. Based upon limited ethnographic data (n=58 HG societies) and a single quantitative dietary study, it has been commonly inferred that gathered plant foods provided the dominant energy source in HG diets.
METHOD AND RESULTS:
In this review we have analyzed the 13 known quantitative dietary studies of HG and demonstrate that animal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). This data is consistent with a more recent, comprehensive review of the entire ethnographic data (n=229 HG societies) that showed the mean subsistence dependence upon gathered plant foods was 32%, whereas it was 68% for animal foods. Other evidence, including isotopic analyses of Paleolithic hominid collagen tissue, reductions in hominid gut size, low activity levels of certain enzymes, and optimal foraging data all point toward a long history of meat-based diets in our species. Because increasing meat consumption in Western diets is frequently associated with increased risk for CVD mortality, it is seemingly paradoxical that HG societies, who consume the majority of their energy from animal food, have been shown to be relatively free of the signs and symptoms of CVD.
CONCLUSION:
The high reliance upon animal-based foods would not have necessarily elicited unfavorable blood lipid profiles because of the hypolipidemic effects of high dietary protein (19-35% energy) and the relatively low level of dietary carbohydrate (22-40% energy). Although fat intake (28-58% energy) would have been similar to or higher than that found in Western diets, it is likely that important qualitative differences in fat intake, including relatively high levels of MUFA and PUFA and a lower omega-6/omega-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD.

Katharine Milton
Department of Environmental Science, Policy & Management, University of California, Berkeley,
J. Nutr. 133: 3886S–3892S, 2003.
ABSTRACT
Wild primates take most of the daily diet from plant sources, eating moderate to small amounts of animal
source foods (ASF). Plant materials make up from 87% to .99% of the annual diet of great apes, the closest living
relatives of modern humans (Homo sapiens sapiens). Reflecting their close genetic relationship, gut form and nutrient
requirements of apes and humans (Hominoidea) are very similar, as is their pattern of digestive kinetics—one
predicated on a relatively slow turnover of ingesta. In plant-eating mammals, in contrast to carnivorous mammals,
greater body size is associated with lower dietary quality. Turning to ASF as a routine rather than occasional dietary
component would have permitted the evolving human lineage to evade the nutritional constraints placed on body size
increases in apes. Without routine access to ASF, it is highly unlikely that evolving humans could have achieved their
unusually large and complex brain while simultaneously continuing their evolutionary trajectory as large, active and
highly social primates. As human evolution progressed, young children in particular, with their rapidly expanding large
brain and high metabolic and nutritional demands relative to adults would have benefited from volumetrically
concentrated, high quality foods such as meat. Today, many humans, particularly those in high income nations, have
a variety of high quality, non-ASF dietary alternatives, but such foods were not generally available to paleolithic human
ancestors nor to many people today in low income nations.

Lindeberg S
Department of Primary Health Care Research, Lund University, Sweden
Am J Hum Biol. 2012 Mar-Apr;24(2):110-5. doi: 10.1002/ajhb.22218. Epub 2012 Jan 19.
Abstract
OBJECTIVES:
To explore the possibility that a paleolithic-like diet can be used in the prevention of age-related degenerative Western disease.
METHODS:
Literature review of African Paleolithic foods in relation to recent evidence of healthy nutrition.
RESULTS AND DISCUSSION:
Available evidence lends weak support in favor and little against the notion that lean meat, fish, vegetables, tubers, and fruit can be effective in the prevention and treatment of common Western diseases. There are no obvious risks with avoiding dairy products, margarine, oils, refined sugar, and cereal grains, which provide 70% or more of the dietary intake in northern European populations. If stroke, coronary heart disease, type 2 diabetes, and cancer are preventable by dietary changes, an ancestral-like diet may provide an appropriate template.

O’Keefe JH Jr1, Cordain L.
Mid America Heart Institute, Cardiovascular Consultants, Kansas City, USA
Mayo Clin Proc. 2004 Jan;79(1):101-8.
Abstract
Our genetic make-up, shaped through millions of years of evolution, determines our nutritional and activity needs. Although the human genome has remained primarily unchanged since the agricultural revolution 10,000 years ago, our diet and lifestyle have become progressively more divergent from those of our ancient ancestors. Accumulating evidence suggests that this mismatch between our modern diet and lifestyle and our Paleolithic genome is playing a substantial role in the ongoing epidemics of obesity, hypertension, diabetes, and atherosclerotic cardiovascular disease. Until 500 generations ago, all humans consumed only wild and unprocessed food foraged and hunted from their environment. These circumstances provided a diet high in lean protein, polyunsaturated fats (especially omega-3 [omega-3] fatty acids), monounsaturated fats, fiber, vitamins, minerals, antioxidants, and other beneficial phytochemicals. Historical and anthropological studies show hunter-gatherers generally to be healthy, fit, and largely free of the degenerative cardiovascular diseases common in modern societies. This review outlines the essence of our hunter-gatherer genetic legacy and suggests practical steps to re-align our modern milieu with our ancient genome in an effort to improve cardiovascular health.

Lindeberg S1, Jönsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjöström K, Ahrén B.
Department of Medicine, University of Lund
Diabetologia. 2007 Sep;50(9):1795-807. Epub 2007 Jun 22.
Abstract
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.

Jönsson T1, Granfeldt Y, Erlanson-Albertsson C, Ahrén B, Lindeberg S.
Department of Clinical Science, University of Lund
Nutr Metab (Lond). 2010 Nov 30;7:85. doi: 10.1186/1743-7075-7-85.
Abstract
BACKGROUND:
We found marked improvement of glucose tolerance and lower dietary energy intake in ischemic heart disease (IHD) patients after advice to follow a Paleolithic diet, as compared to a Mediterranean-like diet. We now report findings on subjective ratings of satiety at meals and data on the satiety hormone leptin and the soluble leptin receptor from the same study.
METHODS:
Twenty-nine male IHD patients with impaired glucose tolerance or diabetes type 2, and waist circumference > 94 cm, were randomized to ad libitum consumption of a Paleolithic diet (n = 14) based on lean meat, fish, fruit, vegetables, root vegetables, eggs, and nuts, or a Mediterranean-like diet (n = 15) based on whole grains, low-fat dairy products, vegetables, fruit, fish, and oils and margarines during 12 weeks. In parallel with a four day weighed food record the participants recorded their subjective rating of satiety. Satiety Quotients were calculated, as the intra-meal quotient of change in satiety during meal and consumed energy or weight of food and drink for that specific meal. Leptin and leptin receptor was measured at baseline and after 6 and 12 weeks. Free leptin index was calculated as the ratio leptin/leptin receptor.
RESULTS:
The Paleolithic group were as satiated as the Mediterranean group but consumed less energy per day (5.8 MJ/day vs. 7.6 MJ/day, Paleolithic vs. Mediterranean, p = 0.04). Consequently, the quotients of mean change in satiety during meal and mean consumed energy from food and drink were higher in the Paleolithic group (p = 0.03). Also, there was a strong trend for greater Satiety Quotient for energy in the Paleolithic group (p = 0.057). Leptin decreased by 31% in the Paleolithic group and by 18% in the Mediterranean group with a trend for greater relative decrease of leptin in the Paleolithic group. Relative changes in leptin and changes in weight and waist circumference correlated significantly in the Paleolithic group (p < 0.001) but not in the Mediterranean group. Changes in leptin receptor and free leptin index were not significant.
CONCLUSIONS:
A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet.

Jönsson T1, Granfeldt Y, Lindeberg S, Hallberg AC.
Center for Primary Health Care Research, Lund University
Nutr J. 2013 Jul 29;12:105. doi: 10.1186/1475-2891-12-105.
Abstract
BACKGROUND:
We found marked improvement of glycemic control and several cardiovascular risk factors in patients with type 2 diabetes given advice to follow a Paleolithic diet, as compared to a diabetes diet. We now report findings on subjective ratings of satiety at meal times and participants’ other experiences of the two diets from the same study.
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. In parallel with a four-day weighed food record, the participants recorded their subjective rating of satiety. Satiety quotients were calculated as the intra-meal quotient of change in satiety during a meal and consumed energy or weight of food and drink for that specific meal. All participants answered the same three open-ended questions in a survey following each diet: “What thoughts do you have about this diet?”, “Describe your positive and negative experiences with this diet” and “How do you think this diet has affected your health?”.
RESULTS:
The participants were equally satiated on both diets. The Paleolithic diet resulted in greater satiety quotients for energy per meal (p = 0.004), energy density per meal (p = 0.01) and glycemic load per meal (p = 0.02). The distribution of positive and negative comments from the survey did not differ between the two diets, and the comments were mostly positive. Among comments relating to recurring topics, there was no difference in distribution between the two diets for comments relating to tastelessness, but there was a trend towards more comments on the Paleolithic diet being satiating and improving blood sugar values, and significantly more comments on weight loss and difficulty adhering to the Paleolithic diet.
CONCLUSIONS:
A Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes. The Paleolithic diet was seen as instrumental in weight loss, albeit it was difficult to adhere to.

Bribiescas RG1, Hickey MS.
Reproductive Ecology Laboratory, Department of Anthropology, Yale University
Nutr Metab (Lond). 2006 Aug 30;3:34.
Abstract
BACKGROUND:
Serum leptin variation is commonly associated with fat percentage (%), body mass index (BMI), and activity. In this investigation, we report population differences in mean leptin levels in healthy men as well as associations with fat % and BMI that are independent of these factors and reflect likely variation resulting from chronic environmental conditions.
METHODS:
Serum leptin levels, fat %, and BMI were compared between lean American distance runners and healthy Ache Native Americans of Paraguay. Mean levels were compared as were the regressions between fat %, BMI, and leptin. Comparisons were performed between male American distance runners (n = 13, mean age 32.2 +/- 9.2 SD) and highly active male New World indigenous population (Ache of Paraguay, n = 20, mean age 32.8 +/- 9.2) in order to determine whether significant population variation in leptin is evident in physically active populations living under different ecological circumstances independent of adiposity and BMI.
RESULTS:
While the Ache were hypothesized to exhibit higher leptin due to significantly greater adiposity (fat %, Ache 17.9 +/- 1.8 SD; runners 9.7 +/- 3.2, p < 0.0001), leptin levels were nonetheless significantly higher in American runners (Ache 1.13 ng/ml +/- 0.38 SD; runners 2.19 +/- 1.15; p < 0.007). Significant differences in the association between leptin and fat % was also evident between Ache and runner men. Although fat % was significantly related with leptin in runners (r = 0.90, p < 0.0001) fat % was negatively related in Ache men (r = -0.50, p < 0.03).
CONCLUSION:
These results illustrate that chronic ecological conditions in addition to activity are likely factors that contribute to population variation in leptin levels and physiology. Population variation independent of adiposity should be considered to be an important source of variation, especially in light of ethnic and population differences in the incidence and etiology of obesity, diabetes, and other metabolic conditions.

Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S.
Department of Clinical Sciences, Lund University, Sweden
Cardiovasc Diabetol. 2009 Jul 16;8:35. doi: 10.1186/1475-2840-8-35.
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.

Carter P1, Achana F, Troughton J, Gray LJ, Khunti K, Davies MJ.
Diabetes Research Unit, University of Leicester, UK.
J Hum Nutr Diet. 2014 Jun;27(3):280-97. doi: 10.1111/jhn.12138. Epub 2013 Jun 22.
Abstract
BACKGROUND:
Overweight or obese individuals with type 2 diabetes are encouraged to lose weight for optimal glucose management, yet many find this difficult. Determining whether alterations in dietary patterns irrespective of weight loss can aid glucose control has not been fully investigated.
METHODS:
We conducted a systematic review and meta-analysis aiming to determine the effects of a Mediterranean diet compared to other dietary interventions on glycaemic control irrespective of weight loss.
RESULTS:
The Mediterranean diet reduced HbA1c significantly compared to usual care but not compared to the Palaeolithic diet.

Pedro Carrera-Bastos1, Maelan Fontes-Villalba, James H O’Keefe, Staffan Lindeberg, Loren Cordain

Abstract: It is increasingly recognized that certain fundamental changes in diet and lifestyle that occurred after the Neolithic Revolution, and especially after the Industrial Revolution and the Modern Age, are too recent, on an evolutionary time scale, for the human genome to have completely adapted.

This mismatch between our ancient physiology and the western diet and lifestyle underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis, which are rare or virtually absent in hunter–gatherers and other non-westernized populations.

It is therefore proposed that the adoption of diet and lifestyle that mimic the beneficial characteristics of the preagricultural environment is an effective strategy to reduce the risk of chronic degenerative diseases.

Kaidonis J1, Townsend G2. School of Dentistry, The University of Adelaide, Australia.
Ann Anat. 2015 Feb 24. pii: S0940-9602(15)00024-2. doi: 10.1016/j.aanat.2015.02.002. [Epub ahead of print]
Abstract
Biofilms are naturally found in all wet environments including the oral structures of nearly all species. Human oral biofilms have existed since our earliest ancestors and have evolved symbiotically with the dentition over many millennia within a Palaeolithic, hunter-gatherer setting. Irrespective of the plant-animal ratio, it can be argued that the Palaeolithic diet was essentially acidic, and acted as a selective force for much of the evolution of the stomatognathic system. The relationship between saliva, biofilm and teeth, the ‘sialo-microbial-dental complex’, provides oral health benefits and offers a different perspective to the old dental paradigm that only associated oral biofilms (plaque) with disease (caries). This new paradigm emphasises that oral biofilms are essential for the ‘mineral maintenance’ of teeth. Oral biofilms provide physical protection from dietary acid and together with bacterial metabolic acids cause the resting pH of the biofilm to fall below neutral. This is then followed by the re-establishment of a neutral environment by chemical interactions mediated by the saliva within the biofilm. Such pH fluctuations are often responsible for the cyclic demineralisation, then remineralisation of teeth, a process necessary for tooth maturation. However, since the advent of farming and especially since the industrial revolution, the increase in consumption of carbohydrates, refined sugars and acidic drinks has changed the ecology of biofilms. Biofilm biodiversity is significantly reduced together with a proliferation of acidogenic and aciduric organisms, tipping the balance of the ‘demin-remin’ cycle towards net mineral loss and hence caries. In addition, the consumption of acidic drinks in today’s societies has removed the protective nature of the biofilm, leading to erosion. Erosion and caries are ‘modern-day’ diseases and reflect an imbalance within the oral biofilm resulting in the demineralisation of teeth.

Yvonne Junker, Sebastian Zeissig, Seong-Jun Kim,Donatella Barisani, Herbert Wieser, Daniel A. Leffler, Victor Zevallos, Towia A. Libermann, Simon Dillon, Tobias L. Freitag, Ciaran P. Kelly, and Detlef Schuppan
J Exp Med. 2012 Dec 17; 209 (13): 2395–2408.
In this study, we show that members of the nongluten α-amylase/trypsin inhibitor (ATI) family contained in wheat and related cereals are strong inducers of innate immune responses in human and murine macrophages, monocytes, and DCs. ATI family members activate the TLR4–MD2–CD14 complex and elicit strong innate immune effects not only in vitro but also in vivo after oral or systemic challenge. Our findings have broad implications not only for celiac disease but also for other intestinal inflammatory disorders of the gastrointestinal tract.

CONCLUSIONS:
Even short-term consumption of a Paleolithic-type diet improved glucose control and lipid profiles in people with type 2 diabetes compared with a conventional diet containing moderate salt intake, low-fat dairy, whole grains and legumes.
BACKGROUND/OBJECTIVES:
The contemporary American diet figures centrally in the pathogenesis of numerous chronic diseases- ‘diseases of civilization’-such as obesity and diabetes. We investigated in type 2 diabetes whether a diet similar to that consumed by our pre-agricultural hunter-gatherer ancestors (‘Paleolithic’ type diet) confers health benefits.
SUBJECTS/METHODS:
We performed an outpatient, metabolically controlled diet study in type 2 diabetes patients. We compared the findings in 14 participants consuming a Paleo diet comprising lean meat, fruits, vegetables and nuts, and excluding added salt, and non-Paleolithic-type foods comprising cereal grains, dairy or legumes, with 10 participants on a diet based on recommendations by the American Diabetes Association (ADA) containing moderate salt intake, low-fat dairy, whole grains and legumes. There were three ramp-up diets for 7 days, then 14 days of the test diet. Outcomes included the following: mean arterial blood pressure; 24-h urine electrolytes; hemoglobin A1c and fructosamine levels; insulin resistance by euglycemic hyperinsulinemic clamp and lipid levels.
RESULTS:
Both groups had improvements in metabolic measures, but the Paleo diet group had greater benefits on glucose control and lipid profiles. Also, on the Paleo diet, the most insulin-resistant subjects had a significant improvement in insulin sensitivity (r=0.40, P=0.02), but no such effect was seen in the most insulin-resistant subjects on the ADA diet (r= 0.39, P=0.3).
Masharani U1, Sherchan P1, Schloetter M2, Stratford S1, Xiao A1, Sebastian A3, Nolte Kennedy M1, Frassetto L1.
Author information
1Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
2Clinical and Translational Science Institute, University of California San Francisco, San Francisco, CA, USA.
31] Department of Medicine, University of California San Francisco, San Francisco, CA, USA [2] Clinical and Translational Science Institute, University of California San Francisco, San Francisco, CA, USA.
Eur J Clin Nutr. 2015 Apr 1. doi: 10.1038/ejcn.2015.39. [Epub ahead of print]