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Paleo Diet

July 20, 2009 Written by JP       [Font too small?]

Sometimes we need to look back to the distant past in order to create a better future. This certainly seems to be the case in terms of dietary choices. A relatively unpublicized, but growing body of research is telling us that so called “primal eating” may be healthier than the most common diets adopted by modern man. It’s hard for some people to accept that “cave men” could possibly have figured out a better way of eating than modern nutritionists and physicians. But as is often the case, it’s not simply a matter of intellect or lack thereof. Rather, it’s an issue of man respecting the laws of nature. If we can manage to combine the intrinsic knowledge of our predecessors with the discoveries of 21st century science, then we can truly benefit from the best of both worlds.

The Paleolithic Age was the time of the hunter-gatherer. Wild animals and seafood were the primary sources of protein and fat, while fruits, nuts, seeds and vegetables made up the remainder of the ancient menu plan. A study published just last week in the journal Cardiovascular Diabetology is the most recent piece of evidence that this sort of eating style may offer modern day advantages. (1)

13 type 2 diabetics, with an average age of 64, participated in the current study – 10 men and 3 women who were not being treated with insulin. On two separate 3 month periods, they were asked to consume one of two diets:

  1. A Paleolithic “Old Stone Age” Diet – Mostly consisting of eggs, fish, fruit, “lean meats”, nuts and vegetables.
  2. A typical “Diabetes Diet” – A low-fat diet that emphasized low-glycemic fruit, (whole) grains and vegetables.

Before and after blood tests were administered during each dietary phase. The testing yielded the following results:

  • The Paleolithic Diet improved long-term blood sugar levels (as measured by HbA1c), reduced blood pressure, triglycerides, body fat and weight and increased the amount of HDL “good” cholesterol – in comparison to the “Diabetes Diet”.
  • The Paleolithic Diet was found to contain smaller amounts of dairy products and grains and larger quantities of eggs, fruit, meat and vegetables than the standard diabetic diet.
  • The lower-fat “Diabetic Diet” turned out to be higher in carbohydrates, fat, glycemic load and total calories.

The last observation was quite unexpected and may be the result of poor appetite management in this application of a “Diabetic Diet”. Ultimately, the authors of the study concluded that, “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”.

Another study from February 2009 prescribed a “paleolithic type diet” to 9 overweight volunteers. Once again, the participants were urged to eat plenty of “lean meat, fruits, vegetables and nuts” and to avoid foods such as “cereal grains, dairy and legumes”. The effects of a 10 day paleolithic eating pattern resulted in a decrease in blood pressure, improved arterial function, a drop in insulin and LDL “bad” cholesterol and triglycerides. These findings were independent of any weight loss effect and indicate that even short term application of this type of diet can result in dramatic changes for those at risk for diabetes and heart disease. (2)

Other short term studies in healthy individuals have found positive changes in body fat composition, a decrease in overall caloric intake, and an increase in dietary antioxidants and vital nutrients such as potassium. Such alterations typically provoke a healthy decline in blood pressure readings which may reduce the likelihood of blindness, heart and kidney disease and strokes. (3)

Source: European Journal of Clinical Nutrition 1997 (link)

A 15 month trial conducted on young pigs also demonstrated the powerful effects of paleolithic nutrition on various health markers. The removal of cereal grains from the food supply of piglets resulted in lower body fat and weight. The cereal free pigs also exhibited greater insulin sensitivity and lower levels of inflammation (as measured by C-reactive protein levels). These physiological effects resulted in 13% lower blood pressure as compared to pigs who were fed a typical cereal based diet. (4)

Many doctors and nutritionists have a hard time accepting these studies. They’ve been taught that eating animal fat and protein is a leading cause of both cardiovascular disease and diabetic complications. This controversy was addressed all the way back in 2002 in the European Journal of Clinical Nutrition. In that paper, a group of scientists provided evidence that “hunter-gatherer” (HG) diets typically get about 65% of their calories from “animal food” and the remaining 35% from “plant food”. While HG diets tend to be higher in total fat and protein and lower in carbohydrates, they also tend to be richer sources of beneficial antioxidants, fiber, nutrients, omega-3 fatty acids and protective phytochemicals. It may very well be that this combination of factors yields the broad array of health benefits noted in the recent experiments I’ve presented today. (5)

It would be a major mistake to disregard all of the leaps and bounds of modern science. But it’s equally foolhardy to forget the lessons that history is desperately trying to teach us. The very foods that countless generations have grown up on are likely our best friends in promoting good health. Newly developed laboratory chemicals may ultimately hold great promise, but they simply don’t have the same track record that real, whole foods do.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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24 Comments & Updates to “Paleo Diet”

  1. Chris B Says:

    None of that suprises me in the slightest…

    It’s taken millions and millions of years for us to evolve and during that time we’ve mostly eaten the same things. It stands to reason eating what our body’s evolved to eat would be healthier for us.

    It’s only the last couple of hundred years (and 200 years in evolutionary terms is nothing) that our diets have strayed away from a “normal” diet.

    In fact a LOT of our ailmenents and conditions are down to the fact we don’t respect how we evolved i.e. we’re evolved to exercise, we’re evolved to get good levels of sun exposure, we evolved to eat mostly fresh raw whole foods etc.

    And looking at macronutrients… higher protein diets are more satiating, fats in foods helps blunt the insulin response (not to mention essential for health), grains can be fairly glycemic. Seems to me the typical “Diabetes Diet” is a bit backwards.

    Cheers,
    Chris

  2. JP Says:

    Good points, Chris. I completely agree.

    I’m hoping that studies like this will help get that message out and possibly help bring about a philosophical shift in what a healthy diet could/should be.

    Be well!

    JP

  3. anne h Says:

    As a Nurse, I cringe anytime I have to educated people on the standard Diabetic type diet. I have never met an actual person with Diabetes who follows the diet without cheating! Except when it comes to weight loss, and they cut way back on ALL carbs, and behold – it works!

  4. JP Says:

    Thanks for that report “from the field”, Anne. :)

    Let’s hope the current Diabetes Diet dogma soon passes.

    Be well!

    JP

  5. Nina K. Says:

    Oh well, our societies are so overdeveloped and far away from our instincts and natural needs, im not surprised.

    Look back at the last 30 years, we improved technically way to much, its also unnatural that we can move physically from New York to Paris in a few hours. Everything has to be efficient, more efficient, efficient to the max. But for what? For a shorter life?

    When i go shopping i always wonder and smile about the funny coloured packages called “foods” – lots of plastics filled with chemicals from the labratory, which shall remember of healthy and tasty foods…

    The oldes old people in the world don’t eat such stuff. They eat really close to the paleo diet. Is that a wonder? No, its sad that a lot of people lost their sense for the wonder of nature and life.

    Through ages we achieved a very high lifespan, but now we are so far away from our natural needs, so a decline in life expectancy and a increase of lifestyle diseases is now the issue. No wonder.

    Stay healthy.
    Nina K.

  6. JP Says:

    Nina,

    I agree that a greater appreciation for simpler, unprocessed foods would be a huge step in the right direction. That kind of a shift isn’t going to be easy as it goes against many popular trends of the current day. But, I’m a firm believer that people can change for the better. I just think it often happens when we see a positive example set. If more people understood that natural, whole foods can be genuinely delicious and nutritious … I think they’d resume their place of prominence in the modern diet.

    Hopefully that old saying is true, “What’s old is new again”. :)

    Be well!

    JP

  7. Derek Says:

    JP,

    What do you think of the Paleo diet for dandruff and acne, considering both are manifestations of inflammation? Also, I’ve read and observed that East Asians have minimal, if any, acne and male pattern baldness, two conditions where inflammation plays a part. But the traditional Japanese diet, which is what I consider the optimal diet in the world, consists of refined white rice. Thoughts on this? Also, I know Western society is not promoting whole grains, such as brown rice. Until recently, I’d never been to a Chinese restaurant or Japanese restaurant that served me brown rice. Perhaps Asians were onto something. I’ve read there’s a connection between gluten in wheat, for example, and neurological manifestations, such as tics. Perhaps the only way to garner the carbohydrate fullness of the grains without any potential neuropathies is to mill the hell out of the grain.

  8. Derek Says:

    That should be, Western society is NOW promoting whole grains.

  9. JP Says:

    Derek,

    Thank you for your thoughtful comments! :)

    I think that unhealthful modern diets can play a role in acne and dandruff. Not only do both conditions involve an inflammatory component but a fungal aspect as well. Refined carbohydrates are known to contribute (negatively) to both of these risk factors.

    re: Asian diet

    I suspect that genetics and a higher intake of phtyochemicals/phytoestrogens and tea may be at work in this case. Another possibility is that greater amounts of dietary fiber and fish may compensate for the downside of eating white rice.

    re: gluten

    I don’t think refining grains is the best option. However, avoiding gluten would be a good step in my opinion. I personally try to avoid gluten altogether and recommend others do the same – if only for a trial period to see if it improves their overall health.

    Be well and happy holidays!

    JP

  10. Derek Says:

    JP,

    Where does the dietary fiber come from in the Japanese diet if not from rice? Isn’t the dietary fiber indeed the white rice?

    I’ve read there’s an isoflavone, a type of phytoestrogen in legumes like soy, peanuts, and red clover tea, that metabolizes in the gut to a molecule called equol which is a potent male pattern baldness fighter. Now, I agree that something like male pattern baldness has multiple causes, such as dihydrotestosterone, inflammation, and so on. I became really interested in nutritional biochemistry and nutrition from my own experience of thinking my hair was starting to thin in spring 2008. In your opinion, do you think not eating soy would adversely affect male pattern baldness growth?

    I will say that I’ve been off of dairy for 21 months, and my back acne cleared up 99% so that I can wear cut off shirts at the gym whenever now. However, I still get the occasional breakout on the face and back. But I do still have dandruff in my hair, which would seem to indicate along with acne that I’m still inflamed because of some reason. So while my diet is worlds better than it was before this all — and my diet was pretty healthy before in my opinion — obviously the dandruff is a sign something’s still wrong. Lack of sunlight during winter, washing with hot water, not shampooing often enough are reasons I’ve read for dandruff, but do you believe perhaps my grain consumption — mostly rice and corn — contributes to this?

  11. JP Says:

    Derek,

    White rice isn’t a good fiber source but soy and vegetables such as bamboo shoots, bell peppers, bok choy, burdock, daikon, green beans, eggplant, onions, sea vegetables, spinach and sweet potatoes all contain decent fiber figures.

    Red clover and soy *may* help with MPB but I’m unaware of any specific studies that prove that dietary soy can reverse MPB. Another source of lignans/phytoestrogens, flax seeds, do have a limited amount of evidence to back their use in this arena. Here’s a recent column I wrote about this topic:

    http://www.healthyfellow.com/236/natural-remedies-for-female-and-male-hair-loss/

    I can’t think of any reason not to avoid corn and rice – at least as a trial. In my opinion, they’re not the healthiest food choices in general. You might also look into only using a mild, natural shampoo (perhaps with added antiseptic properties – such as tea tree oil) and installing a chlorine filter for your shower head. In addition, supplementing with a good probiotic may improve the balance of healthful to harmful bacteria in your system. This could assist in the metabolism of hormones and discourage excessive fungal growth as well.

    These are just a few ideas. Unfortunately, MPB doesn’t always respond well to conventional or natural measures. The upside of trying the natural route is that it generally promotes better health rather than side effects.

    I hope this helps!

    Be well!

    JP

  12. Derek Says:

    JP,

    You say soy is a good source of fiber. Isn’t soy not part of the Paleo diet because it’s a legume?

    I emailed Professor Cordain about the Paleo diet and its relation to male pattern baldness, noting the baldness fighting properties of the isoflavone daidzein found in soy. I’ve been feverishly researching natural male pattern baldness remedies at http://www.hairloss-research.org, and I don’t want to give up soy and peanuts (the highest source of arginine, the basis for nitric oxide supplements and Viagra) if it means having my hair continue to thin. However, I’ve been on this diet for 1.5 years and I still get pretty bad dandruff, so obviously something is up still. Clues.

    I always thought cereal grains were awesome sources of fiber. On another note, I always get starches and fiber confused.

  13. Derek Says:

    In your pie charts, it says primitive man ate 99% fruits, vegetables, roots, legumes, and nuts. What about meat? And I thought primitive man did not eat legumes. And I thought only certain roots were eaten, such as carrots, and many were not eaten, such as potatoes.

    I also saw that Dr. Cordain mentioned tomatoes, a member of the deadly nightshade family (along with potatoes and eggplant I believe) potentially being related to problems similar to those grains and legumes bring.

  14. JP Says:

    Derek,

    Soy is generally not considered to be part of the Paleolithic diet. However, it is a good source of fiber.

    Some cereals are also rich in fiber. Having said that, graines aren’t needed in order to attain plentiful amounts of dietary fiber. There are plenty of Paleo-friendly fruits, nuts, seeds and vegetables that are healthier sources of fiber, IMO.

    re: the pie chart

    Please note that this only references carbohydrate intake. The chart doesn’t address any dietary sources of fat and protein. That’s why there isn’t any mention of meat.

    re: dandruff

    This may or may not be diet related. *If* it related to any diet or lifestyle choice, I would personally try the following:

    + Make sure to eat plenty of omega-3 fatty acids – mostly from fish sourced foods and supplements (fish oil or krill oil).

    + Consider supplementing with a good, high-potency multivitamin/mineral and GLA (gamma linolenic acid).

    + Experiment with eliminating potentially allergic foods. Eat a simple diet and/or rotate suspect foods.

    + Get plenty of (sensible) sunshine and/or supplement with optimal levels of Vitamin D.

    + Install a chlorine filter for your shower head. Chlorine can be drying and irritating.

    + Use only mild, natural shampoos and cleansers. If possible choose products with natural, anti-fungal/antiseptic properties. A fungus by the name of malassezia is believed to be a leading cause of dandruff.

    I hope this help!

    Be well!

    JP

  15. Nick Says:

    The “animal food” eaten by the paleolithic man consisted of wild game. Given the size of the current world population, the limited resources of the planet, and the decline in the number of wild animals, I just don’t see how we could have a similar diet; except maybe for some isolated tribes in the wilderness.

  16. JP Says:

    Nick,

    I’m all for eating wilder sources of protein – bison, fish, free-range chickens, grass-fed meat, fish, ostrich, venison, etc. I think it’s better for all involved – the animals, the land and those that eat them.

    re: the sustainability of a paleolithic diet

    I think Dr. Loren Cordain provides a good summary of this issue:

    “Q. Are hunter-gatherer diets practical to feed the world’s population?

    A. There are more than six billion people alive on the planet in the 21st century. Cereal grains provide more than half of the energy required to feed the world’s people. Without cereal grains, there would be massive starvation of unprecedented proportion on the planet. We have walked down a path of absolute dependence upon cereal grains — a path that cannot be reversed. However, in most western countries, cereals are not a necessity, particularly in many segments of the population that suffer most from Syndrome X and other chronic diseases of civilization. In this population, a return to a Stone Age Diet is not only possible, but highly practical in terms of long-term healthcare costs.”

    http://www.thepaleodiet.com/faqs/

    Thank you for your thoughtful comments!

    Be well!

    JP

  17. sebastian Says:

    really nice to read it all + including this little posting debate.
    i read somewhere that this whole thing about grains is more a question of the anti-nutrients in all theese grains and to some point beans and legumes.

    1. at some other page (http://fanaticcook.blogspot.com/2006/11/paleolithic-diet-4-antinutrients.html) another person points out something about that most paleo-dieters forget about the fact that there are so called anti-nutrients in nuts and some vegetables too, so why not go out and eleminate that one too, he adresses (http://photos1.blogger.com/x/blogger2/2169/1034/1600/132473/toxintable1.jpg)

    2. paleo´s official homepage claims that it may improve IBS and bad digestion, wich i(as a person with bad digestion system) find hard to believe since meat should not be that easily digestible …
    i know that some people who became vegatarians because of that, and i found out that i should keep it lov on pork and red meat myself, so as you can see thats a point where i´m totally confuzed about the paleo diét.

    3. i do not understand why you claim soy as a good, when today theres a lot of fuzz about soy and how unhealthy it is (and the paleo has same view as i noticed. maybe mostly because its a bean) but people (health people like some paleo dieters and basicly all raw food dieters) seems to be soaking and sprouting every grain and been they can found to remove the antru nutrients and have Maximum digestibility(i love how that sounds)

    4. on the other hands in the talk of legumes and beans i found this (i have not got into how reliable the sources is) about the japanese and Okinawan diéts looked like anno 1950, there are tons of sweet potatoes, legumes, calorie restriction and low protein … + longivity ! – study: http://4.bp.blogspot.com/_9mNHNOMqaqM/TFGDVw-hqHI/AAAAAAAADFQ/Cg8YTXpHJwg/s1600/OkinawanDiet1.jpg – whole article: http://fanaticcook.blogspot.com/2010/07/traditional-okinawan-diet-sweet.html

    :) wich is also weird in the whole acid/alkaline food debate huh´!!

    - sebastian :)

  18. JP Says:

    Sebastian,

    Thank you for your thoughtful comments. I’ll briefly try to address some of the issues you’ve brought up:

    + Some people who adhere to a Paleo-style diet sprout nuts and seeds in order to reduce the quantity of anti-nutrients such as phytic acid.

    + Grains may be unsuitable for certain/many people for other reasons including potentially allergenic components including gluten.

    + The notion that meat is hard to digest isn’t universally accepted. Mankind has been eating meat much longer than grains. Therefore, it makes sense that our bodies are generally well adapted to processing it. The key is eat it slowly, in moderation and to it chew thoroughly. This is also a traditional way of eating. :)

    + Many people with digestive conditions and food allergies/sensitivities do well on a so-called elimination diet which often pairs animal sources of protein and vegetables. Dairy and grains are generally limited or restricted in such protocols.

    + The actual science on soy is mixed. I’ve written several columns about this that attempt to illustrate the inconsistent data:

    http://www.healthyfellow.com/218/the-truth-about-soy/

    http://www.healthyfellow.com/310/soy-guide-for-men/

    http://www.healthyfellow.com/577/soy-guide-for-women/

    http://www.healthyfellow.com/472/isoflavone-research/

    http://www.healthyfellow.com/410/food-allergies/

    I hope this is a good start to our discussion. :)

    Be well!

    JP

  19. maria Says:

    Are there any personal experiences about treating inflammation/autoimmune conditions with the paleo-diet? I am on the diet and am seeking encouragement.

  20. JP Says:

    Maria,

    This link may be inspiring to you:

    http://thepaleodiet.com/autoimmune.html

    Be well!

    JP

  21. JP Says:

    Update 05/18/15:

    http://www.nrjournal.com/article/S0271-5317%2815%2900097-4/abstract

    Nutrition Research – May 13, 2015

    Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations

    Recent research suggests that traditional grain-based heart healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol (TC), HDL, LDL and TG concentrations in non-diabetic adults with hyperlipidemia to a greater extent than a grain-based heart healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male, 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart healthy diet for four months, followed by a Paleolithic diet for four months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated measures ANOVA. Four months of Paleolithic nutrition significantly lowered (P < 0.001) mean TC, LDL, and TG and increased (P < 0.001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart healthy dietary recommendations.

    Be well!

    JP

  22. JP Says:

    Updated 1/28/16:

    http://www.nature.com/ijo/journal/vaop/naam/abs/ijo20164a.html

    Int J Obes (Lond). 2016 Jan 20.

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

    BACKGROUND/OBJECTIVES: Our objective was to investigate changes in liver fat and insulin sensitivity during a 2-year diet intervention. An ad libitum Paleolithic diet was compared to a conventional, low-fat diet.

    SUBJECTS/METHODS: Seventy healthy, obese, postmenopausal women were randomized to either a Paleolithic diet or a conventional, low-fat diet. Diet intakes were ad libitum. Liver fat was measured with proton magnetic resonance spectroscopy. Insulin sensitivity was evaluated with oral glucose tolerance tests and calculated as HOMA-IR/Liver IR index for hepatic insulin sensitivity and OGIS/Matsuda for peripheral insulin sensitivity. All measurements were performed at 0, 6, and 24 months. 41 women completed the examinations for liver fat and were included.

    RESULTS: Liver fat decreased after 6 months by 64% (95% CI: 54-74%) in the Paleolithic diet group and by 43% (27-59%) in the low-fat diet group (P<0.01 for difference between groups). After 24 months liver fat decreased 50% (25-75%) in the Paleolithic diet group and 49% (27-71%) in the low-fat diet group. Weight reduction between baseline and 6 months was correlated to liver fat improvement in the low-fat diet group (rs=0.66, P<0.01) but not in the Paleolithic diet group (rs=0.07, P=0.75). Hepatic insulin sensitivity improved during the first 6 months in the Paleolithic diet group (P<0.001 for Liver IR index and HOMA-IR), but deteriorated between 6 and 24 months without association to liver fat changes.

    CONCLUSIONS: A Paleolithic diet with ad libitum intake had a significant and persistent effect on liver fat and differed significantly from a conventional low-fat diet at six months. This difference may be due to food quality, e.g. a higher content of mono- and polyunsaturated fatty acids in the Paleolithic diet. Changes in liver fat did not associate to alterations in insulin sensitivity.

    Be well!

    JP

  23. JP Says:

    Updated 06/03/16:

    http://www.mdpi.com/2072-6643/8/5/314/htm

    Nutrients. 2016 May 23;8(5).

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

    (1) BACKGROUND: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns;

    (2) METHODS: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention;

    (3) RESULTS: Significantly greater weight loss occurred in the Paleolithic group (-1.99 kg, 95% CI -2.9, -1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (-14.63% of energy (E), 95% CI -19.5, -9.7), sodium (-1055 mg/day, 95% CI -1593, -518), calcium (-292 mg/day 95% CI -486.0, -99.0) and iodine (-47.9 μg/day, 95% CI -79.2, -16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01);

    (4) CONCLUSIONS: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations.

    Be well!

    JP

  24. JP Says:

    Updated 05/03/17:

    http://onlinelibrary.wiley.com/doi/10.1002/oby.21815/full

    Obesity (Silver Spring). 2017 May;25(5):892-900.

    Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity.

    OBJECTIVE: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed.

    METHODS: Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent control diet (CD) for 24 months. Blood samples and fat biopsies were collected at baseline, 6 months, and 24 months to analyze inflammation-related parameters.

    RESULTS: Android fat decreased significantly more in the PD group (P = 0.009) during the first 6 months with weight maintenance at 24 months in both groups. Long-term significant effects (P < 0.001) on adipose gene expression were found for toll-like receptor 4 (decreased at 24 months) and macrophage migration inhibitory factor (increased at 24 months) in both groups. Serum interleukin 6 (IL-6) and tumor necrosis factor α levels were decreased at 24 months in both groups (P < 0.001) with a significant diet-by-time interaction for serum IL-6 (P = 0.022). High-sensitivity C-reactive protein was decreased in the PD group at 24 months (P = 0.001).

    CONCLUSIONS: A reduction of abdominal obesity in postmenopausal women is linked to specific changes in inflammation-related adipose gene expression.

    Be well!

    JP

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