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Some have embraced the diet as healthy and reasonable, while others think it is downright harmful.
Fortunately… science can give us some answers here, because 5 human studies have been done on the paleo diet so far.
In this article, I take an objective look at each of these studies and their conclusions, then I summarize the findings at the end. The paleo diet emulates the diet of our hunter-gatherer ancestors, based on the premise that they did not suffer from the same diseases as modern humans. This diet advocates consumption of unprocessed animals and plants, including meat, fish, eggs, vegetables, fruits, nuts and seeds. All of these studies are done in humans and are published in respected, peer-reviewed scientific journals. Details: 29 men with heart disease and elevated blood sugars or type 2 diabetes, were randomized to either a paleolithic diet (n=14) or a Mediterranean-like diet (n=15). As you can clearly see from the graphs, only the paleo diet group saw a significant improvement in glucose tolerance.
The 2-hour Area Under the Curve (AUC) for blood glucose went down by 36% in the paleo group, compared to 7% in the control group. Every patient in the paleo group ended up having normal blood sugars, compared to 7 of 15 patients in the control group. The paleo group ended up eating 451 fewer calories per day (1344 compared to 1795) without intentionally restricting calories or portions. Conclusion: A paleolithic diet lead to greater improvements in waist circumference and glycemic control, compared to a Mediterranean-like diet. Details: 14 healthy medical students (5 male, 9 female) were instructed to eat a paleolithic diet for 3 weeks.
Details: 13 individuals with type 2 diabetes were placed on either a paleolithic diet or a typical Diabetes diet in a cross-over study.

Conclusion: The paleo diet caused more weight loss and several improvements in cardiovascular risk factors, compared to a Diabetes diet.
Details: 10 healthy women with a BMI over 27 consumed a modified paleolithic diet for 5 weeks. So, only human studies that isolate diet as the sole variable are included in the analysis. The studies had statistically significant reductions in waist circumference, which should translate to a reduced risk of diseases like diabetes and cardiovascular disease. It is worth mentioning again that Ryberg, et al (5) had an average reduction in liver fat of 47% after 5 weeks on the paleo diet, which is very impressive.
There were reductions in Total Cholesterol in two studies (4, 5), but the difference was not statistically significant in the other two (2, 3).
All of the studies had reductions in blood triglyceride levels, but the difference was not statistically significant in one study (2).
It is clear from looking at the studies that the paleo diet does lead to improvements in insulin sensitivity and glycemic control (1, 3, 5), although the results were not always statistically significant (2, 4). Four of the studies (2-5) looked at blood pressure levels before and after the intervention. However, only one study (2) reached statistical significance for Systolic Blood Pressure (higher number) while the three others reached statistical significance for Diastolic Blood Pressure (lower number) only. Overall, the paleo diet was very well tolerated and there were no reports of adverse effects.
Additionally, the paleo diet used in the studies is not typical for the way paleo is often practiced today. Obviously we can’t make any firm conclusions based on these 5 studies alone, since they are too small and too short in duration. How a person with diabetes eats is fundamentally a personal decision with no ‘correct’ way to do this; only guidelines to work within and which should be personalised.

In this study, the women had an average reduction in liver fat of 49%, but no significant effect on the fat content of muscle cells. 1984 – In this study, 10 diabetics lived as hunter-gatherers for 7 weeks and had incredible improvements in health. The popularity of different dietary approaches can wax and wane in the public’s eye, with sometimes similar types of dietary approaches ‘rebranded’ under different names. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet.
A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. Very interesting study, but there are too many confounders to conclude anything about the diet itself.
Low-carbohydrate and Palaeolithic diets are enjoying a large degree of popularity and are capturing the headlines, not just for people with diabetes, but the broader population. Just what the basis of these diets are, how they are promoted and followed, and importantly evidence for a benefit in the management of diabetes is explored in this presentation with practical advice on how they can be sensibly followed and supported by someone if they choose to eat within the broad parameters of these types of dietary patterns.

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