Abstract
The aim of this meta-analysis was to review the impact of a Paleolithic diet (PD) on selected health indicators (body composition, lipid profile, blood pressure, and carbohydrate metabolism) in the short and long term of nutrition intervention in healthy and unhealthy adults. A systematic review of randomized controlled trials of 21 full-text original human studies was conducted. Both the PD and a variety of healthy diets (control diets (CDs)) caused reduction in anthropometric parameters, both in the short and long term. For many indicators, such as weight (body mass (BM)), body mass index (BMI), and waist circumference (WC), impact was stronger and especially found in the short term. All diets caused a decrease in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), albeit the impact of PD was stronger. Among long-term studies, only PD cased a decline in TC and LDL-C. Impact on blood pressure was observed mainly in the short term. PD caused a decrease in fasting plasma (fP) glucose, fP insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) in the short run, contrary to CD. In the long term, only PD caused a decrease in fP glucose and fP insulin. Lower positive impact of PD on performance was observed in the group without exercise. Positive effects of the PD on health and the lack of experiments among professional athletes require longer-term interventions to determine the effect of the Paleo diet on athletic performance.
Highlights
The popularity of the Paleolithic diet has increased in recent years
Four studies included subjects that had type 2 diabetes mellitus and or were obese [51,52], eleven studies included overweight or obese postmenopausal women [37,40,41,42,43,44,45,46,47,48,49], one study included subject with hypercholesterolemia [39], one study recruited subjects with ischemic heart disease plus either glucose intolerance or type 2 diabetes [28], one study was conducted in subjects with at least two characteristics of the metabolic syndrome [53], and four studies recruited healthy but inactive adults [18,55,56,71]
We examined the significance of the change in Paleolithic diet (PD) and healthy diets (CDs) based on the Nordic Nutrition Recommendation (NNR) [40,45,46,49], the Dutch Health Council [53], the Australian Guide to Healthy Eating (AGHE) [54], the American Diabetes Association (ADA) [52], the American Heart Association (AHA) [39], the Mediterranean diet [28], a conventional low-fat diet (LFD) [41], and the so-called “diabetes diet” [51]
Summary
The popularity of the Paleolithic diet has increased in recent years. Paleolithic nutrition is based on the principles of evolutionary biology with a focus on the low or moderate carbohydrate options available to the hunter–gatherers [1,2,3,4,5,6]. Some researchers have found that a Paleo diet intervention yielded an improvement in glucose tolerance that appeared to be independent of energy intake and macronutrient distribution, prompting them to conclude that avoiding Western foods is more important than counting calories, fat, carbohydrate, or protein [28,36]. The authors estimate the following ratio of macronutrients: 35% energy from fats, 35% from carbohydrates, and 30% from protein ( no specific amount is considered to be the goal) [18,37]. According to this wellknown division, it seems that the Paleo diet has a moderate amount of carbohydrates [38]
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