title: Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study. A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes Established dietary estimates of net acid production do not predict measured net acid excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets Experiences of barriers and facilitators to weight-loss in a diet intervention - a qualitative study of women in Northern Sweden Decreased lipogenesis-promoting factors in adipose tissue in postmenopausal women with overweight on a Paleolithic-type diet Palaeolithic diet decreases fasting plasma leptin concentrations more than a diabetes diet in patients with type 2 diabetes: a randomised cross-over trial GRADE guidelines: 3. Rating the quality of evidence. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. A multimodal intervention for patients with secondary progressive multiple sclerosis: feasibility and effect on fatigue. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial Strong and persistent effect on liver fat with a Paleolithic diet during a two-year intervention Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity.
abstract: There is evidence for health benefits from ' Palaeolithic ' diets ; however , there are a few data on the acute effects of rationally design ed Palaeolithic-type meals . In the present study , we used Palaeolithic diet principles to construct meals comprising readily available ingredients : fish and a variety of plants , selected to be rich in fibre and phyto-nutrients . We investigated the acute effects of  two Palaeolithic-type meals ( PAL 1 and PAL 2 ) and a reference meal based on WHO guidelines ( REF ) , on blood glucose control , gut hormone responses and appetite regulation . Using a r and omised cross-over trial design , healthy subjects were given three meals on separate occasions . PAL2 and REF were matched for energy , protein , fat and carbohydrates ; PAL1 contained more protein and energy . Plasma glucose , insulin , glucagon-like peptide-1 ( GLP-1 ) , glucose-dependent insulinotropic peptide ( GIP ) and peptide YY ( PYY ) concentrations were measured over a period of 180 min . Satiation was assessed using electronic visual analogue scale ( EVAS ) scores . GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 ( P= 0·001 and P < 0·001 ) and PAL2 ( P= 0·011 and P= 0·003 ) compared with the REF . Concomitant EVAS scores showed increased satiety . By contrast , GIP concentration was significantly suppressed . Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals . Consumption of meals based on Palaeolithic diet principles result ed in significant increases in incretin and anorectic gut hormones and increased perceived satiety . Surprisingly , this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity 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 r and omized 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 . Trial registration Clinical Trials.gov 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 r and omized 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 design ed 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 st and ard 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 result ed 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 . Trial registration Clinical Trials.gov NCT00435240 Objective : It has been suggested that overweight is negatively associated with cognitive functions . The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women . Methods : 20 overweight postmenopausal women were r and omized to either a modified paleolithic diet or a st and ard diet adhering to the Nordic Nutrition Recommendations for 6 months . We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions . Results : Episodic memory performance improved significantly ( p = 0.010 ) after the dietary interventions . Concomitantly , brain activity increased in the anterior part of the right hippocampus during memory encoding , without differences between diets . This was associated with decreased levels of plasma free fatty acids ( FFA ) . Brain activity increased in pre-frontal cortex and superior/middle temporal gyri . The magnitude of increase correlated with waist circumference reduction . During episodic retrieval , brain activity decreased in inferior and middle frontal gyri , and increased in middle/superior temporal gyri . Conclusions : Diet-induced weight loss , associated with decreased levels of plasma FFA , improves episodic memory linked to increased hippocampal activity 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 r and omized 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 design ed 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 result ed 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 . Trial registration Clinical Trials.gov : Background / objectives : Formulas developed to estimate diet-dependent net acid excretion ( NAE ) generally agree with measured values for typical Western diets . Whether they can also appropriately predict NAE for ‘ Paleolithic-type ’ ( Paleo ) diets — which contain very high amounts of fruits and vegetables ( F&V ) and concurrent high amounts of protein is unknown . Here , we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D).Subjects/ methods : Thirteen subjects with well-controlled T2D were r and omized to either a Paleo or American Diabetes Association ( ADA ) diet for 14 days . Twenty-four hour urine collection s were performed at baseline and end of the diet period , and analyzed for titratable acid , bicarbonate and ammonium to calculate measured NAE . Three formulas for estimating NAE from dietary intake were used ; two ( NAE_diet R or L ) that include dietary mineral intake and sulfate- and organic acid ( OA ) production , and one that is empirically derived ( NAE_diet F ) only considering potassium and protein intake . Results : Measured NAE on the Paleo diet was significantly lower than on the ADA-diet ( + 31±22 vs 112±52 mEq/day , P=0.002 ) . Although all formula estimates showed similar and reasonable correlations ( r=0.52–0.76 ) with measured NAE , each one underestimated measured values . The formula with the best correlation did not contain an estimate of dietary OA production . Conclusions : Paleo-diets are lower in NAE than typical Western diets . However , commonly used formulas clearly underestimate NAE , especially for diets with very high F&V ( as the Paleo diet ) , and in subjects with T2D . This may be due to an inappropriate estimation of proton loads stemming from OAs , underlining the necessity for improved measures of OA-related proton sources Background There is a lack of research about the experiences of participating in weight-reducing interventions . The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden . Method In the intervention the women were r and omised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months . A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class , civil status and age . Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses . Results The results showed that the women in the dietary intervention experienced two main barriers – struggling with self ( related to difficulties in changing food habits , health problems , lack of self-control and insecurity ) and struggling with implementing the diet ( related to social relations and project-related difficulties ) – and two main facilitators– striving for self-determination ( related to having clear goals ) and receiving support ( from family/friends as well as from the project ) – for weight-loss . There was a greater emphasis on barriers than on facilitators . Conclusion It is important to also include drop-outs from diet interventions in order to fully underst and barriers to weight-loss . A gender-relational approach can bring new insights into underst and ing experiences of barriers to weight-loss . Trial registration Clinical Trials gov NCT00692536 Purpose We studied effects of diet-induced postmenopausal weight loss on gene expression and activity of proteins involved in lipogenesis and lipolysis in adipose tissue . Methods Fifty-eight postmenopausal women with overweight ( BMI 32.5 ± 5.5 ) were r and omized to eat an ad libitum Paleolithic-type diet ( PD ) aim ing for a high intake of protein and unsaturated fatty acids or a prudent control diet ( CD ) for 24 months . Anthropometry , plasma adipokines , gene expression of proteins involved in fat metabolism in subcutaneous adipose tissue ( SAT ) and lipoprotein lipase ( LPL ) activity and mass in SAT were measured at baseline and after 6 months . LPL mass and activity were also measured after 24 months . Results The PD led to improved insulin sensitivity ( P < 0.01 ) and decreased circulating triglycerides ( P < 0.001 ) , lipogenesis-related factors , including LPL mRNA ( P < 0.05 ) , mass ( P < 0.01 ) , and activity ( P < 0.001 ) ; as well as gene expressions of CD36 ( P < 0.05 ) , fatty acid synthase , FAS ( P < 0.001 ) and diglyceride acyltransferase 2 , DGAT2 ( P < 0.001 ) . The LPL activity ( P < 0.05 ) and gene expression of DGAT2 ( P < 0.05 ) and FAS ( P < 0.05 ) were significantly lowered in the PD group versus the CD group at 6 months and the LPL activity ( P < 0.05 ) remained significantly lowered in the PD group compared to the CD group at 24 months . Conclusions Compared to the CD , the PD led to a more pronounced reduction of lipogenesis-promoting factors in SAT among postmenopausal women with overweight . This could have mediated the favorable metabolic effects of the PD on triglyceride levels and insulin sensitivity Abstract Background We have previously shown that a Palaeolithic diet consisting of the typical food groups that our ancestors ate during the Palaeolithic era , improves cardiovascular disease risk factors and glucose control compared to the currently recommended diabetes diet in patients with type 2 diabetes . To eluci date the mechanisms behind these effects , we evaluated fasting plasma concentrations of glucagon , insulin , incretins , ghrelin , C-peptide and adipokines from the same study . Methods In a r and omised , open-label , cross-over study , 13 patients with type 2 diabetes were r and omly assigned to eat a Palaeolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts , or a diabetes diet design ed in accordance with current diabetes dietary guidelines during two consecutive 3-month periods . The patients were recruited from primary health-care units and included three women and 10 men [ age ( mean ± SD ) 64 ± 6 years ; BMI 30 ± 7 kg/m2 ; diabetes duration 8 ± 5 years ; glycated haemoglobin 6.6 ± 0.6 % ( 57.3 ± 6 mmol/mol ) ] with unaltered diabetes treatment and stable body weight for 3 months prior to the start of the study . Outcome variables included fasting plasma concentrations of leptin , adiponectin , adipsin , visfatin , resistin , glucagon , insulin , C-peptide , glucose-dependent insulinotropic polypeptide , glucagon-like peptide-1 and ghrelin . Dietary intake was evaluated by use of 4-day weighed food records . Results Seven participants started with the Palaeolithic diet and six with the diabetes diet . The Palaeolithic diet result ed in a large effect size ( Cohen ’s d = −1.26 ) at lowering fasting plasma leptin levels compared to the diabetes diet [ mean difference ( 95 % CI ) , −2.3 ( −5.1 to 0.4 ) ng/ml , p = 0.023 ] . No statistically significant differences between the diets for the other variables , analysed in this study , were observed . Conclusions Over a 3-month study period , a Palaeolithic diet result ed in reduced fasting plasma leptin levels , but did not change fasting levels of insulin , C-peptide , glucagon , incretins , ghrelin and adipokines compared to the currently recommended diabetes diet . Trial registration : Clinical Trials.gov This article introduces the approach of GRADE to rating  quality of evidence .  GRADE specifies four categories-high , moderate , low , and very low-that are applied to a body of evidence , not to individual studies . In the context of a systematic review , quality reflects our confidence that the estimates of the effect are correct . In the context of recommendations , quality reflects our confidence that the effect estimates are adequate to support a particular recommendation . R and omized trials begin as high- quality evidence , observational studies as low quality . " Quality " as used in GRADE means more than risk of bias and so may also be compromised by imprecision , inconsistency , indirectness of study results , and publication bias . In addition , several factors can increase our confidence in an estimate of effect . GRADE provides a systematic approach for considering and reporting each of these factors . GRADE separates the process of assessing quality of evidence from the process of making recommendations . Judgments about the strength of a recommendation depend on more than just the quality of evidence Aims /hypothesisMost studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat , carbohydrate , fibre , fruits and vegetables . Instead , we aim ed 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 r and omised 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 Glucose0–120 ) and plasma insulin AUC ( AUC Insulin0–120 ) in OGTTs . Results Over 12 weeks , there was a 26 % decrease of AUC Glucose0–120 ( 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 Glucose0–120 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 Insulin0–120 in the Palaeolithic group , but because of the strong association between change in AUC Insulin0–120 and change in waist circumference ( r = 0.64 , p = 0.0003 ) , this did not remain after multivariate analysis . Conclusions /interpretationA Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference 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 , HDL , LDL , and TG concentrations in nondiabetic 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 and 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 4 months , followed by a Paleolithic diet for 4 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 analysis of variance . Four months of Paleolithic nutrition significantly lowered ( P < .001 ) mean total cholesterol , LDL , and TG and increased ( P < .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 BACKGROUND Multiple sclerosis is an autoimmune disease influenced by environmental factors . OBJECTIVES The feasibility of a multimodal intervention and its effect on perceived fatigue in patients with secondary progressive multiple sclerosis were assessed . DESIGN / SETTING This was a single-arm , open-label intervention study in an outpatient setting . INTERVENTIONS A multimodal intervention including a modified paleolithic diet with supplements , stretching , strengthening exercises with electrical stimulation of trunk and lower limb muscles , meditation , and massage was used . OUTCOME MEASURES Adherence to each component of the intervention was calculated using daily logs . Side-effects were assessed from a monthly question naire and blood analyses . Fatigue was assessed using the Fatigue Severity Scale ( FSS ) . Data were collected at baseline and months 1 , 2 , 3 , 6 , 9 , and 12 . RESULTS Ten ( 10 ) of 13 subjects who were enrolled in a 2-week run-in phase were eligible to continue in the 12-month main study . Of those 10 subjects , 8 completed the study and 6 subjects fully adhered to the study intervention for 12 months . Over a 12-month period , average adherence to diet exceeded 90 % of days , and to  exercise/muscle stimulation  exceeded 75 % of days .  Nutritional supplements  intake varied among and within subjects . Group daily average duration of meditation  was 13.3 minutes and of massage was 7.2 minutes . No adverse side-effects were reported . Group average FSS scores decreased from 5.7 at baseline to 3.32 ( p=0.0008 ) at 12 months . CONCLUSIONS In this small , uncontrolled pilot study , there was a significant improvement in  fatigue  in those who completed the study . Given the small sample size and completer rate , further evaluation of this multimodal therapy is warranted Background / Objectives : Short-term studies have suggested beneficial effects of a Palaeolithic-type diet ( PD ) on body weight and metabolic balance . We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women , in comparison with a diet according to the Nordic Nutrition Recommendations (NNR).Subjects/ Methods : Seventy obese postmenopausal women ( mean age 60 years , body mass index 33 kg/m2 ) were assigned to an ad libitum PD or NNR diet in a 2-year r and omized controlled trial . The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry . Results : Both groups significantly decreased total fat mass at 6 months ( −6.5 and −2.6 kg ) and 24 months ( −4.6 and −2.9 kg ) , with a more pronounced fat loss in the PD group at 6 months ( P<0.001 ) but not at 24 months ( P=0.095 ) . Waist circumference and sagittal diameter also decreased in both the groups , with a more pronounced decrease in the PD group at 6 months ( −11.1 vs−5.8 cm , P=0.001 and −3.7 vs−2.0 cm , P<0.001 , respectively ) . Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group ( P<0.001 and P=0.004 ) . Nitrogen excretion did not differ between the groups . Conclusions : A PD has greater beneficial effects vs an NNR diet regarding fat mass , abdominal obesity and triglyceride levels in obese postmenopausal women ; effects not sustained for anthropometric measurements at 24 months . Adherence to protein intake was poor in  the PD group . The long-term consequences of these changes remain to be studied 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 ( PD ) was compared with a conventional low-fat diet (LFD).Subjects/ Methods : Seventy healthy , obese , postmenopausal women were r and omized to either a PD or a conventional LFD . 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 homeostasis model assessment -insulin resistance (HOMA-IR)/liver insulin resistance ( Liver IR ) index for hepatic insulin sensitivity and oral glucose insulin sensitivity (OGIS)/Matsuda for peripheral insulin sensitivity . All measurements were performed at 0 , 6 and 24 months . Forty-one women completed the examinations for liver fat and were included . Results : Liver fat decreased after 6 months by 64 % ( 95 % confidence interval : 54–74 % ) in the PD group and by 43 % ( 27–59 % ) in the LFD group ( P<0.01 for difference between groups ) . After 24 months , liver fat decreased 50 % ( 25–75 % ) in the PD group and 49 % ( 27–71 % ) in the LFD group . Weight reduction between baseline and 6 months was correlated to liver fat improvement in the LFD group ( rs=0.66 , P<0.01 ) but not in the PD group ( rs=0.07 , P=0.75 ) . Hepatic insulin sensitivity improved during the first 6 months in the PD group ( P<0.001 for Liver IR index and HOMA-IR ) , but deteriorated between 6 and 24 months without association with liver fat changes . Conclusions : A PD with ad libitum intake had a significant and persistent effect on liver fat and differed significantly from a conventional LFD at 6 months . This difference may be due to food quality , for example , a higher content of mono- and polyunsaturated fatty acids in the PD . Changes in liver fat did not associate with alterations in insulin sensitivity 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 r and omized  to a Paleolithic-type diet ( PD ) or a prudent control diet ( CD ) for 24 months . Blood sample s and fat biopsies  were collected at baseline , 6 months , and 24 months to analyze inflammation-related parameters . RESULTS And roid 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
target: The analysis showed a positive association of adopting the Paleolithic diet in relation to weight loss .
  Conclusion The Paleolithic diet may assist in controlling weight and waist circumference and in the management of chronic diseases .
background: Background The Paleolithic diet has been studied in the scope of prevention and control of chronic noncommunicable diseases ( CNCD ) .
  The objective of this study was to analyze the influence of the Paleolithic diet on the prevention and control of CNCD in humans , specifically on anthropometric markers , through a systematic review with meta- analysis .
  Methods What is the effect of the Paleolithic diet on anthropometric parameters ( weight , body mass index and waist circumference ) compared to other control diets based on recommendations in adults ?