Paleo Diet and Diabetes: Improved Cardiovascular Risk Factors

Compared to a standard diabetic diet, a Paleolithic diet improves cardiovascular risk factors in type 2 diabetics, according to investigators at Lund University in Sweden.

Researchers compared the effects of a Paleo and a modern diabetic diet in 13 type 2 diabetic adults (10 men) with average hemoglobin A1c’s of 6.6% (under fairly good control, then).  Most were on diabetic pills; none were on insulin.  So this was a small, exploratory, pilot study.  Each of the diabetics followed both diets for three months.

How Did the Diets Differ?

Compared to the diabetic diet, the paleo diet was mainly lower in cereals and dairy products, higher in fruits and vegetables, meat, and eggs.  The paleo diet was lower in carbohydrates, glycemic load, and glycemic index.  Paleo vegetables were primarily leafy and cruciferous.  Cruciferous vegetables include broccoli, brussels sprouts, cauliflower, and cabbage.  Root vegetables were allowed; up to 1 medium potato daily.  The paleo diet also featured lean meats (why lean?), fish, eggs, and nuts, while forbidding refined fats, sugars, and beans.  Up to one glass of wine daily was allowed.

See the actual report for details of the diabetic diet, which seems to me to be similar to the diabetic diet recommended by most U.S. dietitians.

What Did the Researchers Find?

Compared to the diabetic diet, the paleo diet yielded lower hemoglobin A1c’s (0.4% lower—absolute difference), lower trigylcerides, lower diastolic blood pressure, lower weight, lower body mass index, lower waist circumference, lower total energy (caloric) intake, and higher HDL cholesterol (the good cholesterol).  Glucose tolerance was the same for both diets.  Fasting blood sugars tended to decrease more on the Paleo diet, but did not reach statistical significance (p=0.08, which is very close to significant).

So What?

The greater improvement in multiple cardiovascular risk factors seen here suggests that the paleo diet has potential to reduce the higher cardiovascular disease rates we see in diabetics.  This is just a pilot study.  Larger studies—more participants—are needed for confirmation.  Ultimately, we need data on hard clinical endpoints such as heart attacks, strokes, and death.

These diabetics had their blood sugars under fairly good control at baseline.  I wouldn’t be surprised if diabetics under poor control—hemoglobin A1c of 9%, for example—would see even greater improvements in risk factors as well as glucose levels while eating paleo.

There are so few women in this study as to be almost meaningless.

Results of this study may or may not apply to non-Swedes.

I see a fair amount of overlap between this version of the paleo diet and Dr. Bernstein’s Diabetes Solution diet and the Low-Carb Mediterranean Diet. 

Steve Parker, M.D.

Reference:  Jönsson, T., Granfeldt, Y., Ahrén, B., Branell, U., Pålsson, G., Hansson, A., Söderström, M., & Lindeberg, S.  Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.  Cardiovascular Diabetology, 8 (2009)  doi: 10.1186/1475-2840-8-35