Not Dr. Frassetto
Dr. Lynda Frassetto is a Professor of Medicine and Nephrology at the University of California San Francisco. She and her colleagues have completed a study of the Paleolithic diet as a treatment for diabetes (type 2, I think). As far as I know, details have not yet been published in the medical literature.
Dr. Frassetto spoke at the Ancestral Health Symposium-2012 earlier this year. You can view the 35-minute video here.
She is convinced that a paleo diet, compared to a Mediterranean-style diet, is better at controlling blood sugars and “reducing insulin” in diabetics (presumably type 2s). Insulin sensitivity is improved, particularly in those with insulin resistance to start with. The paleo diet group saw an average drop of fasting glucose by 23 mg/dl (1.3 mmol/l). One slide you’ll see in the video indicates the paleo diet reduced absolute hemoglobin A1c by 0.3%, compared to 0.2% with the “Mediterranean” diet. (Let me know if I got the numbers wrong.)
Color me underwhelmed so far.
Questions raised by the video include:
- what is the UCSF version of the paleo diet?
- how many participants were in her study?
- how long did her study last?
- did she study only type 2 diabetics?
- what exactly was the control diet?
- how severe were the cases of diabetes studied?
For answers, we await publication of the formal report.
Paleo Diabetic 
Im so glad to see her publication will be it eventually. If the study was less than 3 months as you are aware the Hgba1c is a weighted average covering a 2-3 mon period of time. Hopefully a fructosamine (2 wk average) was utilized as well. It’s not a ‘standard of care’ lab but has merit in short term tracking.
I found their original Paleo HG trial in prehypertensive, overweight, insulin resistant (with undiagnosed intestinal permeability) completely awesome and with staggering results that Pharma cannot duplicate
–68% reduction insulin
–72% reduction HOMA
Personally I’ve observed tremendous improvements in a1c and reversals of macro and microvascular disease in patients even if only following a partly Paleo regimen. Haven’t you in your patients?
Thanks for commenting, doc.
Dr. F in the video does mention fructosamine but I didn’t pay enough attention. May have been in a slide instead of comments.
Yes, I have seen blood sugar improvements in my patients experimenting with paleo diets. Much of that improvement may predominantly reflect the avoidance of refined sugar and grains, which account for about 40% of the standard American diet calories, if memory serves me.
I’d swear the UCSF group finished the study about a year ago. I’m not sure what’s holding up the publication, but admit I don’t know much about academic publishing. I may try to email Dr. F personally.
-Steve
Steve,
Thanks for your reply — I concur — if patients just try a semi-paleo diet and reduce significantly sugar and high GI carbs, they are doing themselves a huge service. The veg and meat/egg content can stay the same. However T2DM patients suffer from immense IR (insulin resistance)and chronic inflammation. If they also suffer from microvasc complications, then they have adrenal/thyroid issues and likely polyglandular disease. Studies show elevated cortisol in the presence of the microvasc progression.
How much of this is tied to gluten/casein related intestinal permeability and subsequent auto-antibodies and immune complexes junking up the organs and tissues?
There are several things I like about the Mediterranean diet and lifestyle (phytochemicals, omega-3, sun-rich relaxed environment, etc) and many I don’t. What I don’t…
(1) ancestrally, Mediterranean doesn’t fit everyone’s genomes
(2) gluten heavy and much of the global wheat crops are the Rockefeller hybrid wheat (which is different from ancestral wheat, or fermented in the processing)
(3) seafood heavy — much now is contaminated by neolethal industrial pollution (pesticides, dioxins, PCBs, flame retardants, mercury, etc)
Do you have her email? If not I’ll send to you. She is awesome — I hope you get a chance to talk personally with her as you two share a lot in common.
G
G, you make many valid points. If you could send me Dr. Frasetto’s email, I’d appreciate it and not abuse it! I’m at steveparkermd AT gmail DOT com. Thanks.
Just to add, T2DM are typically horribly deficient of the below. All the below in clinical trials show improvement of human IR. Taurine has even been shown in in animal trials to improve T2DM microvasc complications (two human trials show signif improvement of CHF).
–magnesium (this alone when corrected can reverse IR)
–zinc
–other trace minerals like iodine
–omega-3
–vitamin D, A, K2, tocopherols
–taurine
–normal gut function (anything that supports intestinal impermeability will improve all the above as well)
None of these improve overnight. A1C and fructosamine are important but just one metric (glycosylation/protein damage). There are other wonderful lab tests that can help practitioners like you and I to track the progress — mitochondrial testing for metabolites in addition to minerals and their sufficiency. One test I like is the Metametrix/GDX Organix:
http://www.metametrix.com/learning-center/articles/2006/assessment-of-biochemical-and-nutritional-individuality-through-organic-acid-testing
I need to dig more deeply into the paleo diet to see how it stacks up in terms of those nutrients. Cordaine says it should be fairly good in terms of vitamin D (sunshine, certain fish), omega-3s, K, magnesium, and zinc.
-Steve