This study is a secondary analysis of a randomized controlled trial using
Paleolithic diet and exercise in individuals with
type 2 diabetes. We hypothesized that increased adherence to the
Paleolithic diet was associated with greater effects on blood pressure, blood
lipids and HbA1c independent of
weight loss. Participants were asked to follow a
Paleolithic diet for 12 weeks and were randomized to supervised exercise or general exercise recommendations. Four-day food records were analyzed, and food items characterized as "Paleolithic" or "not Paleolithic". Foods considered Paleolithic were lean meat, poultry, fish, seafood, fruits, nuts, berries, seeds, vegetables, and water to drink; "not Paleolithic" were legumes, cereals,
sugar,
salt, processed foods, and dairy products. A Paleo ratio was calculated by dividing the Paleolithic calorie intake by total calorie intake. A multiple regression model predicted the outcome at 12 weeks using the Paleo ratio, group affiliation, and outcome at baseline as predictors. The Paleo ratio increased from 28% at baseline to 94% after the intervention. A higher Paleo ratio was associated with lower fat mass, BMI, waist circumference, systolic blood pressure, and serum
triglycerides at 12 weeks, but not with lower HbA1c levels. The Paleo ratio predicted
triglyceride levels independent of
weight loss (p = 0.046). Moreover, an increased monounsaturated/
saturated fatty acids ratio and an increased polyunsaturated/
saturated fatty acids ratio was associated with lower
triglyceride levels independent of
weight loss. (p = 0.017 and p = 0.019 respectively). We conclude that a higher degree of adherence to the
Paleolithic diet recommendations improved fat quality and was associated with improved
triglyceride levels independent of
weight loss among individuals with
type 2 diabetes.