Top

Published in:

01-06-2014 | Cardiovascular Disease (JH Goedecke, Section Editor)

Deconstructing the Paleolithic Diet: Components that Reduce Cardiovascular Disease Risk

Authors: Christopher P. F. Marinangeli, Peter J. H. Jones

Published in: Current Nutrition Reports | Issue 2/2014

Abstract

Studies demonstrate that a Paleolithic-type diet reduces risk for cardiovascular disease (CVD). Deconstruction of the Paleolithic diet shows that ancestral hominids followed a dietary pattern that consisted of raw-whole foods containing efficacious levels of mono- and polyunsaturated fatty acids, long-chain omega-3 fatty acids, dietary fibre, phytosterols, protein, and potassium. While Paleolithic diets provided modest levels of carbohydrate-derived energy, these diets also were low in sodium. Therefore, the objective of this review is to identify the attributes of ancestral diets that reduce risk factors for CVD. These risk factors include dyslipidemia, elevated blood pressure, diabetes/hyperglycaemia, and excess body weight/obesity. Overall, data suggest that the Paleolithic diet is a dietary paradigm, which contains bioactive components that modulate biological processes and decrease CVD risk in modern-day humans.

Cordain L, Eaton SB, Miller JB, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr. 2002;56 Suppl 1:S42–52. doi:10.1038/sj.ejcn.1601353.PubMed

2.••

Smith Jr SC, Chen D, Collins A, Harold JG, Jessup M, Josephson S, et al. Moving from political declaration to action on reducing the global burden of cardiovascular diseases: a statement from the global cardiovascular disease taskforce. J Am Coll Cardiol. 2013;62(22):2151–3. doi:10.1016/j.jacc.2013.08.722. This article outlines global targets for reducing the global burden of cardiovascular disease.PubMed

World Health Organization. Cardiovascular diseases (CVDs): Fact sheet N°317. World Health Organization, Geneva. 2013. http://www.who.int/mediacentre/factsheets/fs317/en/. Accessed 3 Dec 2013.

Statistics Canada. Leading Causes of Death in Canada, 2009. Ottawa 2012.

Eyre H, Kahn R, Robertson RM, Clark NG, Doyle C, Hong Y, et al. Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. Circulation. 2004;109(25):3244–55. doi:10.1161/01.CIR.0000133321.00456.00.PubMed

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53.PubMed

Brown A, Reynolds LR, Bruemmer D. Intensive glycemic control and cardiovascular disease: an update. Nat Rev Cardiol. 2010;7(7):369–75. doi:10.1038/nrcardio.2010.35.PubMed

Smith Jr SC, Collins A, Ferrari R, Holmes Jr DR, Logstrup S, McGhie DV, et al. Our time: a call to save preventable death from cardiovascular disease (heart disease and stroke). J Am Coll Cardiol. 2012;60(22):2343–8. doi:10.1016/j.jacc.2012.08.962.PubMed

Eaton SB, Konner M. A consideration of its nature and current implications. N Engl J Med. 1985;312(5):283–9. doi:10.1056/nejm198501313120505.PubMed

10.

Eaton SB, Eaton 3rd SB, Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications. Eur J Clin Nutr. 1997;51(4):207–16.PubMed

11.

Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr. 2000;71(3):682–92.PubMed

12.

Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2010;25(6):594–602. doi:10.1177/0884533610385702.

13.

Eaton SB. The ancestral human diet: what was it and should it be a paradigm for contemporary nutrition? Proc Nutr Soc. 2006;65(1):1–6.PubMed

14.

Marean CW, Bar-Matthews M, Bernatchez J, Fisher E, Goldberg P, Herries AI, et al. Early human use of marine resources and pigment in South Africa during the Middle Pleistocene. Nature. 2007;449(7164):905–8. doi:10.1038/nature06204.PubMed

15.

Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia. 2007;50(9):1795–807. doi:10.1007/s00125-007-0716-y.PubMed

16.

Jonsson T, Granfeldt Y, Ahren B, Branell UC, Palsson G, Hansson A, et al. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35. doi:10.1186/1475-2840-8-35.PubMedCentralPubMed

17.•

Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, et al. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013;274(1):67–76. doi:10.1111/joim.12048. This recent study outlines the effects of the Palaeolithic diet on risk factors for cardiovascular disease. This study also examines the effects of a Palaeolithic diet on ectopic fat deposition.PubMed

18.

Osterdahl M, Kocturk T, Koochek A, Wandell PE. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr. 2008;62(5):682–5. doi:10.1038/sj.ejcn.1602790.PubMed

19.

Frassetto LA, Schloetter M, Mietus-Synder M, Morris Jr RC, Sebastian A. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009;63(8):947–55. doi:10.1038/ejcn.2009.4.PubMed

20.•

Flock MR, Kris-Etherton PM. Diverse physiological effects of long-chain saturated fatty acids: implications for cardiovascular disease. Curr Opin Clin Nutr Metab Care. 2013;16(2):133–40. doi:10.1097/MCO.0b013e328359e6ac. This comprehensive review summarizes saturated fatty acid metabolism as well as the effects of saturated fatty acids on circulating lipoprotein cholesterol levels.PubMed

21.

Kuipers RS, Luxwolda MF, Dijck-Brouwer DA, Eaton SB, Crawford MA, Cordain L, et al. Estimated macronutrient and fatty acid intakes from an East African Palaeolithic diet. Br J Nutr. 2010;104(11):1666–87. doi:10.1017/s0007114510002679.PubMed

22.••

Micha R, Michas G, Mozaffarian D. Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes–an updated review of the evidence. Curr Atheroscler Rep. 2012;14(6):515–24. doi:10.1007/s11883-012-0282-8. This meta-analysis demonstrates that unprocessed red meats do not increase risk for coronary artery disease.PubMedCentralPubMed

23.

Ros E, Mataix J. Fatty acid composition of nuts–implications for cardiovascular health. Br J Nutr. 2006;96 Suppl 2:S29–35.PubMed

24.

Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341–54.PubMed

25.

Hoffman LC, Wiklund E. Game and venison - meat for the modern consumer. Meat Sci. 2006;74(1):197–208. doi:10.1016/j.meatsci.2006.04.005.PubMed

26.

Labonte ME, Jenkins DJ, Lewis GF, Chiavaroli L, Wong JM, Kendall CW, et al. Adding MUFA to a dietary portfolio of cholesterol-lowering foods reduces apoAI fractional catabolic rate in subjects with dyslipidaemia. Br J Nutr. 2013;110(3):426–36. doi:10.1017/S000711451200534X.PubMed

27.

Schwingshackl L, Hoffmann G. Monounsaturated fatty acids and risk of cardiovascular disease: synopsis of the evidence available from systematic reviews and meta-analyses. Nutrients. 2012;4(12):1989–2007. doi:10.3390/nu4121989.PubMedCentralPubMed

28.

Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy Jr WS, et al. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. 2012;176 Suppl 7:S44–54. doi:10.1093/aje/kws264.PubMedCentralPubMed

29.

Davidson MH. Mechanisms for the hypotriglyceridemic effect of marine omega-3 fatty acids. Am J Cardiol. 2006;98(4A):27i–33.PubMed

30.

Skulas-Ray AC, Kris-Etherton PM, Harris WS, Vanden Heuvel JP, Wagner PR, West SG. Dose-response effects of omega-3 fatty acids on triglycerides, inflammation, and endothelial function in healthy persons with moderate hypertriglyceridemia. Am J Clin Nutr. 2011;93(2):243–52. doi:10.3945/ajcn.110.003871.PubMedCentralPubMed

31.

Harris WS. n-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(5 Suppl):1645S–54.PubMed

32.

Musa-Veloso K, Binns MA, Kocenas AC, Poon T, Elliot JA, Rice H, et al. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid dose-dependently reduce fasting serum triglycerides. Nutr Rev. 2010;68(3):155–67. doi:10.1111/j.1753-4887.2010.00272.x.PubMed

33.

Naughton JM, O'Dea K, Sinclair AJ. Animal foods in traditional Australian aboriginal diets: polyunsaturated and low in fat. Lipids. 1986;21(11):684–90.PubMed

34.

Eaton SB, Eaton 3rd SB, Sinclair AJ, Cordain L, Mann NJ. Dietary intake of long-chain polyunsaturated fatty acids during the paleolithic. World Rev Nutr Diet. 1998;83:12–23.PubMed

35.

Dyerberg J, Bang HO, Hjorne N. Fatty acid composition of the plasma lipids in Greenland Eskimos. Am J Clin Nutr. 1975;28(9):958–66.PubMed

36.

Bang HO, Dyerberg J, Nielsen AB. Plasma lipid and lipoprotein pattern in Greenlandic West-coast Eskimos. Lancet. 1971;1(7710):1143–5.PubMed

37.

Simopoulos AP. Omega-3 fatty acids and cardiovascular disease: the epidemiological evidence. Environ Health Prev Med. 2002;6(4):203–9. doi:10.1007/BF02897971.PubMedCentralPubMed

38.

Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med. 2008;233(6):674–88. doi:10.3181/0711-MR-311.

39.

Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis. 2006;189(1):19–30. doi:10.1016/j.atherosclerosis.2006.02.012.PubMed

40.

Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr. 2006;83(6 Suppl):1467S–76.PubMed

41.

Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, et al. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr. 2006;84(1):5–17.PubMed

42.

Lavie CJ, Milani RV, Mehra MR, Ventura HO. Omega-3 polyunsaturated fatty acids and cardiovascular diseases. J Am Coll Cardiol. 2009;54(7):585–94. doi:10.1016/j.jacc.2009.02.084.PubMed

43.

Talati R, Baker WL, Pabilonia MS, White CM, Coleman CI. The effects of barley-derived soluble fiber on serum lipids. Ann Fam Med. 2009;7(2):157–63. doi:10.1370/afm.917.PubMedCentralPubMed

44.

AbuMweis SS, Jew S, Ames NP. beta-glucan from barley and its lipid-lowering capacity: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr. 2010;64(10.1038/ejcn.2010.178):1472–80.PubMed

45.

Tiwari U, Cummins E. Meta-analysis of the effect of beta-glucan intake on blood cholesterol and glucose levels. Nutrition. 2011;27(10):1008–16. doi:10.1016/j.nut.2010.11.006.PubMed

46.

Anderson JW, Allgood LD, Lawrence A, Altringer LA, Jerdack GR, Hengehold DA, et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr. 2000;71(2):472–9.PubMed

47.

Wei ZH, Wang H, Chen XY, Wang BS, Rong ZX, Wang BS, et al. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr. 2009;63(7):821–7. doi:10.1038/ejcn.2008.49.PubMed

48.

Brouns F, Theuwissen E, Adam A, Bell M, Berger A, Mensink RP. Cholesterol-lowering properties of different pectin types in mildly hyper-cholesterolemic men and women. Eur J Clin Nutr. 2012;66(5):591–9. doi:10.1038/ejcn.2011.208.PubMed

49.

Vuksan V, Jenkins AL, Rogovik AL, Fairgrieve CD, Jovanovski E, Leiter LA. Viscosity rather than quantity of dietary fibre predicts cholesterol-lowering effect in healthy individuals. Br J Nutr. 2011;106(9):1349–52. doi:10.1017/S0007114511001711.PubMed

50.

Gunness P, Gidley MJ. Mechanisms underlying the cholesterol-lowering properties of soluble dietary fibre polysaccharides. Food Funct. 2010;1(2):149–55. doi:10.1039/c0fo00080a.PubMed

51.

The Institute of Medicine. Chapter 7 - Dietary, functional, and total fiber. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients). Washington, DC: National Academy of Sciences; 2005. p. 339–421.

52.

Margareta E, Nyman GL. Importance of processing for physico-chemical and physiological properties of dietary fibre. Proc Nutr Soc. 2003;62(1):187–92. doi:10.1079/pns2002227.

53.

Svanberg SJM, Gustafsson KBH, Suortti T, Margareta E, Nyman GL. Molecular-weight distribution, measured by HPSEC, and viscosity of water-soluble dietary fiber in carrots following different types of processing. J Agric Food Chem. 1995;43(10):2692–7. doi:10.1021/jf00058a026.

54.

Nyman E, Svanberg SJM, Asp NGL. Molecular-weight distribution and viscosity of water-soluble dietary fiber isolated from green beans, brussel-sprouts and green peas following different types of processing. J Sci Food Agric. 1994;66(1):83–91. doi:10.1002/jsfa.2740660113.

55.

Guillon F, Champ M. Structural and physical properties of dietary fibres, and consequences of processing on human physiology. Food Res Int. 2000;33(3–4):233–45. doi:10.1016/s0963-9969(00)00038-7.

56.

Tosh SM, Yada S. Dietary fibres in pulse seeds and fractions: characterization, functional attributes, and applications. Food Res Int. 2010;43(2):450–60. doi:10.1016/j.foodres.2009.09.005.

57.

Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78(8):965–78. doi:10.4065/78.8.965.PubMed

58.

Abumweis SS, Barake R, Jones PJ. Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials. Food Nutr Res. 2008;52. doi:10.3402/fnr.v52i0.1811.

59.

Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, et al. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr. 2009;139(2):271–84. doi:10.3945/jn.108.095125.PubMed

60.

Carr TP, Ash MM, Brown AW. Cholesterol-lowering phytosterols: factors affecting their use and efficacy. Nutr Diet Suppl. 2010;2:59–72.

61.

Santosa S, Varady KA, AbuMweis S, Jones PJ. Physiological and therapeutic factors affecting cholesterol metabolism: does a reciprocal relationship between cholesterol absorption and synthesis really exist? Life Sci. 2007;80(6):505–14. doi:10.1016/j.lfs.2006.10.006.PubMed

62.

Phillips KM, Ruggio DM, Ashraf-Khorassani M. Phytosterol composition of nuts and seeds commonly consumed in the United States. J Agric Food Chem. 2005;53(24):9436–45. doi:10.1021/jf051505h.PubMed

63.

Ryan E, Galvin K, O'Connor TP, Maguire AR, O'Brien NM. Phytosterol, squalene, tocopherol content and fatty acid profile of selected seeds, grains, and legumes. Plant Foods Hum Nutr. 2007;62(3):85–91. doi:10.1007/s11130-007-0046-8.PubMed

64.

Webster JL, Dunford EK, Hawkes C, Neal BC. Salt reduction initiatives around the world. J Hypertens. 2011;29(6):1043–50. doi:10.1097/HJH.0b013e328345ed83.PubMed

65.

He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens. 2009;23(6):363–84. doi:10.1038/jhh.2008.144.PubMed

66.

Cogswell ME, Zhang Z, Carriquiry AL, Gunn JP, Kuklina EV, Saydah SH, et al. Sodium and potassium intakes among US adults: NHANES 2003-2008. Am J Clin Nutr. 2012;96(3):647–57. doi:10.3945/ajcn.112.034413.PubMedCentralPubMed

67.

Adrogue HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2007;356(19):1966–78. doi:10.1056/NEJMra064486.PubMed

68.•

Koliaki C, Katsilambros N. Dietary sodium, potassium, and alcohol: key players in the pathophysiology, prevention, and treatment of human hypertension. Nutr Rev. 2013;71(6):402–11. doi:10.1111/nure.12036. This comprehensive review summarizes the mechanisms by which high sodium/low potassium diets cause hypertension.PubMed

69.

Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344(1):3–10. doi:10.1056/NEJM200101043440101.PubMed

70.

Geleijnse JM, Giltay EJ, Grobbee DE, Donders AR, Kok FJ. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens. 2002;20(8):1493–9.PubMed

71.

Campbell F, Dickinson HO, Critchley JA, Ford GA, Bradburn M. A systematic review of fish-oil supplements for the prevention and treatment of hypertension. Eur J Prev Cardiol. 2013;20(1):107–20. doi:10.1177/2047487312437056.PubMed

72.

Pase MP, Grima NA, Sarris J. Do long-chain n-3 fatty acids reduce arterial stiffness? A meta-analysis of randomised controlled trials. Br J Nutr. 2011;106(7):974–80. doi:10.1017/S0007114511002819.PubMed

73.

Xin W, Wei W, Li X. Effect of fish oil supplementation on fasting vascular endothelial function in humans: a meta-analysis of randomized controlled trials. PLoS One. 2012;7(9):e46028. doi:10.1371/journal.pone.0046028.PubMedCentralPubMed

74.

Cicero AF, Ertek S, Borghi C. Omega-3 polyunsaturated fatty acids: their potential role in blood pressure prevention and management. Curr Vasc Pharmacol. 2009;7(3):330–7.PubMed

75.•

Ulu A, Harris TR, Morisseau C, Miyabe C, Inoue H, Schuster G, et al. Anti-inflammatory effects of omega-3 polyunsaturated fatty acids and soluble epoxide hydrolase inhibitors in angiotensin-II-dependent hypertension. J Cardiovasc Pharmacol. 2013;62(3):285–97. doi:10.1097/FJC.0b013e318298e460. This article presents preclinical data that helps to delineate the mechanisms by which long-chain omega-3 fatty acids lower blood pressure.PubMed

76.

Cavalot F, Petrelli A, Traversa M, Bonomo K, Fiora E, Conti M, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab. 2006;91(3):813–9. doi:10.1210/jc.2005-1005.PubMed

77.

Strable MS, Ntambi JM. Genetic control of de novo lipogenesis: role in diet-induced obesity. Crit Rev Biochem Mol Biol. 2010;45(3):199–214. doi:10.3109/10409231003667500.PubMedCentralPubMed

78.

Peter R, Okoseime OE, Rees A, Owens DR. Postprandial glucose - a potential therapeutic target to reduce cardiovascular mortality. Curr Vasc Pharmacol. 2009;7(1):68–74.PubMed

79.

Robertson RP, Harmon JS. Diabetes, glucose toxicity, and oxidative stress: a case of double jeopardy for the pancreatic islet beta cell. Free Radic Biol Med. 2006;41(2):177–84. doi:10.1016/j.freeradbiomed.2005.04.030.PubMed

80.

Cernea S, Dobreanu M. Diabetes and beta cell function: from mechanisms to evaluation and clinical implications. Biochem Med. 2013;23(3):266–80.

81.

Jenkins DJ, Kendall CW, Banach MS, Srichaikul K, Vidgen E, Mitchell S, et al. Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care. 2011;34(8):1706–11. doi:10.2337/dc11-0338.PubMedCentralPubMed

82.

Jenkins DJ, Thorne MJ, Camelon K, Jenkins A, Rao AV, Taylor RH, et al. Effect of processing on digestibility and the blood glucose response: a study of lentils. Am J Clin Nutr. 1982;36(6):1093–101.PubMed

83.

Jenkins DJ, Wolever TM, Jenkins AL, Thorne MJ, Lee R, Kalmusky J, et al. The glycaemic index of foods tested in diabetic patients: a new basis for carbohydrate exchange favouring the use of legumes. Diabetologia. 1983;24(4):257–64.PubMed

84.

Kendall CW, Esfahani A, Josse AR, Augustin LS, Vidgen E, Jenkins DJ. The glycemic effect of nut-enriched meals in healthy and diabetic subjects. Nutr Metab Cardiovasc Dis: NMCD. 2011;21 Suppl 1:S34–9. doi:10.1016/j.numecd.2011.03.013.PubMed

85.

Granfeldt Y, Hagander B, Bjorck I. Metabolic responses to starch in oat and wheat products. On the importance of food structure, incomplete gelatinization or presence of viscous dietary fibre. Eur J Clin Nutr. 1995;49(3):189–99.PubMed

86.

Jarvi AE, Karlstrom BE, Granfeldt YE, Bjorck IM, Vessby BO, Asp NG. The influence of food structure on postprandial metabolism in patients with non-insulin-dependent diabetes mellitus. Am J Clin Nutr. 1995;61(4):837–42.PubMed

87.

Buyken AE, Mitchell P, Ceriello A, Brand-Miller J. Optimal dietary approaches for prevention of type 2 diabetes: a life-course perspective. Diabetologia. 2010;53(3):406–18. doi:10.1007/s00125-009-1629-8.PubMed

88.••

Sievenpiper JL, Chiavaroli L, de Souza RJ, Mirrahimi A, Cozma AI, Ha V, et al. 'Catalytic' doses of fructose may benefit glycaemic control without harming cardiometabolic risk factors: a small meta-analysis of randomised controlled feeding trials. Br J Nutr. 2012;108(3):418–23. doi:10.1017/S000711451200013X. This article provides meta-analytic data showing that modest consumption of fructose does not increase the risk for cardiovascular disease and may help facilitate glycaemic control.PubMedCentralPubMed

89.

Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab. 2010;7:85. doi:10.1186/1743-7075-7-85.

90.

Jonsson T, Granfeldt Y, Lindeberg S, Hallberg AC. Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013;12:105. doi:10.1186/1475-2891-12-105.PubMedCentralPubMed

91.

Brennan IM, Luscombe-Marsh ND, Seimon RV, Otto B, Horowitz M, Wishart JM, et al. Effects of fat, protein, and carbohydrate and protein load on appetite, plasma cholecystokinin, peptide YY, and ghrelin, and energy intake in lean and obese men. Am J Physiol Gastrointest Liver Physiol. 2012;303(1):G129–40. doi:10.1152/ajpgi.00478.2011.PubMed

92.

Chambers AP, Sandoval DA, Seeley RJ. Integration of satiety signals by the central nervous system. Curr Bio: CB. 2013;23(9):R379–88. doi:10.1016/j.cub.2013.03.020.

93.

Geliebter A. Neuroimaging of gastric distension and gastric bypass surgery. Appetite. 2013;71:459–65. doi:10.1016/j.appet.2013.07.002.PubMed

94.

Iwasaki Y, Yada T. Vagal afferents sense meal-associated gastrointestinal and pancreatic hormones: mechanism and physiological role. Neuropeptides. 2012;46(6):291–7. doi:10.1016/j.npep.2012.08.009.PubMed

95.

Thabuis C, Tissot-Favre D, Bezelgues JB, Martin JC, Cruz-Hernandez C, Dionisi F, et al. Biological functions and metabolism of oleoylethanolamide. Lipids. 2008;43(10):887–94. doi:10.1007/s11745-008-3217-y.PubMed

96.

Sarro-Ramirez A, Sanchez-Lopez D, Tejeda-Padron A, Frias C, Zaldivar-Rae J, Murillo-Rodriguez E. Brain molecules and appetite: the case of oleoylethanolamide. Cent Nerv Syst Agents Med Chem. 2013;13(1):88–91.PubMed

97.

Lo Verme J, Gaetani S, Fu J, Oveisi F, Burton K, Piomelli D. Regulation of food intake by oleoylethanolamide. Cell Mol Life Sci: CMLS. 2005;62(6):708–16. doi:10.1007/s00018-004-4494-0.PubMed

98.

Lin L, Rideout T, Yurkova N, Yang H, Eck P, Jones PJ. Fatty acid ethanolamides modulate CD36-mRNA through dietary fatty acid manipulation in Syrian Golden hamsters. Appl Physiol Nutr Metab. 2013;38(8):870–8.PubMed

99.

Livesey G. Energy values of unavailable carbohydrate and diets: an inquiry and analysis. Am J Clin Nutr. 1990;51(4):617–37.PubMed

100.

de Castro JM. Dietary energy density is associated with increased intake in free-living humans. J Nutr. 2004;134(2):335–41.PubMed

101.

Ledikwe JH, Blanck HM, Kettel Khan L, Serdula MK, Seymour JD, Tohill BC, et al. Dietary energy density is associated with energy intake and weight status in US adults. Am J Clin Nutr. 2006;83(6):1362–8.PubMed

102.

Duncan KH, Bacon JA, Weinsier RL. The effects of high and low energy density diets on satiety, energy intake, and eating time of obese and nonobese subjects. Am J Clin Nutr. 1983;37(5):763–7.PubMed

103.

Smit HJ, Kemsley EK, Tapp HS, Henry CJ. Does prolonged chewing reduce food intake? Fletcherism revisited. Appetite. 2011;57(1):295–8. doi:10.1016/j.appet.2011.02.003.PubMed

104.

Kristensen M, Jensen MG. Dietary fibres in the regulation of appetite and food intake. Importance of viscosity. Appetite. 2011;56(1):65–70. doi:10.1016/j.appet.2010.11.147.PubMed

105.

Miles CW, Kelsay JL, Wong NP. Effect of dietary fiber on the metabolizable energy of human diets. J Nutr. 1988;118(9):1075–81.PubMed

106.

Grant G, Alonso R, Edwards JE, Murray S. Dietary soya beans and kidney beans stimulate secretion of cholecystokinin and pancreatic digestive enzymes in 400-day-old hooded-lister rats but only soya beans induce growth of the pancreas. Pancreas. 2000;20(3):305–12.PubMed

107.

Herzig KH, Bardocz S, Grant G, Nustede R, Folsch UR, Pusztai A. Red kidney bean lectin is a potent cholecystokinin releasing stimulus in the rat inducing pancreatic growth. Gut. 1997;41(3):333–8.PubMedCentralPubMed

108.

Bonjour JP, Kraenzlin M, Levasseur R, Warren M, Whiting S. Dairy in adulthood: from foods to nutrient interactions on bone and skeletal muscle health. J Am Coll Nutr. 2013;32(4):251–63. doi:10.1080/07315724.2013.816604.PubMedCentralPubMed

109.

Vatanparast H, Calvo MS, Green TJ, Whiting SJ. Despite mandatory fortification of staple foods, vitamin D intakes of Canadian children and adults are inadequate. J Steroid Biochem Mol Biol. 2010;121(1–2):301–3. doi:10.1016/j.jsbmb.2010.03.079.PubMed

110.

Cho SS, Qi L, Fahey Jr GC, Klurfeld DM. Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease. Am J Clin Nutr. 2013;98(2):594–619. doi:10.3945/ajcn.113.067629.PubMed

111.

He M, van Dam RM, Rimm E, Hu FB, Qi L. Whole-grain, cereal fiber, bran, and germ intake and the risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus. Circulation. 2010;121(20):2162–8. doi:10.1161/CIRCULATIONAHA.109.907360.PubMedCentralPubMed

112.

O'Keefe Jr JH, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clin Proc. 2004;79(1):101–8. doi:10.4065/79.1.101.PubMed

113.

Bersaglieri T, Sabeti PC, Patterson N, Vanderploeg T, Schaffner SF, Drake JA, et al. Genetic signatures of strong recent positive selection at the lactase gene. Am J Hum Genet. 2004;74(6):1111–20. doi:10.1086/421051.PubMedCentralPubMed

114.

Metzgar M, Rideout TC, Fontes-Villalba M, Kuipers RS. The feasibility of a Paleolithic diet for low-income consumers. Nutr Res (New York, NY). 2011;31(6):444–51. doi:10.1016/j.nutres.2011.05.008.

Title: Deconstructing the Paleolithic Diet: Components that Reduce Cardiovascular Disease Risk
Authors: Christopher P. F. Marinangeli
Peter J. H. Jones
Publication date: 01-06-2014
Publisher: Springer US
Published in: Current Nutrition Reports / Issue 2/2014
Electronic ISSN: 2161-3311
DOI: https://doi.org/10.1007/s13668-014-0077-3

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2014

Prevention of Late-life Cognitive Disorders: Diet-Related Factors, Dietary Patterns, and Frailty Models

Dairy and Cardiovascular Disease: A Review of Recent Observational Research

Diet and Healthy Patterns in the Elderly

Dietary Fiber Intake and Risk of Stroke

Malnutrition and Neurodegenerative Diseases

Genetic Variants in the FADS Gene: Implications for Dietary Recommendations for Fatty Acid Intake

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage