Lynda Frassetto, M.D. —Paleolithic Diets and Diabetes Control: How Do We Think It Works?

Dr. Lynda Frassetto presenting at the 2nd Annual Ancestral Health Symposium 2012 (AHS12).

Lynda Frassetto, MD, is a Professor of Medicine and Nephrology at the University of California San Francisco. She is the director of a clinical research center at UCSF, supervises patient care at three of the University’s hospitals, and helps teach courses on improved communications and behavioral stress modification techniques.

Obesity is one of the major health problems in the world today, in both developed and third world countries. Being overweight or obese increases the risk of developing insulin resistance and diabetes; about 85-90% of people with type 2 diabetes are overweight or obese.

Nutritional guidelines for diabetes rely on moderating carbohydrate intake and promoting weight loss. Recent meta- analysis suggest that weight loss, and not any particular diet, is the most important intervention for improving glucose levels (1,2). A recent Cochrane review of dietary advice for diabetes control concluded, “There are no high quality data on the efficacy of the dietary treatment of type 2 diabetes”(3).

There is, however, evidence in short term studies, that dietary composition can affect glucose control independent of weight loss. Thus studies of isocaloric Paleolithic-type diets demonstrate improvement of glucose levels and insulin sensitivity. Which component(s) of the “paleo-diet” is responsible for these improvements are not known. The diet is high in fiber and very large increases in fiber in the diet can lower glucose levels. Another possibility is that the quantity or quality of foods can alter neuro-hormonal control of appetite and satiety. In our presentation, we will review evidence available from clinical trials comparing dietary treatments for diabetes.

1. Aucott LS. Influences of weight loss on long-term diabetes outcomes. Proc Nutr Soc. 2008;67(1):54-9
2. Gillies CL, Abrams KR, Lambert PC et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007;334(7588):299

3. Nield L, Moore HJ, Hooper L et al. Dietary advice for treatment of type 2 diabetes mellitus in adults. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004097