The New Paleo Diet Study: Paleo-type-style-ish Diets vs. "Paleo"
There's a new Swedish paleo diet study out: A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. The title sounds promising, but my first reaction to it, sadly, not so much about the potential findings, but, what exactly is this paleo-TYPE diet?? It would appear to be based loosely on Cordain's original Paleo Diet (I hear that's trademarked).
This was a small study, 10 women, no control group, lasting only 5 weeks. There were some benefits including around 10 lbs average weight loss and almost 50% reduction in liver fat. This shall be for another blog post. But what diet was tested? Here's the diet description from the full text:
Participants were given prepared meal portions that were intended to provide an average intake of about 30 energy percentage (E%) protein, 40 E% fat (mostly unsaturated) and 30 E% carbohydrates for breakfast, lunch and dinner, together with 40 g nuts (walnuts and sweet almonds) on a daily basis for 5 weeks.
All meals were prepared by the food service ... The diet included lean meat, fish, fruit, vegetables (including root vegetables), eggs and nuts. Dairy products, cereals, beans, refined fats and sugar, added salt, bakery products and soft drinks were excluded. Participants were instructed to complement the provided food with other included food items from the list, ad libitum. ... They were also advised to use only rapeseed [canola] or olive oil in food preparation. The recommended alcohol intake was less than two glasses of red wine per week.
There are likely a few others, but so far we have Lindeberg, Frasetto and now Ryberg paleo studies. The nutritional comparisons are shown here.
The descriptions of Lindeberg's and Ryberg's paleo diets are the same (both Swedish, no surprise!), while Frasetto's is notably higher in carb including more honey and high sugar fruit such as pineapple -- there was more attention paid to potassium content as well. The Ryberg diet is a bit higher in fat, but at 40% prescribed and 44% (median) actual, it is still rather low in fat compared to what is espoused in various paleo diet books by various advocates. Indeed two of these diets would qualify as "officially" low fat by the 30% standard, and all three diets are at the sub-10% target set out by the so-called saturated lipophobes. PUFA contents ranging from 7 to 13% of total dietary intake are quite high and the results in each of these studies must be considered when PUFA is a revived finger pointing target of late.
All of these diets counsel elimination of all dairy. No Kerrygold popsicles, yogurt smoothies, certainly no sour cream and Philly cream cheese. No coconut breaded offal parmigiana or artificially sweetened whey protein peanut butter concoctions from the "ancestral education video" non-profiteer here. Whether intentional (as in the current study) or not, the saturated fat content of the tested diets beats the so-called "misguided" recommendation of 10% tops, and speaking of coconut, you don't hear any of that! At the very least, these studies CANNOT be seen as any sort of "vindication" of sat fats or free pass. Neither are they endorsements for the most popular paleo and paleo-inspired diets. Having been used by such folks as Nora Gedgaudas and Paul & Shou Ching Jaminet in support of their dietary recommendations, Lindeberg's diet comes in very low fat by comparison. I've become increasingly disappointed with Paul's recent attempts to score "authentic paleo" points with evermore imaginative claims reconciling PHD with paleo. We don't know. It wasn't the same for all paleos. We couldn't recreate it with modern foods if we wanted to. We have NO way to know what their true state of health was, and thus if we should even be attempting to emulate their ways.
Which leaves us where? I exchanged tweets with Robb Wolf regarding this study. He seemed no more hopeful that "paleo" would be defined in the clinical trial realm than it is in practice. Which makes the label all the more confusing and, IMO, ultimately meaningless. More thoughts to come in my post on the study per se ... But these studies are increasingly demonstrating that lower-to-low fat relatively higher PUFA diets, per USDA recs, may just not be a problem! Nobody has as yet denounced any of these studies as not "real" paleo, as the LCers are wont to do when a study doesn't demonstrate the supposed superiority of the low carb diet.
Followup posts on the clinical results of the study:
The New Paleo Diet Study: The Weight Loss
The New Paleo Diet Study: Just the Fats Ma'am
Followup posts on the clinical results of the study:
The New Paleo Diet Study: The Weight Loss
The New Paleo Diet Study: Just the Fats Ma'am
Comments
Now, had I not registered paleodiet.com before he published his first book, he may have taken that for his domain name.
no need to fear protein
no need to fear fat
no need to fear carbs
no need to fear the reaper
http://en.wikipedia.org/wiki/Journal_of_Internal_Medicine
So when someone tests a high-SFA or low-protein diet Paleo diet they will need to find another term. I guess Perfect Health Diet will be the devalued term when that happens.
Of course for some purposes, such as resistance to oxidation, MUFA and SFA are virtually interchangable. There would be no issue with higher levels of PUFA over the time scales of these studies assuming that a) omega 6 and 3 are balanced, b) the subject is not already swamped in them. The salutary effects of DHA and EPA appear faster when these are added than any harmful effect of linoleic acid disappear when it is withdrawn.
@Jorgen, intractable hiccups are a serious if unusual condition, other cures used in the past include I.V. methamphetamine.
Canola oil? And rapeseed oil has been used in other studies, really?
Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events
A Systematic Review and Meta-analysis
Conclusion
Overall, omega-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association.
http://www.lecturepad.org/index.php?option=com_content&view=article&id=1103:re-analysis-of-sydney-heart-study-are-omega-6-fatty-acids-atherogenic&catid=65:diabetic-therapeutic-agents&Itemid=445
http://www.lecturepad.org/index.php?option=com_content&view=article&id=1104:commentary-response-to-jama-on-omega-3-fatty-acids&catid=47:prevention&Itemid=423
http://www.dhaomega3.org/Cardiovascular-Health/DHAEPA-Institute-Comments-on-Recent-Review-Omega-3-Supplementation-and-Cardiovascular-Events
http://www.texasgrassfedbeef.com/HTMLobj-5953/Response_to_JAMA_Sept_12_2012.pdf
Some of the responses from the scientific community regarding recent JAMA report.
http://www.wholefoodsmagazine.com/columns/vitamin-connection/amid-continuing-reports-fish-oils-effectiveness-flawed-studies-add-confu
http://www.drkarafitzgerald.com/omega-3-benefits
The liver fat is probably more related to less leaky gut >> less endotoxins in the bloodstream.
Perhaps the most important thing for fatty liver is choline. The dietary guidelines have really got to get their act together because they are recommending choline deficient diets. What's more, the adequate intake is based on the minimum amount for liver damage to not occur
Horses for courses?
Thank you for posting the info on omega-3s. I am so tired of all the omega-3 hype. I wonder if "paleo people" worried about omega-3/omega-6 balance or had easy access to omega-3 food sources in northern continental climates?
It doesn't help with muscle pain but it does resolve joint inflammation quickly if taken in therapeutic as opposed to supplement doses as mentioned in the last article referenced by Charles.
My bottom line is that the results of various studies continue to be all over the map, and to me this means it cannot be PUFA per se. If it were, there would be consistency, and perhaps neg effect or no effect, yet we often see neg, no, or positive. That should not occur unless there's more to it!
Dietary fat content modifies liver fat in overweight nondiabetic subjects.
'We have previously found a correlation between between the percent saturated and total fat in the diet and liver fat content.'
which points to this study:
(http://www.ncbi.nlm.nih.gov/pubmed/12606511)
Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content.
'At baseline, LFAT correlated with the percent of fat (r = 0.44, P < 0.05) and saturated fat (r = 0.45, P < 0.05) of total caloric intake but not intra-abdominal or subcutaneous fat or fasting serum free fatty acids. '
LFAT=liver fat
From this same study:
' The decrease in LFAT was closely correlated with baseline LFAT (r = -0.85, P < 0.001) but not with changes in the volumes of intra-abdominal or subcutaneous fat depots, which decreased similarly in both groups. LFAT appears to be related to the amount of fat in the diet rather than the size of endogenous fat depots in obese women. '
and
'We found, however, a significant correlation between total fat and saturated fat intake and LFAT, raising the possibility that fatty acids derived from the diet may influence LFAT content.'
You say:
'Also interesting that the total SFA decreased by more than half (-57%) on the paleo diet. Possibly relevant considering the impressive decreases in liver fat.'
That seems to be the case, given both these studies. Decreases in liver fat occur during weight loss. In the study you cite, there wasn't weight loss, but there was decrease in LFAT. During the diet, 'The difference in fat intake was mainly a result of the difference in the intake of calories from saturated but also from mono- and polyunsaturated fat.' These are the authors' words, but the study isn't about saturated fat - it seems to me to be more about total fat.
The second study does look more closely at saturated fat.
It considers identical weight loss. The chart (Fig. 2) shows the effects of saturated fat on liver fat.
Formation of trans fats during food preparation.
Canola oil was the oil used.
There are some trans fats in canola oil (4 grams in a cup) but just 17 grams of saturated fat in that cup. There are no trans fats in a cup of butter, but 117 grams of saturated fat. Guess you pick your poison! Even olive oil has 30 grams of saturated fat in a cup.
Cooking vegetable oil doesn't seem to matter, though.
'Baking and stir-frying at normal and/or extreme temperatures do not significantly affect the amounts of trans fats. Likewise, heating oil to the smoking point during stir-frying may decrease the amount of polyunsaturated fatty acids because of oxidative degradation.'
It always make me think of omega-3 capsules and how long they have been sitting on the shelf before being eaten. I wish someone would test them if they are rancid.
The Extraordinary Science of Addictive Junk Food
Ectopic fat is fat stored in non-adipose tissue -- including organs like the liver. Yet another thing Dr. Eades had a hand in confusing people about for fun and profit in the abominable 6 Week Cure. Liver fat is not belly fat!
@Subcalva -- Yeah, I wonder about my olive oil since I don't use a whole lot it sits around :(
Here is my page why not try these out
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