Two Paleo Diets from Lindeberg's Group
Here's another paleo diet study: Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study It's from Lindeberg's research group but I'll refer to this one as Jonsson (lead author) to distinguish it from the others.
In a randomized cross-over study, 13 patients with type 2 diabetes, 3 women and 10 men, were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; and a Diabetes diet designed in accordance with dietary guidelines during two consecutive 3-month periods. ... Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6% units by MonoS standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day.
The paleo diet outperformed the diabetes diet, but that is not the purpose of this post, rather to show the composition of the paleo diet tested and add it to my summary table of same. Here are the diets compared. As with Lindeberg before this, we have a significant caloric difference between the tested diets that makes comparison difficult.
I would note that while this is a higher fat diet by percentage, at 39% we really are talking about the SAD in practice. However at the caloric levels we're talking, the absolute fat intake amounted to 68 g (vs. 72g for Dia) while the saturated fat intake was only 19 g (vs. 27 g for Dia) which amounted to only 11% of total calories -- close to the standard target for conventional LF diets.
At right are the foods for just the paleo diet. The one thing that stands out to me (and this is a recurring theme) is that there is higher fruit consumption than we hear even recommended by most of the popular paleo diet plans that tend to favor non-starchy veggies. Also, the veggies included root veg (other than potatoes) such as carrots. To me, the total meat consumption amounts is less than expected totalling roughly 8 oz., with about 3.5 oz of fish which isn't a whole lot when compared to what we're told many paleos eat.
Below is the expanded summary table of paleo diets.
I don't think I've ever posted the diets from the Lindeberg studies ... or rather study. There are two fairly frequently cited papers from data that came from a single dietary clinical trial: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease and A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. Thus both "Lindeberg" in the above table. Below are the diet breakdowns and foods. I note they are (expectedly) quite similar to the study above, though this trial was the lowest fat diet of them all, both by percent (28%) and absolute intake (a mere 42 g total, 13 g sat fat). Also we see the relatively large fruit intake and smaller than expected meat and fish consumption (as well as calories).
Comments
When did "paleo" COMPLETELY ignore ultra high LDL-C levels?
Remember this
http://content.onlinejacc.org/article.aspx?articleid=1135650
Optimal low-density lipoprotein is 50 to 70 mg/dl
Lower is better and physiologically normal
James H O'Keefe, Jr, MD; Loren Cordain, PhD; William H Harris, PhD; Richard M Moe, MD, PhD; Robert Vogel, MD
"We live in a world very different from that for which we are genetically adapted. Profound changes in our environment began with the introduction of agriculture and animal husbandry 10,000 years ago, too recent on an evolutionary time scale for the human genome to adjust. As a result of this ever-worsening discordance between our ancient genetically determined biology and the nutritional, cultural, and activity patterns in modern populations, many of the so-called diseases of civilization, including atherosclerosis, have emerged. Evidence from hunter-gatherer populations while they were still following their indigenous lifestyles showed no evidence for atherosclerosis, even in individuals living into the seventh and eighth decades of life (15- 16). These populations had total cholesterol levels of 100 to 150 mg/dl with estimated LDL cholesterol levels of about 50 to 75 mg/dl. The LDL levels of healthy neonates are even today in the 30 to 70 mg/dl range. Healthy, wild, adult primates show LDL levels of approximately 40 to 80 mg/dl (17). In fact, modern humans are the only adult mammals, excluding some domesticated animals, with a mean LDL level over 80 mg/dl and a total cholesterol over 160 mg/dl (15- 16) (Figure 1). Thus, although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted."
Show me a paper authored by Cordain that repudiates these statements.
Wiliam "Wheat Belly" Davis - who most people in the paleosphere love
http://www.healthcentral.com/heart-disease/c/1435/48470/ldl-naturally/
In this, the third post on the "Rule of 60," we now turn to ways to reduce LDL cholesterol towards 60 mg/dl.
SO - Dr Davis is an advocate of lowering LDL-C to around 60mg/dl - How come NO ONE EVER mentions this?
Has he changed his position - does he now advocate that LDL levels of >300mg/dl (ala Jimmy Moore) are now no longer a problem??
This is what REALLY PISSES me off
Robb Wolf takes part in a study where statin drugs are used to reduce LDL-P. How come NO ONE has attacked him for using these "deadly" drugs??
http://perfecthealthdiet.com/2011/08/low-carb-high-fat-diets-and-the-thyroid/#comment-28096
http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/
My doctor started me on Armour a few weeks ago - 1/2 grain (30 mgs) per day - increasing by 1/2 grain per week until I get to 2 grains per day - will have blood tests on 6/17 - I'll try to get a full lipid panel done sometime in July - will be interested to see if the levels change
I wonder if Robb is fine with LDL-P north of 2000?
What science is he talking about? Bro? LMAO
"Folks like Dr. Thomas Dayspring and Dr. Tara Dall of the National Lipid Association certainly see this and have offered very specific guidelines when we should not just default, but run to a ketogenic/LC diet. If the individual shows A1C above 6.5 and trig's above 200 we have significant pancreatic beta cell damage. We are now looking at a situation akin to the spiral-down of the honeymoon phase of type 1 diabetes. Ie. a limited run of any type of endogenous insulin production.
Solution?
Dramatically limit carbs, reestablish the neuroregualtion of appetite (unless someone is too impulsive to live within these constraints...) get the body fat down and activity level up. This approach saves lives. Well, so long as people are aware it is an option.
That Evelyn cannot make heads or tails of the science is kind of pathetic at this point. But the fact her broken psyche does not allow her to STFU and take a powder when the big kids are talking about things that they actually do for a day job...I'm not really sure HOW to categorize that."
In the last chart, what makes up "sweet beverages excluding juice"? If it's sweetened sodas, how is that part of a recommended diabetes or Mediterranean diet? Makes me wonder how the directions and advice differed between the two groups.
I'm also intrigued by the "bakery" and alcohol entries in the first chart for the Paleolithic diet foods. Have to read that paper too. Anyone know offhand what the "official" positions are on booze among the different ancestral gurus? I know Mark Sisson's includes wine but I think that's the 20% outside allowance rather than on the approved list. What is the low-carber position on alcohol?
Paleo certainly suffers the same problems as Mediterranean in that there is no standard definition. Which I would note is evident in Lindeberg as the relatively high dairy intake is not typical of most Medtn diets.
If Robb believed his own schtick, he'd promote the diet used in these studies which was Loren Cordain's original diet. People cringed at canola oil being used in Ryberg when that was in Cordain's original. He has changed his stance on both canola and sat fats so the original page I once read is no longer there. However Cordain was more interested in recreating the macro/micro profile of the paleo diet with modern foods than trying to mimic the foods that were available to paleo man. At least around the time I started blogging in 2010.
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Blood was drawn 2/25/13
TSH - 1.44 Reference Range 0.34 - 4.82 ulU/mL
Free T4 - 1.10 Reference Range 0.77 - 1.60 ng/dL
FT3 - 3.4 Reference Range 2.1 - 4.0 pg/ml
Reverse T3 - 336 Reference Range 90-350 pg/mL
As to my diet - I stopped eating meat about 2 months ago (just lost the taste for it) so I'm now eating pastured eggs, grass fed butter, raw sprouted nuts and seeds, full fat yogurt, a lot of fresh/frozen fruit, potatoes, whey protein isolate in my smoothies, 100% dark chocolate or 100% organic cacao powder, organic pasta sauce (on my eggs), avocados
Tara L Dall serves on the speaker bureaus for Abbott, GlaxoSmithKline, LipoScience, Merck Schering Plough, Takeda, and Santarus
"In patients with insulin resistance as the core etiology of dyslipidemia, weight loss, increased exercise, and lower carbohydrate diets will also favorably decrease LDL-P."
Jimmy Moore - LDL-P 3451, Small LDL-P 221, TC 359, LDL-C 285, HDL-C 65, Trigs 46 (NMR Panel done on 10/25/12)
What would Dr Dall say about that??
coffee paleo dieters they'll try to tell you Ldl is rather meaningless
if you have high HLD/low trigs + low inflammation.
They'll also try to convince you that low cholesterol and low LDL is dangerous
and increases mortality. They all seem to support Sisson and Attia about
the importance of LDL-P, though I have yet to see any paleo/primal/low
carbers with a high LDL yet low LDL-p. The only one who has a LDL under
1000 is Peter attia, but he has a LDL of under 70, so he seems to be the
exception rather than the norm in paleoland.
"That now gives me a TOTAL WEIGHT LOSS OF 75.2 POUNDS in eleven months. If I reach 80 pounds lost by the time I update you next following the Low-Carb Cruise, then I’ll be happy with that as a nice one-year weight loss total. As you know, this experiment has not focused on weight loss as a primary goal. Sure, it’s a nice side effect and I’ll take it, but I’m much more interested in hunger and craving control, improving inflammation and lipid numbers, blood sugar control and how I look, feel and perform being in a keto-adapted state. It was encouraging to meet so many fantastic people at PaleoFX who said they have been inspired by my NK journey and I look forward to continuing on this adventure in the months and years to come. Now let’s look at my blood sugar levels in Day 301-330 starting with the AM readings:"
"has not focused on weight loss" what a liar.
Look at ahis blood sugar levels - all over the place EVEN with berberine - blame it on his less than 3 day fast - he has an excuse for everything
"What’s next? I would like to have another NMR Lipoprofile test run to see what’s going on with my LDL particles and particle size. A very generous fan of my work paid for me to have genetic testing of my DNA to see if I have familial hypercholesterolemia or not. I don’t think I do, but the test results due in on April 15, 2013 will confirm or deny. Stay tuned! Another wonderful reader has agreed to pay the costs to have my hair tested for minerals. I’m currently letting it grow out to the required 1 to 1 1/2 inches for the test and will scalp the back of my head to do this test. It may not be long enough until mid-May, but I look forward to see the results from this test when I can get it done. I’m still very interested in doing more testing in the coming months, so let me know what you’d like to see me have done. And if you would like to contribute towards helping me run more health tests in the coming months, then feel free to e-mail me what tests you would like to see along with making a donation towards this effort through PayPal.
Hair analysis - OMG - This man is a WHORE!! He will have ANY test done if someone pays for it. I sense some serious psychological problems here.
Now that he is down to 231 what next - how will he shift over to maintenance?
“We look at Body Mass Index, blood pressure, smoking history. We look at a basic lipid panel. We look at sugars. We do a metabolic syndrome calculation,” said Dr. James Greenwald, with Specialty Health. If there is a suggestion of increased risk, Greenwald said, physicians look further with something called “advanced lipid testing.”
Dr. Tara Dall, a Wisconsin-based lipidologist who is working on the Reno project, said it is very important to test for the right things. Many at-risk individuals are missed because of improper tests, she said.
“Half of all people who have cardiovascular events have normal cholesterol levels,” said Dall, who recommends checking lipoproteins, the particles in blood that carry cholesterol and triglycerides. She said it’s not the passengers (the cholesterol), it’s the cars (the particle number) that is most important.
“It’s the (lipoproteins) that really define risk,” said Dall, adding that lipids give a window into diabetes because they began to change long before sugar levels get elevated.
The first behavioral change is diet. Specialty Health prescribes a “Paelo” low-carb diet – with basic foods and nothing processed.
“Certain foods make you sick,” said science journalist Gary Taubes. “If you don’t eat them you won’t be sick, you won’t be fat, you won’t be pre-diabetic, or diabetic, you won’t get heart disease.”
Exercise is another important consideration when treating insulin resistance. Exercise raises the HDL (good) cholesterol and promotes insulin sensitivity in muscle.
Weight loss, even just 5% of body weight, can have a significant impact on metabolism – especially dangerous belly fat.
And in some cases, Specialty Health prescribes medication, such as Metformin, which promotes insulin sensitivity and fights the progression of insulin resistance and/or the development of Type 2 diabetes."
Notice there is NO mention of statin drugs in this article!!
SO - according to Dr Dall high LDL-P is a precursor to diabetes!!
My oh my what will Jimmy say/do?? How do you reduce LDL-P while on a very high saturated diet??
Dr Dayspring told JM to REDUCE his saturated fat intake IMMEDIATELY and if his LDL-P doesn't drop start on a statin regimen. After all even Robb Wolf uses statins now.
Here's a new name for the movement. PayPaleo !
The people who work on copper believe most of us have copper deficiency, in startling contrast to the UK Dept of Health which told me in a letter 'copper deficiency is rare'. The RDA for copper in the US was recently set at a level found by Klevay to cause symptoms of heart disease in volunteers. Too low. It means millions of people have copper deficiency and think they don't.
The interesting thing is that Specialty Health is looking at those with hidden risk -- normal to marginally high LDL but high particle number. This would ADD to the mainstream advocacy for statins. :(
http://www.scribd.com/doc/134715081/nm-3145
This isn't vastly different from the latest iteration of the mainstream DASH diet:
"THE DASH DIET WEIGHT LOSS SOLUTION turbocharges the DASH diet, ranked as the "Best Overall Diet" by US News & World Reports in 2011, 2012, and 2013, with proven NIH research on DASH (Dietary Approaches to Stop Hypertension) to create a program guaranteed to speed weight loss and boost metabolism. Based on long-overlooked DASH research and developed into a weight loss plan by the foremost DASH dietitian and leading nutrition expert, Marla Heller, MS, RD, this effective and easy weight loss program includes menu plans, recipes, shopping lists, and more. Readers will enjoy a diet rich in fruits, vegetables, low-fat and nonfat dairy, lean meats/fish/poultry, nuts/beans/seeds, heart healthy fats, and limited amounts of whole grains.
So DASH turbocharged is basically the Rob Wolf diet, plus lowfat dairy, beans, and limited amounts of whole grains.....
I
http://livinlavidalowcarb.com/blog/jimmy-moores-n1-experiments-nutritional-ketosis-day-301-330/18195#comments
Joe Fraizer • 5 hours ago
Jimmy, I have been following your blog for two years and have, until now, been too shy to comment. The pictures you posted, however, have inspired me to do so. You look unreal! You appear to be physically lean and appear to be closing in on an athletic physique. I am of Aboriginal descent, and the only success I have ever maintained with regards to weight loss has been via an approach similar to the methods you are currently using! Keep posting pictures man
LLVLCBlog Mod Joe Fraizer • 5 hours ago
THANKS Joe! I feel more athletic than I have in my entire life...saying a lot since I'm past the age when most men would be in their prime for physique. But I'm bound and determined to keep pursuing this with a goal to see myself get stronger and stronger and one day see my abs for the first time. It's a BIG challenge, but I'm up for it now that I've found what is right for me. KEEP IT UP, Joe!
"You look unreal! You appear to be physically lean and appear to be closing in on an athletic physique."
JM wants to see his abs one day - OMG - he is still a fat tub of goo!!
My heart-healthy PAM eating plan includes 45 to 50 percent slow-burning, low-glycemic index carbohydrates; 30 percent healthy fats; and 20 to 25 percent protein. I’d also urge you to eat organic as much as possible. In short, here are some guidelines:
Increase your intake of:
Oatmeal and complex carbohydrate pastas, such as those made with whole wheat, spelt, or Jerusalem artichoke
Slow-burning, low-glycemic index vegetables, such as asparagus, broccoli, kale, Brussels sprouts, and spinach
Legumes, such as lentils, soybeans, and chickpeas (these contain folic acid, and they help lower insulin levels)
Onions and garlic (these contain allicin, which helps lower cholesterol levels)
Fresh herbs, such as rosemary, thyme, and basil
Fruits, such as cherries, peaches, plums, strawberries, blueberries, apricots, pears, and apples (melons, grapes, and kiwi are suitable, but they contain more sugar)
Sources of essential fatty acids (EFAs) and protein, such as cold-water fish and organic eggs
Soy products, such as tofu, soybeans, tempeh, and soy milk
Fish, especially fatty ones, such as salmon
Healthy fats, such as olive, sesame, walnut, avocado, and flax oils
Nuts and seeds, including walnuts, almonds, chestnuts, and flaxseed
Low-fat cottage cheese, feta cheese, and grated Parmesan
Decrease your intake of:
Foods containing refined white flour or sugar, such as breads and bagels
Partially hydrogenated oils, found in commercially prepared crackers, cookies, chips, and other snacks
Starchy vegetables such as corn, peas, and carrots
Canned vegetables, because they’re usually very high in sodium
Processed fruit juices, which are often loaded with sugars
Red meats and organ meats
Omega-6 oils, such as corn, safflower, sunflower, and canola
Full-fat dairy products, including whole milk and many cheeses
What is JMs exercise program currently? Is it still Ultimate Frisbee? I'm reading Heart 411 right now and apparently aerobic (cardio) exercise performed regularly raises your HDL, lowers your LDL and increases your insulin sensitivity. (I knew before that exercise was vaguely "good for you", but I didn't know those specifics.) Do the "cardio kills" followers ever address this?
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From Dr. Peter Attia's website - in the comments section
http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-v
Thomas Dayspring aka "Dr Lipid" May 26, 2012
Well the 50th percentile cutpoint is not normal if one is trying to prevent atherosclerosis. The 20th percentile cutpoint would be considered desirable: that is 80 mg/dL for apoB and < 1000 nmol/L for LDL-P
Barkeater May 31, 2012
Thanks
for replying and thanks for this series.
I am anxious for the grand train wreck that comes when Dr. A tells Jimmy Moore and the low-carb/ paleo crowd that have achieved > 2000 LDL-Ps (yes, I am in that club, thanks to FH) that they have to get to an 1100 LDL-P, and good luck getting there with anything but statins or unproven crap like zetia (or maybe an Ornish diet – me, I choose to eat food). As TO
says, get your popcorn.
Jimmy Moore has gotten an NMR, and reported LDL-P of 2130. I see a significant number of low-carbers seem to have spikes in their LDL-C and LDL-P that would appear to be driven by diet. They are not necessarily FHers like me (but I have seen wide ranging LDL-P, from 1500 to 2800, and cannot yet tie it out to diet). Commenter MacKillop below refers to a double-digit percentage of folks on low-carb diets who see very high LDL-C. Mr. and Mrs.
Jaminet have blogged at some length on the issue. I see the view expressed by some that this phenomenon is due to ApoE4, but I don’t buy it (I am a 3/3).
Peter Attia May 31, 2012
The question we don’t know the answer to is if an LDL-P of 2,000 in someone who eats no carbs is the same as an LDL-P of 2,000 in someone who does. I had breakfast with Eric Westman today and we discussed this topic. Eric makes a pretty compelling case that these 2 states are not, in fact, the same thing. I think we can safely say we don’t know the answer. At least I don’t. I’ll keep looking for clues, though.
Peter Attia May
31, 2012
I completely agree with Eric’s assertion (in fact, I’m having breakfast with Eric in an hour). This brings up a much larger question that I’m sure I will detail more closely in this series: It is
possible that all of the risk stratification we have for heart disease is predicated on someone consuming a normal Western diet? Furthermore, is it possible that once the body stops relying on glycogen and turns over to metabolic pathways of ketosis that the “numbers” we target as “normal” are irrelevant? I think I know the answer for some physiologic parameters, but I’m still trying to develop my “universal theory” uniting it all.
MY questions are these
1) "is an LDL-P of 2,000 in someone who eats no carbs the same as an LDL-P of 2,000 in someone who does
2) "is it possible that all of the risk stratification we have for heart disease is predicated on someone consuming a normal Western diet? Furthermore, is it possible that once the body stops relying on glycogen and turns over to metabolic pathways of ketosis that the “numbers” we target as “normal” are irrelevant?"
OR
3) Is DR Thomas Dayspring right when he says "Well the 50th percentile cutpoint is not normal if one is trying to prevent atherosclerosis. The 20th percentile cutpoint would be considered desirable: that is 80 mg/dL for apoB and < 1000 nmol/L for LDL-P.
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