Osterdahl Paleo Study

In the interests of having all of the clinical trials studying the "paleo diet" on the record, I decided to exhume and publish this post up on a small 2008 study by Osterdahl et. al.

Effects of a short-term intervention with a paleolithic diet in healthy volunteers

This study was small (14 subjects, 5 male, 9 female) and short (3 weeks).   Full dietary records were available for 6 subjects (1 male, 5 female), here is the dietary intake.

There were some minor changes in weight (2.9 kg , 6.4 lbs) and lower BP of statistical significance.  Lipids and all other parameters except PAI-1 were not statistically significant.

The average starting weight was about 65 kg (143 lbs) with a BMI of 22.2.  In the latest round of Is This Your Paleo Diet?, here is the diet description:
Allowed food ad libitum: All fresh or frozen fruits, berries and vegetables except legumes, canned tomatoes without additives except for citric acid, fresh or frozen unsalted fish and seafood, fresh or frozen unsalted lean meats and minced meat, unsalted nuts (except peanuts), fresh squeezed lemon or lime juice (as dressing), flaxseed or rapeseed oil (as dressing), coffee and tea (without sugar, honey, milk or cream), all salt-free spices.
Allowed food in restricted quantity: Dried fruit (ad lib 2 days/week), salted seafood (one meal/week), fat meat (one meal/week), potatoes (two medium sized/day), honey (used in marinade once/week), cured meats (as entree once/week), mineral water (only when drinkable tap water was not available).
Prohibited food: All milk and dairy products, all grain products (including maize and rice), all legumes (including peanuts), charcuterie products (for example, sausages, paˆte´s and so on), canned food (except tomatoes, see above) and all forms of candy, ice cream, sorbet, soft drinks, juices, syrups, liquor, sugar and salt.
  • Notable differences vs. other paleo clinical trials is the specific allowance of two medium-sized potatoes per day.  
  • Notable similarities would be not only the exclusion of grains, but also dairy (that includes butter!).  Also salt (sodium) is highly restricted.
  • Just notable:  Whether warranted or not, Cordain and others made a fairly high profile switch on canola (rapeseed) oil, but that doesn't change the fact that dressings in this study were canola or flax oil and lemon/lime juice.

Notable differences vs. Paleo™:   Do I even need to list?  OK, just a few:
  • Relatively low fat (36%), very low sat fat (5.5%)
  • 40% Carb including "real" carbs (fruits & potatoes)
  • Macro proportions at least in line with Eaton & Konner
  • Fruit allowed ad libitum.  All fruit.  
  • Organ meats?  Nope.
  • Rice?  Nope.
  • Lean Meat?  Yep!
  • Bacon?  Once per week
  • Eggs not mentioned
  • A dangerously 4 grams of carbohydrate into the insidious weight gain range of Mark Sisson's idiotic carb curve.

Nothing smashingly ground breaking here.  But I've updated my spreadsheet of paleo clinical trials for use in an upcoming post on Paleo 2014, coming soon!


Karin said…
Geez, they cut almost 1000 calories off their original diet. I guess they considered 6.4 pounds to be only a minor weight change, but in only three weeks that seems like fairly rapid weight loss to me. Since the lower bp was of statistical significance can you list the change in numbers? Thanks.
carbsane said…
To be clear, I say there were minor changes. This high potassium low sodium and lower carb (even though this is not low carb, it is about half of the original) all would lead to water weight loss. The potassium/sodium likely responsible for the BP change.
charles grashow said…

Look at the United States!! OMG
carbsane said…
Probably not and here's why. He advocates 100g starch and not to count non-starchy veggies. Nutrient analyses do, so while I agree with his rule (it's silly to count carbs in broccoli) most PHD's would be consuming about 50g carb from that. There's no hard and fast rule on fruit so let's just say another 20g there. So we're pretty well out of low carb range. Further, depending on overall intake, those same carbs and high end protein could make his diet 30/30/40 P/C/F <-- that's what it worked out for me when I was PHD-ish.
eulerandothers said…
Weight Watchers estimates a 2 pound loss (or 1 to 2 pounds) each week, averaging out, I guess, when you stick to the diet. This is usually too slow for most people who want to lose weight quickly!
Lighthouse Keeper said…
The paleo diet has just come bottom in the U.S. News best diets of 2014 out of 32 diets. Whilst one may think of taking such a thing with a pinch of salt the panel of experts here are high ranking and relevant and one would say trump Jimmy Moore's Cholesterol Clarity experts at least as far as credentials are concerned. What is strange here is that said panel placed some seemingly dodgy diets much higher than the paleo diet. Another conspiracy perhaps?
Lighthouse Keeper said…
Spot on, don't think you missed anything there either.
carbsane said…
(Beavis laugh)

Did someone say balls? ;-)
carbsane said…
Yes, and predictably Robb Wolf came out swinging with class and dignity. A tease on what's in store here soon ;-)
Valhalla said…
Referencing genitalia in this forum would be inappropriate. No one has a problem with those.

However, Paleo is the new dietary Purtianism.

You must cleanse your soul! (and your GI tract of any gluten)
charles grashow said…
Loren Cordain, PhD

"The macronutrient content of the experimental diet (38 % protein, 39 % fat, 23 % carbohydrate by energy) varied considerably from current western values."

Look at Table 3

Macronutrient and other dietary characteristics in a contemporary diet based on Paleolithic food groups for females (25 yrs, 2200 kcal daily energy intake)

Fat (g) 100.3
Fat (% Total Energy) 39.0

Saturated Fat (g) 18
Saturated Fat (% Total Energy) 7.0

SO - it's NOT high in saturated fat at all!!
Valhalla said…
Oops I forgot Big Primal Fuel and Big Bulletproof Coffee.
Lighthouse Keeper said…
"Bollocks" would be apt in this context.
ExEffectsGuy said…
I've heard of this guy Robb Wolf but today is the first time I ever looked at his website. He sure mentions science a lot doesn't he! He seems quite agitated by US News and World Report, an organization obviously in someone's pockets though it's unclear who that would be. Is he the guy people call "The Cute One?" If you want to bring up science, I wouldn't let people refer to me as that. Anyway, I considered buying his book on the website......NOT!! It's titled Real Food or something like that. I don't need a book for that. I already know what real food is.
John Craft said…
Checkout this great paleo recipes and cookbooks www.paleo99diet.com
Lighthouse Keeper said…
Both mixed with Paleo Water no doubt.
carbsane said…
I don't know about the cute one, but he's been described as a boy genius and used to have the attached cartoon logo. He's quite upset (again) over any criticism. Tact, professionalism and, sadly, scientific rigor are not his strong suits.

He has been nicknamed the Paleo Baby Jesus ;-)

He and I have a bit of a history at this point. Dishing to come in my next post because he's at it again.
ExEffectsGuy said…
Looking forward to it! Paleo Jesus? Even as an agnostic I find that offensive! I guess I need to just stop paying any attention at all to these guys. They make my blood boil! This goes for Paleo, Veganism, And the rest! No, I really don't care what people do, but I actively dislike those that preach their way as gospel!
Jethro Bodine said…
Isn't 30/30/40 P/C/F the zone diet? Do you think that's the way to go?
charles grashow said…

The Effect of High-, Moderate-, and Low-Fat Diets on Weight Loss and Cardiovascular Disease Risk Factors

"One hundred men and women followed one of four dietary programs for 1 year: a moderate-fat (MF) program without calorie restriction (28 patients); a low-fat (LF) diet (phase I) (16 patients); a MF, calorie-controlled (phase II) diet (38 patients); and a high-fat (HF) diet (38 subjects). Weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), homocysteine (Ho), and lipoprotein(a) [Lp(a)], were measured every 4th month. The TC/HDL-C ratio was calculated and fibrinogen levels were measured at baseline and after one year."

"Dietary Regimens

High-Fat (HF) Diet

This diet is defined as one in which patients consume 55%-65% of their daily caloric intake in the form of fat calories. Less than 100 g of carbohydrates (RCHO) were consumed daily and protein intake constituted 25%-30% of the total caloric intake. Patients ate until satiated.

Moderate-Fat (MF) Diet
Patients following this dietary program consumed 20%-30% of their calories in the form of fat. Approximately 60% of their calories were from carbohydrate sources and the remaining calories were derived from protein. Patients consumed 10–12 calories per pound per day on this diet.

MF, Calorie-Controlled (Phase II) Diet

Patients following this program were asked to consume 350–500 fewer kilocalories per day than required15,20 to maintain body weight. This was determined by multiplying their current weight in pounds by 10 kcal/lb to determine the required kcal intake per day; 350–500 was subtracted from this figure to determine the desired daily intake of calories. Of these calories, 15% were protein and 70% were carbohydrate, with an emphasis on complex carbohydrates vs.simple sugars. The remaining 15% of the calories could be consumed as fat in a 2:1 ratio of nonsaturated (polyunsaturated and monosaturated)
to saturated fat, with no more than 5 g of saturated fat intake per day.

Low-Fat (LF) (Phase I) Diet
The LF diet consisted of fruits, vegetables, a limited amount of grain/cereals for breakfast and a multiple vitamin that included 100% ofthe US Department of Agriculture recommended daily intake of vitamins and minerals. Patients ate until satiated. Of the caloric intake, 10% was fat, 15% was protein, and 75% was carbohydrate, with an emphasis on complex vs. simple carbohydrates as shown in Table I.

Reductions in TC, LDL-C, TGs, and TC/HDL ratios were significant only in patients either following a LF diet or a MF, calorically reduced diet. Only patients following HF diets showed a worsening of each cardiovascular disease risk factor (LDL-C, TG, TC, HDL-C, TC/HDL ratio, Ho, Lp(a), and fibrinogen), despite achieving statistically significant weight loss."
lucyricardanon said…
Am I reading this wrong, or did they lower bp from low-normal to even lower? Because if so, 1) that's not hard to do and 2) it's not necessarily good.
charles grashow said…

"Most discussions of the evolution of the human diet implicate meat as the proverbial smoking gun responsible for many hallmarks of human evolution such as brain expansion, cooperation, family formation, pair bonding, tool making, and even selection of marriage partners. Some alternative interpretations discuss the importance of plant foods, like tubers (starchy underground storage organs – similar to potatoes), and suggest that the collection and consumption of plant foods is what made us human. The debate of the significance of meat versus potatoes, so to speak, appears to be rooted in deep evolutionary time.

More recently, however, there has been a trend in incorporating a wider range of foods in evolutionary reconstructions of the human diet. With the popularity of the “Paleolithic Diet” and “caveman cooking” steadily on the rise, it is increasingly important to turn to different lines of evidence to inform our thinking on the history of humans and their food. As new lines of evidence converge, it is becoming clear that the ancestral human diet was varied and included a combination of both animal protein and fat as well as plant foods; a Paleolithic menu that included meat, potatoes…..and dessert!

It appears that the human sweet tooth has a long history in human evolution. New research proposes that honey may have been important in human evolution. Upper Paleolithic (8,000 – 40,000 years ago) rock art from all around the world depicts images of early humans collecting honey. The images range from figures climbing ladders to access hives residing high in trees to figures smoking out hives filled with honeycomb. Honey and bee larvae are important foods consumed by many populations of hunters and gatherers worldwide. Foragers in Latin America, Asia, Australia, and Africa include honey and bee larvae as major components of their diet. The Hadza hunter-gatherers of Tanzania, the population with whom I work, even list honey as their number one preferred food item!

Honey is a highly nutritious (and delicious!) food source, composed primarily of fructose and glucose. Combined with larvae, which is high in protein, fat, and B vitamins, honeycomb is nature’s energy bar. The ethnographic cross-cultural evidence of honey consumption, combined with depictions of honey hunting portrayed in rock art around the world, suggest that honey has long been been a part of human history. Early humans, and their expanding brains, would have greatly benefited from consuming honey and bee larvae because the human brain needs glucose to fuel the high metabolic demands of neural development and function. The Paleolithic diet likely included meat, plant foods, and honeycomb…..one of the sweet secrets to human evolution!"
LWC said…
So I went and read the linked study. Isn't the HF diet close to what NuSi wants to use? Or am I confused?
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