Palaeolithic diet decreases fasting plasma leptin concentrations more than a diabetes diet in patients with type 2 diabetes: a randomised cross-over trial

Abstract

BackgroundWe have previously shown that a Palaeolithic diet consisting of the typical food groups that our ancestors ate during the Palaeolithic era, improves cardiovascular disease risk factors and glucose control compared to the currently recommended diabetes diet in patients with type 2 diabetes. To elucidate the mechanisms behind these effects, we evaluated fasting plasma concentrations of glucagon, insulin, incretins, ghrelin, C-peptide and adipokines from the same study.MethodsIn a randomised, open-label, cross-over study, 13 patients with type 2 diabetes were randomly assigned to eat a Palaeolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, or a diabetes diet designed in accordance with current diabetes dietary guidelines during two consecutive 3-month periods. The patients were recruited from primary health-care units and included three women and 10 men [age (mean ± SD) 64 ± 6 years; BMI 30 ± 7 kg/m2; diabetes duration 8 ± 5 years; glycated haemoglobin 6.6 ± 0.6 % (57.3 ± 6 mmol/mol)] with unaltered diabetes treatment and stable body weight for 3 months prior to the start of the study. Outcome variables included fasting plasma concentrations of leptin, adiponectin, adipsin, visfatin, resistin, glucagon, insulin, C-peptide, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 and ghrelin. Dietary intake was evaluated by use of 4-day weighed food records.ResultsSeven participants started with the Palaeolithic diet and six with the diabetes diet. The Palaeolithic diet resulted in a large effect size (Cohen’s d = −1.26) at lowering fasting plasma leptin levels compared to the diabetes diet [mean difference (95 % CI), −2.3 (−5.1 to 0.4) ng/ml, p = 0.023]. No statistically significant differences between the diets for the other variables, analysed in this study, were observed.ConclusionsOver a 3-month study period, a Palaeolithic diet resulted in reduced fasting plasma leptin levels, but did not change fasting levels of insulin, C-peptide, glucagon, incretins, ghrelin and adipokines compared to the currently recommended diabetes diet.Trial registration: ClinicalTrials.gov NCT00435240Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0398-1) contains supplementary material, which is available to authorized users.

Leptin and adiponectin as predictors of cardiovascular risk after gestational diabetes mellitus

“…Indeed, experimental studies indicate that the effects of leptin on glucose homeostasis are suppressed during pregnancy [30]. Furthermore, both diet and low birthweight may have an impact on leptin levels, irrespective of body mass [31, 32]. A low birth weight was associated with a higher prevalence of diabetes and obesity, higher leptin levels and leptin to fat mass ratio possibly related to nutrition or the development of leptin resistance and/or higher leptin production by body fat unit [32].…”

A Review of the Leptin Hormone and the Association with Obesity and Diabetes Mellitus

“…The Palaeolithic diet was found to have a more significant reducing effect on fasting leptin concentration [21]. The reduction in leptin, however, concurs with reduction in weight during the diet [21].…”

“…The reduction in leptin, however, concurs with reduction in weight during the diet [21]. The diet induced reduction in leptin may be due to a concurring loss of fat [21].…”

“…Research has found that diet can reduce the levels of leptin [21]. The Palaeolithic diet was found to have a more significant reducing effect on fasting leptin concentration [21].…”

Self-experimentation: a Pathway to Ancestral Health Practices

“…During this time, scientific evidence about the health benefits of ancestral diets has also been accumulating. Benefits for treatment of type-2 diabetes [3], [4], [5], [6], [7], [8], cardiovascular disease [4], [9], [10], [11], multiple sclerosis [12], [13], inflammatory bowel disease [14], obesity [15], and all-cause mortality [16] have been documented through human trials.…”