Type 2 Diabetes is one of the many “diseases of affluence” so I wanted to dig deeper and find out if we went back to our roots and answer the question “Is the paleo diet good for type 2 diabetes?”
Is The Paleo Diet Good For Type 2 Diabetes?
Did you know that the rate of prevalence of type 2 diabetes has more than doubled since records were started in 1980? The disease officially affects over 400 million adults in the world.
Type 2 Diabetes is one of the biggest causes of death, disability and has a huge economic cost either directly or indirectly. Just to give you an idea, in 2016 alone, over half a million people died due to type 2 diabetes. In Europe, over 40 million euros were spent due to type 2 diabetes.
This has been a challenge for many governments to tackle. A huge amount of research and money has gone into finding out more about type 2 diabetes and how this can be prevented.
A substantial amount of the results point towards regulation of macronutrient consumption by dietary intervention. The diets that have higher protein intake and lower carbohydrates have proved to be better at managing type 2 diabetes.
In this study, Jonsson et al enrolled 15 participants with type 2 diabetes, all over 18 years old. They also ensured to recruit participants that had a waist circumference of over 80 cm for women and 94 cm for men.
The procedure adopted was to teach the chosen participants on how to fill in the sheet below link fig 1. Participants were asked to consume two diets, healthy diet A which contained cereals and grains and healthy diet B containing no cereals and grains (Paleo diet).
Why did the researchers choose these two diets?
To ensure all bases are covered and effectively single out whether adopting a Paleo or Paleo type diet would be beneficial for those as a sustainable diet to manage type 2 diabetes.
The participants were given detailed meal plans and asked not to deviate from this. In addition to this, they were also asked to send photographs of meals to the investigators. They were asked not to change those physical habits for the duration do this study to get the most accurate results.
The researchers wanted to avoid weight loss as this is expected on a Paleo diet. So they arranged a weekly weigh in of all participants. If a subject had lost over 1 kg, their meal plan was modified to increase calorie intake to make up for this deficit. This was done to ensure that weight loss had no part to play in managing type 2 diabetes.
Now on to the diet
Healthy diet A contained fruit, vegetables, meat, nuts, eggs, olive oil, whole grains, low fat dairy products and legumes.
Healthy diet B was a Paleo type diet that was pretty much like the above but with no grains, dairy or legumes.
The aim of this study was to investigate which diet led to better glucose control and management regardless of glycemic index, fibre content and macronutrients composition. This was the guidelines the researchers used to design two 7 day meal plans for healthy diets A and B
The starting point was to do a simple glucose tolerance test. This was done by getting the participants to ingest 75 grams of glucose and blood samples drawn and tested for glucose and glucagon levels immediately, after 15 mins, 30, 60, 90 and 120 minutes. The levels will be a measure of how well the participant can tolerate glucose.
The results of the test concluded that the healthy diet B or Paleo diet was a better way for patients to manage type 2 diabetes.
Ever heard of the term “Insulin Resistance”?
Insulin Resistance is best described as a lack of responsiveness to blood sugar in the face of apparently adequate supply of insulin.
This term was coined by Root in 1929 after studying a lot of cases where certain individuals often with disease such as arthritis who had an inadequately high need for insulin.
The past century has seen the prevalence of insulin resistance in diabetes, infections, obesity, sepsis, arthritis, lupus. Insulin resistance also presents itself in mental states such as schizophrenia.
When looking at several instances of insulin resistance occurring across all the states described above, a pattern emerges.
You can identify insulin resistance as two clinical entities. One that is inflammation with an active immune response and the other that presents itself with increased mental activation.
On the topic of cereals, the next paper I want to highlight investigates…
The Effects Of A Paleo Diet On Pigs Compared With The Effects Of A Standard Cereal Based Diet
Since the incidence of western disease (such as type 2 diabetes, obesity etc) was less prevalent in hunter gatherers on a Paleo diet, Jonsson et al studied the long term effects of the Paleo diet on pigs.
How they did this was to separate 24 piglets straight as they are ready to be weaned into two groups. The cereal group (fed with standard swine feed containing cereals) and the Paleo group (fed a Paleo diet). 17 months down the line, they performed a glucose to tolerance test similar to the one described earlier and specimens of each pig’s pancreas was taken to run an immunochemical test.
The results were interesting…
After the 17 month period, the group of pigs on the Paleo diet weighed 22% less than the group consuming cereals and they also had 43% less subcutaneous fat!
The Paleo group demonstrated a significantly higher insulin sensitivity and lower insulin response than the group consuming cereals. Blood pressure was significantly lower in the pigs on the Paleo diet as well.
This study proves that the Paleo diet confers higher insulin sensitivity, lower insulin response and lower blood pressure when compared to being on a cereal based diet.
In my search to uncover studies that prove diet can be a great way to minimise or be able to manage diseases of affluence such as type 2 diabetes, I came across this great paper by Melnik et al and they have a unique approach and that is use the lessons learned from people who suffer from Laron syndrome.
What is Laron syndrome?
Larons syndrome is a form of dwarfism that is characterised by an insensitivity to human growth hormone. Recently, Aguirre et al did a study on 99 Ecuadorians who had Larons syndrome. These subjects did not developed type 2 diabetes and no cancer when compared with others who had normal insulin and growth factor signalling.
To further prove this theory, a worldwide survey by Steurman et al reported that of the 230 participants with Larons syndrome, none of them developed cancer. This and other related studies and experiments have given us a substantial link between insulin / IGF signalling and how the reduction of this pathway as in the case of people with Larons syndrome is a way to slow down or prevent the prevalence of western diseases which cause exaggerated insulin / IGF signalling.
The following are the studies that support the findings that increased insulin / IGF signalling causes cancer, type 2 diabetes, acne and other western diseases.
Insulin/IGF-1/FoxO signaling and type 2 diabetes – This paper
FoxO1 inhibits b-cell proliferation. Nutritional alterations of b-cell FoxO1 transcriptional activity are predominantly mediated through glucose-stimulated insulin secretion and insulin receptor signaling. Recently, the concept of a “metabolic diapause” has been proposed for the changes induced by FoxO1 to protect b-cells against oxidative stress underpinning the concept of b-cell rest as a treatment goal in T2D. Thus, FoxO1, the convergence point of IIS, orchestrates b-cell proliferation and apoptosis which both are increased in T2D.
Insulin/IGF-1/FoxO signaling and cancer – This paper
GH, IGF-1 and insulin have cancer-promoting actions and raised serum IGF-1 levels have been associated with increased risk of prostate, breast and colorectal cancers. IIS regulates the nuclear distribution of FoxO proteins which are increasingly considered to represent unique cellular targets directed against human cancer in light of their pro-apoptotic effects and their ability to lead to cell cycle arrest. FoxOs are involved in the control of angiogenesis, stem cell proliferation, cel