Masharani U, Sherchan P, Schloetter M, Stratford S, Xiao A, Sebastian A, Nolte Kennedy M, Frassetto L
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Clinical and Translational Science Institute, University of California San Francisco, San Francisco, CA, USA.
Eur J Clin Nutr. 2015 Aug;69(8):944-8. doi: 10.1038/ejcn.2015.39. Epub 2015 Apr 1.
BACKGROUND/OBJECTIVES: The contemporary American diet figures centrally in the pathogenesis of numerous chronic diseases--'diseases of civilization'--such as obesity and diabetes. We investigated in type 2 diabetes whether a diet similar to that consumed by our pre-agricultural hunter-gatherer ancestors ('Paleolithic' type diet) confers health benefits.
SUBJECTS/METHODS: We performed an outpatient, metabolically controlled diet study in type 2 diabetes patients. We compared the findings in 14 participants consuming a Paleo diet comprising lean meat, fruits, vegetables and nuts, and excluding added salt, and non-Paleolithic-type foods comprising cereal grains, dairy or legumes, with 10 participants on a diet based on recommendations by the American Diabetes Association (ADA) containing moderate salt intake, low-fat dairy, whole grains and legumes. There were three ramp-up diets for 7 days, then 14 days of the test diet. Outcomes included the following: mean arterial blood pressure; 24-h urine electrolytes; hemoglobin A1c and fructosamine levels; insulin resistance by euglycemic hyperinsulinemic clamp and lipid levels.
Both groups had improvements in metabolic measures, but the Paleo diet group had greater benefits on glucose control and lipid profiles. Also, on the Paleo diet, the most insulin-resistant subjects had a significant improvement in insulin sensitivity (r = 0.40, P = 0.02), but no such effect was seen in the most insulin-resistant subjects on the ADA diet (r = 0.39, P = 0.3).
Even short-term consumption of a Paleolithic-type diet improved glucose control and lipid profiles in people with type 2 diabetes compared with a conventional diet containing moderate salt intake, low-fat dairy, whole grains and legumes.
背景/目的：当代美国饮食在众多慢性疾病（如肥胖症和糖尿病等“文明病”）的发病机制中起着核心作用。我们研究了在2型糖尿病患者中，一种与我们农业时代之前的狩猎采集祖先所食用的饮食类似的“旧石器时代”类型饮食是否具有健康益处。
受试者/方法：我们对2型糖尿病患者进行了一项门诊代谢控制饮食研究。我们比较了14名食用包含瘦肉、水果、蔬菜和坚果且不含添加盐的旧石器时代饮食的参与者，以及10名食用基于美国糖尿病协会（ADA）建议的饮食（包含适量盐摄入、低脂乳制品、全谷物和豆类）的非旧石器时代类型食物的参与者的研究结果。有三种为期7天的递增饮食，然后是14天的测试饮食。结果包括：平均动脉血压；24小时尿电解质；糖化血红蛋白和果糖胺水平；通过正常血糖高胰岛素钳夹法测量的胰岛素抵抗以及血脂水平。
两组的代谢指标均有所改善，但旧石器时代饮食组在血糖控制和血脂方面有更大益处。此外，在旧石器时代饮食中，胰岛素抵抗最强的受试者胰岛素敏感性有显著改善（r = 0.40，P = 0.02），但在ADA饮食中胰岛素抵抗最强的受试者中未观察到这种效果（r = 0.39，P = 0.3）。
与包含适量盐摄入、低脂乳制品、全谷物和豆类的传统饮食相比，即使短期食用旧石器时代类型饮食也能改善2型糖尿病患者的血糖控制和血脂情况。
