Category: Diet

Paleo diet and heart health

Paleo diet and heart health

Jealth Hypoglycemic unawareness prevention association between the PaleoDiet and Low-intensity yoga routines risk is supported by the previously diwt effect of the PaleoDiet on different markers of Hypoglycemic unawareness prevention risk [ 18 ]. A common characteristic of these dietary patterns is a high consumption of fruits and vegetables, whole grains, nuts, legumes, vegetable oils, fish, and seafood; a moderate consumption of low-fat dairy products; and a low consumption of processed meat, sugar-sweetened beverages, and sodium [ 9 ]. Mayo Clin Proc — Paleo diet and heart health

Paleo diet and heart health -

She adds that removing packaged and processed foods, refined grains, added sugar and artificial sweeteners, limiting alcohol, and including whole foods — especially fruits and veggies — are all major positives.

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Show references Tahreem A, et al. Fad diets: Facts and fiction. Frontiers in Nutrition. Aggarwal M, et al. Controversial dietary patterns: A high yield primer for clinicians.

American Journal of Medicine. Palma-Morales M, et al. Food made us human: Recent genetic variability and its relevance to the current distribution of macronutrients. Department of Agriculture and U.

Department of Health and Human Services. Dietary Guidelines for Americans, December Accessed Sept. A score appraising paleolithic diet and the risk of cardiovascular disease in a Mediterranean prospective cohort. European Journal of Nutrition.

Dinu M, et al. Effects of popular diets on anthropometric and cardiometabolic parameters: An umbrella review of meta-analyses of randomized controlled trials.

Advances in Nutrition. Pontzer H, et al. Effects of evolution, ecology, and economy on human diet: Insights from hunter-gatherers and other small-scale societies. Annual Review of Nutrition. The endpoint was a composite of acute myocardial infarction with or without ST elevation, non-fatal stroke both confirmed by a review of medical records with prior permission of relatives and cardiovascular death.

When a CVD was self-reported in a follow-up questionnaire, complete medical information was requested to the participant to confirm the CVD diagnosis by a cardiologist who was blind to diet and lifestyle exposure.

In addition, we consulted the National Death Index annually to identify the deceased participants and to obtain their cause of death. All variables shown in Tables 1 and 2 were age- and sex-adjusted using the Inverse Probability Weighting method [ 34 ].

Standard tests were applied to assess differences between the means and proportions of cohort characteristics according to PaleoDiet score quintiles. We first analyzed the PaleoDiet score as a continuous variable and then categorized it into quintiles to define low Q1 , low-moderate Q2 , moderate Q3 , high-moderate Q4 and high Q5 adherence to the PaleoDiet.

We used the lowest quintile as the reference value and we also calculated the HRs for 5-unit increase in the PaleoDiet score. In addition, we estimated the relative importance of each of the components of the PaleoDiet score by subtracting alternately one component from the original score, and afterwards estimating the HRs per 5-unit increment in the score.

A crude model and three multivariable-adjusted models were fitted. Age was used as the underlying time-variable in all Cox models. To investigate linear trends across the quintiles of PaleoDiet scores we assigned the median value to each quintile and considered the variable as continuous. We calculated Pearson correlation coefficients r to assess the strength and direction of the association between the PaleoDiet and the two MedDiet indices.

To assess the potential effect of PaleoDiet in participants within a Mediterranean country, we conducted a joint analysis for the combination of MedDiet using the MDS and MEDAS scores and PaleoDiet scores.

Both the MDS and PaleoDiet scores were divided into three categories Q1, merged Q2—Q3—Q4, and Q5. Therefore, a joint variable with nine categories was created. The joint analysis for PaleoDiet and MEDAS were divided into three categories Q1, merged Q2—Q3—Q4, and Q5 for PaleoDiet and into two categories according to the median for the MEDAS.

Therefore, a joint variable with six categories was created. Radar plot is a useful technique for the graphic presentation of multivariate data [ 36 ].

We applied radar plots according to the joint analysis categories of PaleoDiet and MDS score to observe the standardized mean intake of the food groups used to define the PaleoDiet.

The vertexes of the radar plot show the characteristic dark light line and non-characteristic thick longitudinal line foods of the PaleoDiet score. Cox proportional hazard regression models were used to estimate the association between the joint categories of the PaleoDiet and MedDiet scores and CVD incidence, using the category with the lowest quintile for both MedDiet and PaleoDiet as the reference category.

Likelihood-ratio tests were applied to assess potential effect modification by these variables. We used STATA software to conduct all the analyses STATA version All P values presented are two-tailed.

Statistical significance was considered at the conventional 0. Among 18, participants After a median follow-up of Age- and sex-adjusted baseline characteristics of participants according to quintiles of the PaleoDiet score are summarized in Table 1. Higher prevalent type 2 diabetes, and lower percentage of current smokers were observed across quintiles of the PaleoDiet score.

Participants in the highest quintile practiced more physical activity, reported higher adherence to the MedDiet, and were more likely to follow special diets. Whereas, they were less likely to consume snacks between meals and watching television.

As expected, participants across successive quintiles of the PaleoDiet score consumed more fruits, nuts, fish, eggs, vegetables, olive oil and unprocessed meats, and fewer cereals and grains, dairy products, legumes, ultra-processed foods, culinary ingredients and sugar-sweetened beverages.

Baseline age and sex-adjusted energy and nutrient intakes according to adherence to the PaleoDiet score are displayed at Table 2. Participants in the highest quintile referred the lowest total daily energy and carbohydrate intakes, but highest total protein animal and plant source and fat intake monounsaturated MUFA , polyunsaturated PUFA and n-3 fatty acids; and a lower intake of saturated SFA and n-6 fatty acids.

As expected, participants with higher adherence to PaleoDiet consumed more fiber, Fe, K, Mg, P, Se, Zn, vitamin A, all vitamins from group B, vitamin C and vitamin E than those with lower adherence. Table 3 shows a significant inverse association between the highest quintile of the PaleoDiet score and CVD risk compared to the lowest quintile in all regression models.

A significant inverse association was also found for Q3 but not for Q4, although the P for linear trend was statistically significant in all models. We repeated Cox regression analysis after alternatively excluding one dietary component of the PaleoDiet score at a time Table 4. No substantial changes were observed for these HRs compared to the HR calculated for the original PaleoDiet score except when the contribution of ultra-processed foods as continuous variable per 5-unit increment , and when ultra-processed foods, fruits and vegetables comparison between extreme quintiles were removed from the PaleoDiet score the inverse association between the PaleoDiet score and CVD was reduced, and the P value was no longer statistically significant.

Moreover, significant but weaker inverse associations were found for the alternative PaleoDiet scores without nuts or fish, and stronger association when cereal and grains did not negatively score Table 4.

Pearson correlation coefficients between the PaleoDiet score and MDS and MEDAS, were 0. Figure 2 c, f and i show that among participants with the highest adherence to the PaleoDiet Q5 , all positive items associated with the Paleodiet, but also legumes and cereals and grains, increased with a higher adherence to the MedDiet.

When we applied the joint analysis of the PaleoDiet and the MEDAS scores, we also observed an inverse association with CVD risk among participants with the highest quintile for both scores compared to participants with the lowest adherence to both diets.

C Category. The radar plot axis is expressed in standard deviations SD. This prospective Mediterranean cohort study, conducted among young adult participants, showed an inverse association between higher adherence to the PaleoDiet and CVD risk.

This association was not significantly modified by sex, weight status or physical activity, and the results were robust in multiple sensitivity analyses aimed at controlling for residual confounding. A similar association was also observed when we alternatively excluded items one by one from the PaleoDiet score, although the consumption of fruits and vegetables, and the avoidance of ultra-processed foods may be key components of this diet.

However, weaker inverse associations were also found when nuts or fish were excluded, suggesting the synergistic effect of all components within the PaleoDiet score. However, the prohibition of grains and cereals should be further explored since a stronger inverse association was found when this limitation was not part of the PaleoDiet score.

Finally, in the joint analysis according to levels of adherence to PaleoDiet and MedDiet, the strongest inverse association with CVD was found among participants with the highest adherence to both dietary patterns. Our findings are consistent with those published in a previous cohort study supporting the inverse association between the PaleoDiet and CVD death.

In this study, only a stronger inverse association was found for the MedDiet compared to the PaleoDiet for total and specific causes of death.

The Moli-sani cohort study, which used a similar PaleoDiet definition as Whalen and cols. In that study, no modification effect of the PaleoDiet was observed in a stratified analysis by level of adherence to the MedDiet [ 20 ]. In another study, a score comprising dietary habits and other lifestyle behaviors that could be concordant with a PaleoDiet lifestyle such as limited alcohol consumption, not smoking, high levels of physical activity, and low levels of sedentary behavior showed an inverse relationship with all CVD mortality [ 38 ].

The inverse association between the PaleoDiet and CVD risk is supported by the previously reported effect of the PaleoDiet on different markers of CVD risk [ 18 ].

The PaleoDiet has shown a significant reduction in the risk of anthropometric markers such as body weight [ 12 , 39 , 40 , 41 , 42 , 43 ], waist circumference [ 12 , 39 , 40 , 41 , 42 ], BMI [ 12 , 40 , 41 ], and the percentage of fat mass [ 39 , 42 , 44 ].

Additionally, those who followed a PaleoDiet-style lowered their systolic and diastolic blood pressure, total blood cholesterol, triglycerides, LDL-cholesterol and had increased levels of HDL-cholesterol [ 12 , 39 , 40 , 41 , 42 , 43 ]. However, most of these studies had a small sample size and short follow-up [ 17 ].

The potential beneficial effects of the PaleoDiet for cardiovascular risk could be attributed to a high consumption of fruits, vegetables important sources of fiber , fish and nuts, MUFAs and PUFAs, as well as to a limited consumption of ultra-processed foods, added sugar, salt and refined oils intake.

Similar to traditional and ancient diets, the PaleoDiet promotes higher nutrient density [ 45 ] and higher fiber intake [ 46 ] compared to current Western diets [ 47 ].

Eaton and cols. Fiber consumed by humans during the Paleolithic area came primarily from fruits, legumes, nuts, and other noncereal vegetable sources, and its content of phytic acid would had been less than that of the fiber consumed now in industrialized nations, which comes largely from grains [ 48 ].

According to Eaton and Konner, the proportion of soluble, fermentable fiber relative to insoluble, non-fermentable fiber was likely higher in meals consumed by preagricultural humans [ 48 ].

highest PaleoDiet quintiles and there was only a small difference in SFA intake. The low mean SFAs intake found in our study is explained because the PaleoDiet score quintiles depend on the distribution of SFAs in our Mediterranean population which is relatively low [ 17 , 49 ].

We observed a moderate correlation between the PaleoDiet score and two MedDiet indices. Moreover, a stronger inverse association of the PaleoDiet with CVD was observed when adherence to the MedDiet was highest. This finding means that although the PaleoDiet is proxy of a healthy eating model, the MedDiet may exert even higher cardiovascular benefits.

Contrary to the MedDiet, the PaleoDiet recommends a low consumption of legumes and whole cereals and grains, and a high consumption of lean meat white or red meat. Several studies have suggested that legume consumption improves multiple cardiovascular risk factors blood pressure, LDL concentrations in blood, body weight and protects against type 2 diabetes, reducing glycated hemoglobin levels in diabetic patients and improving insulin sensitivity [ 52 , 53 ].

In addition, the limitation of whole grains consumption in the PaleoDiet may hamper that key nutrients needs such as fiber, vitamins, minerals, lignans, and phytochemicals phenolic acids, polyphenols, and phytosterol compounds are met [ 54 , 55 ].

These nutrients have been positively associated with longevity, and lower risk of obesity, type 2 diabetes, heart disease and colon cancer [ 54 , 55 , 56 , 57 ].

Finally, there is still some controversy about the cardiovascular effect of unprocessed red meat [ 58 , 59 ], but several recent analyses [ 60 , 61 , 62 ] suggested a positive association between the consumption of unprocessed red meats and cardiovascular risk.

Moreover, no evidence from these studies suggests any cardiometabolic benefits of unprocessed red meat consumption [ 59 ]. This study has some limitations. First, the SUN cohort participants did not actively choose a lifestyle according to a PaleoDiet, since we applied an a posteriori classification criterion using a self-reported semi-quantitative FFQ.

A randomized intervention study with long-term follow-up will be needed to assess the effect of an increased adherence to the PaleoDiet, and also to other lifestyle factors associated with this diet, on cardiovascular risk. Second, we used a self-reported semi-quantitative FFQ, which is susceptible to non-differential measurement error, which would more likely underestimate the true association.

However, the FFQ is considered as the most appropriate and practical approach to assess usual food consumption in large cohorts [ 22 ].

Third, our participants were young adults with low prevalence of cardiovascular risk factors and this explains the small number of observed cardiovascular events, especially among women. Further analyses in larger studies are needed to confirm our results and to explore potential interactions with variables such age, sex or other lifestyles such as physical activity.

Fourth, the SUN cohort did not collect biomarkers of cardiovascular risk factors and therefore we were not able to identify potential mechanisms that could explain the inverse association between the PaleoDiet and the risk of CVD.

Five, the FFQ was not specifically designed to collect data about the new NOVA classification of ultra-processed foods consumption. We could not include some items cereal and energy bars, energy drinks, health and slimming products, and meat or vegetable nuggets because the FFQ of the SUN project did not include these items.

Therefore, there is the potential for some degree of misclassification of ultra-processed food consumption inherent in our methodology. However, our FFQ was previously validated and represents the main foods ingested by the studied population [ 23 ], including ultra-processed foods and this potential misclassification would be non-differential according to the status of participants at the end of the study.

Six, we cannot rule out the existence of residual confounding, although we adjusted for the well-known risk factors of CVD in different multivariable models and the results were very similar regardless of the variables used for adjustment.

Seven, another limitation is the difficulty of measuring the PaleoDiet, although we used a new index based on our previous comprehensive review [ 17 ].

Current adaptations of the PaleoDiet may vary from some archeological records [ 63 ] and, for example, although potato intake was not included in our score, some studies suggest that root vegetables with high starch content may be a component of Paleolithic diets [ 64 ].

Finally, the external validity of our results is limited since participants in our cohort were relatively young with high educational level and with low prevalence of cardiovascular risk factors, which limits the generalization of the results to the general population.

However, lack of representativeness does not necessarily imply lack of validity, and the inclusion of highly educated participants in our cohort improves the quality of self-reported information and reduces the possible confounding by educational level and other socio-economic factors [ 22 ].

In addition, the characteristics of our cohort do not prevent from establishing associations that can be generalized to other groups, as long as similar biological mechanisms are plausible in these populations.

Lastly, we conducted a wide array of sensitivity analyses to test the robustness of our results. In conclusion, our results suggest that the PaleoDiet may decrease CVD risk in young adult participants from a Mediterranean country.

This association could be explained by the synergistic effect of all the items of the PaleoDiet score although low consumption of ultra-processed foods, and high consumption of fruits and vegetables seem to be key components to reduce CVD risk.

A slightly higher inverse association was also found when cereals and grains were not negatively scored in the PaleoDiet. Moreover, a stronger inverse association with the PaleoDiet was found as the level of adherence to the MedDiet increased.

Further research with different populations and longer follow-up is needed to replicate these findings and to better clarify the health impact that restriction of typical Mediterranean foods, such as legumes and whole grains, may have on the prevention of CVD for the general population.

This study uses data from the Seguimiento Universidad de Navarra SUN cohort. All data and materials as well as software application or custom code used during the current study shall be made available from the corresponding author on reasonable request. Timmis A, Townsend N, Gale CP et al European society of cardiology: cardiovascular disease statistics Eur Heart J — Article PubMed Google Scholar.

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Korean J Fam Med — Article PubMed PubMed Central Google Scholar. Gheorghe A, Griffiths U, Murphy A et al The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health Turco JV, Inal-Veith A, Fuster V Cardiovascular health promotion: an issue that can no longer wait.

J Am Coll Cardiol — Mozaffarian D, Appel LJ, van Horn L Components of a cardioprotective diet. Circulation — Martínez-González MA, Gea A, Ruiz-Canela M The Mediterranean diet and cardiovascular health.

Circ Res — Article CAS PubMed Google Scholar. Yu E, Malik VS, Hu FB Cardiovascular disease prevention by diet modification: JACC health promotion series.

Bocherens H Neanderthal dietary habits: review of the isotopic evidence. Evol Hominin Diets. Article Google Scholar. Andrikopoulos S The paleo diet and diabetes: studies are inconclusive about the benefits of the paleo diet in patients with type 2 diabetes.

Purpose: To assess anc association between a Hypoglycemic unawareness prevention Plaeo adherence to the PaleoDiet Paloe the risk of cardiovascular disease Hypoglycemic unawareness prevention in a Mediterranean cohort. Methods: Halth included Sunflower seed toppings, participants from the Seguimiento Universidad Paleo diet and heart health Navarra Anv cohort study. CVD was defined as acute myocardial infarction with or without ST elevation, non-fatal stroke and cardiovascular death. Cox proportional hazards models adjusted for potential confounders were fitted to assess the association between the PaleoDiet score and CVD risk, and the PaleoDiet and MedDiet indices to explore differences between both diets. Results: During A significant inverse association was found between the PaleoDiet score and CVD HR Q5 vs. Thinking about trying a new diet healtb Paleo diet and heart health sure which way to Pre-game meal hacks An evidence-based analysis of 10 popular Hypoglycemic unawareness prevention patterns shows some promote heart health much better than others. A scientific statement Pa,eo the American Heart Duet published Thursday in heaalth journal Paleo diet and heart health found the Paleo diet and heart health, DASH-style, pescetarian and vegetarian eating PPaleo strongly aligned with heart-healthy eating Immune system resilience boosters, while the popular an and ketogenic diets contradicted them. Paleo diet and heart health said in a news release. Gardner is the Rehnborg Farquhar Professor of Medicine at Stanford University in California. The report evaluates how well each of 10 popular diets or eating patterns aligns with nine of 10 features of AHA's dietary guidance for heart-healthy eating: consuming a wide variety of fruits and vegetables; choosing mostly whole grains instead of refined grains; using liquid plant oils rather than tropical oils; eating healthy sources of protein, such as from plants, seafood or lean meats; minimizing added sugars and salt; limiting alcohol; choosing minimally processed foods instead of ultraprocessed foods; and following this guidance wherever food is prepared or consumed. The one feature not included in scoring was the energy balance needed to maintain a healthy weight, because it is influenced by factors other than dietary choices, such as physical activity levels.

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Study Links Paleo Diet To Heart Disease!

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