The effect of paleolithic diet on glucose metabolism and lipid profile among patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective

Several randomized clinical trials (RCTs) have investigated the effects of the Paleolithic diet (PD) in adult patients suffering from metabolic disorders. However, the results of these RCTs are conflicting. Therefore, we conducted a systematic review and meta-analysis to assess the effects of the PD in patients with metabolic disorders.

Methods

We searched the PubMed/Medline, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases up to June, 2020. The data were pooled using a random-effects model. From the eligible publications, 10 articles were selected for inclusion in this systematic review and meta-analysis. The meta-analysis was performed using a random-effects model. The heterogeneity was determined using the I² statistics and the Cochrane Q test.

Results

The pooled results from the random-effects model showed a significant reduction of the homeostatic model assessment of insulin resistance (HOMA-IR) (weighted mean difference, WMD: −0.39, 95% CI: −0.70, −0.08), fasting insulin (WMD: −12.17 μU/mL, 95% CI: −24.26, −0.08), total cholesterol (WMD: −0.32 mmol/l, 95% CI: −0.49, −0.15), triglycerides (WMD: −0.29 mmol/L, 95% CI: −0.42, −0.16), low-density lipoprotein cholesterol (WMD: −0.35 mmol/L, 95% CI: −0.67, −0.03), blood pressure (BP)(WMD − 5.89 mmHg; 95% CI − 9.973 to − 1.86 for the systolic BP and WMD − 4.01 mmHg; 95% CI − 6.21 to − 1.80 for the diastolic BP values) and C-reactive protein (CRP) levels (WMD: −0.84, mg/L, 95% CI: −1.62, −0.06) in the PD group versus control group.

Conclusions

Our findings provide better insights into the effect of the PD on the modulation of the glucose and lipid metabolism factors in patients with metabolic disorders, providing comprehensive information for the development of future RCTs with a high quality design.

Keywords:

• Meta-analysis
• paleolithic diet
• randomized controlled trials
• systematic review
• metabolic disorders

Acknowledgements

This study was supported by the Student Research Committee, Fac-ulty of Public Health, Iran University of Medical Sciences, Tehran, Iran (Code NO:98-3-15-16443). The funding body had no role in designing the study and did not take part in data collection, data analysis, interpretation of the data, or writing of the manuscript.

Authorship

Mh.S. and S.F. carried out the concept, design and drafting of this study. M.G. and A.L. searched databases, screened articles and extracted data. S.F. and H.O. performed the acquisition, analysis, and interpretation of data. Mh.S and M.G. critically revised the manuscript. All authors approved the final version of the manuscript.

Disclosure statement

None of the authors had any personal or financial conflicts of interest.

Consent for publication

All authors of this manuscript declared their consent for publication.

Competing interests

The authors declare that they have no competing interests.