title: Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes.
abstract: Means to reduce future risk for cardiovascular disease in subjects with type 2 diabetes are urgently needed.
  
  
  
  Thirty-two patients with type 2 diabetes (age 59 ± 8 years) followed a Paleolithic diet for 12 weeks. Participants were randomized to either standard care exercise recommendations (PD) or 1-h supervised exercise sessions (aerobic exercise and resistance training) three times per week (PD-EX).
  
  
  
  For the within group analyses, fat mass decreased by 5.7 kg (IQR: -6.6, -4.1; p < 0.001) in the PD group and by 6.7 kg (-8.2, -5.3; p < 0.001) in the PD-EX group. Insulin sensitivity (HOMA-IR) improved by 45% in the PD (p < 0.001) and PD-EX (p < 0.001) groups. HbA1cdecreased by 0.9% (-1.2, -0.6; p < 0.001) in the PD group and 1.1% (-1.7, -0.7; p < 0.01) in the PD-EX group. Leptin decreased by 62% (p < 0.001) in the PD group and 42% (p < 0.001) in the PD-EX group. Maximum oxygen uptake increased by 0.2 L/min (0.0, 0.3) in the PD-EX group, and remained unchanged in the PD group (p < 0.01 for the difference between intervention groups). Male participants decreased lean mass by 2.6 kg (-3.6, -1.3) in the PD group and by 1.2 kg (-1.3, 1.0) in the PD-EX group (p < 0.05 for the difference between intervention groups).
  
  
  
  A Paleolithic diet improves fat mass and metabolic balance including insulin sensitivity, glycemic control, and leptin in subjects with type 2 diabetes. Supervised exercise training may not enhance the effects on these outcomes, but preserves lean mass in men and increases cardiovascular fitness. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Julia
authors.initials: J
authors.lastname: Otten
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stomby
authors.affiliation: Department of Food and Nutrition, Umeå University, Umeå, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Waling
authors.affiliation: Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, Umeå, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Isaksson
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Tellström
authors.affiliation: Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
authors.forename: Lillemor
authors.initials: L
authors.lastname: Lundin-Olsson
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
authors.forename: Søren
authors.initials: S
authors.lastname: Brage
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Ryberg
authors.affiliation: Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, Umeå, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Svensson
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Olsson
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D066046:Diet, Paleolithic; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D010101:Oxygen Consumption; D011379:Prognosis
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Paleolithic diet; diet intervention; exercise; glycosylated haemoglobin A; insulin sensitivity; leptin; type 2 diabetes