The Effect of the Paleolithic Diet vs. Healthy Diets on Glucose and Insulin Homeostasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Recently, the Paleolithic diet became popular due to its possible health benefits. Several,
albeit not all, studies suggested that the consumption of the Paleolithic diet might improve glucose
tolerance, decrease insulin secretion, and increase insulin sensitivity. Therefore, the aim of this
meta-analysis was to compare the effect of the Paleolithic diet with other types of diets on glucose
and insulin homeostasis in subjects with altered glucose metabolism. Four databases (PubMed, Web
of Sciences, Scopus, and the Cochrane Library) were searched to select studies in which the effects of
the Paleolithic diet on fasting glucose and insulin levels, glycated hemoglobin (HbA1c), homeostasis
model assessment of insulin resistance (HOMA-IR), and area under the curve (AUC 0–120) for
glucose and insulin during the oral glucose tolerance test were assessed. In total, four studies with 98
subjects which compared the effect of the Paleolithic diet with other types of diets (the Mediterranean
diet, diabetes diet, and a diet recommended by the Dutch Health Council) were included in this
meta-analysis. The Paleolithic diet did not differ from other types of diets with regard to its effect on
fasting glucose (standardized mean difference (SMD): −0.343, 95% confidence interval (CI): −0.867,
0.181, p = 0.200) and insulin (SMD: −0.141; 95% CI: −0.599, 0.318; p = 0.548) levels. In addition, there
were no differences between the Paleolithic diet and other types of diets in HOMA-IR (SMD: −0.151;
95% CI: −0.610, 0.309; p = 0.521), HbA1c (SMD: −0.380; 95% CI: −0.870, 0.110; p = 0.129), AUC 0–120
glucose (SMD: −0.558; 95% CI: −1.380, 0.264; p = 0.183), and AUC 0–120 insulin (SMD: −0.068; 95%
CI: −0.526, 0.390; p = 0.772). In conclusion, the Paleolithic diet did not differ from other types of diets
commonly perceived as healthy with regard to effects on glucose and insulin homeostasis in subjects
with altered glucose metabolism
