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Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
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2014 (Engelska)Ingår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, nr 3, s. 350-7Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background/Objectives: Short-term studies have suggested beneficial effects of a Palaeolithic-type diet (PD) on body weight and metabolic balance. We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women, in comparison with a diet according to the Nordic Nutrition Recommendations (NNR).

Subjects/Methods: Seventy obese postmenopausal women (mean age 60 years, body mass index 33 kg/m(2)) were assigned to an ad libitum PD or NNR diet in a 2-year randomized controlled trial. The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry.

Results: Both groups significantly decreased total fat mass at 6 months (-6.5 and-2.6 kg) and 24 months (-4.6 and-2.9 kg), with a more pronounced fat loss in the PD group at 6 months (P<0.001) but not at 24 months (P=0.095). Waist circumference and sagittal diameter also decreased in both the groups, with a more pronounced decrease in the PD group at 6 months (-11.1 vs-5.8 cm, P=0.001 and-3.7 vs-2.0 cm, P<0.001, respectively). Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group (P<0.001 and P=0.004). Nitrogen excretion did not differ between the groups.

Conclusions: A PD has greater beneficial effects vs an NNR diet regarding fat mass, abdominal obesity and triglyceride levels in obese postmenopausal women; effects not sustained for anthropometric measurements at 24 months. Adherence to protein intake was poor in the PD group. The long-term consequences of these changes remain to be studied.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2014. Vol. 68, nr 3, s. 350-7
Nyckelord [en]
adipose tissue, diet, insulin resistance, postmenopausal, weight
Nationell ämneskategori
Näringslära Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-86275DOI: 10.1038/ejcn.2013.290ISI: 000332634300011PubMedID: 24473459OAI: oai:DiVA.org:umu-86275DiVA, id: diva2:698285
Anmärkning

C. Mellberg, S. Sandberg and M. Ryberg share first authorship.

T. Olsson and B. Lindahl share senior authorship.

Tillgänglig från: 2014-02-21 Skapad: 2014-02-21 Senast uppdaterad: 2018-06-08Bibliografiskt granskad
Ingår i avhandling
1. Effects of diet intervention on body composition and ectopic fat accumulation in obese postmenopausal women
Öppna denna publikation i ny flik eller fönster >>Effects of diet intervention on body composition and ectopic fat accumulation in obese postmenopausal women
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background Obesity is increasing worldwide and is a major contributor to morbidity and mortality. Notably, abdominal (central) obesity carries a high risk of obesity-related diseases, while peripheral fat accumulation can act in a protective manner. A redistribution of fat from peripheral to central depots is seen after the menopause and is associated with an increasing prevalence of diabetes and cardiovascular disease. A key mediator may be ectopic fat accumulation in the liver. Our hypothesis was that a Palaeolithic-type diet (PD) consumed ad libitum improves body composition and metabolic risk markers, including liver fat and insulin sensitivity, in obese postmenopausal women.

Methods In study I the study subjects (n=10) used a PD during 5 weeks. In study II and III (n=70) the effect of a Palaeolithic-type diet (PD) was compared to a diet according to the Nordic Nutrition Recommendations diet (NNR) during a 2-year randomized clinical trial (RCT). Food records and nitrogen excretion in urine validated food intake. Anthropometric measurements were performed in a standardized manner. Body composition was calculated using Dual Energy X-ray Absorptiometry (DXA). Total energy expenditure was calculated by accelerometry (Actiheart®) in combination with indirect calorimetry. Liver and muscle fat content was estimated by magnet resonance spectroscopy (1H-MRS). Insulin sensitivity was measured either with hyperinsulinemic euglycemic clamps (paper I) or oral glucose tolerance tests (OGTTs) (paper III).

Results In study I a significant weight loss, linked to improved lipid and blood pressure levels, was associated with a 49% decrease in liver fat. Concomitantly, hepatic insulin sensitivity improved, while peripheral insulin sensitivity (and muscle fat) was unaltered. In study II/III both groups had a significant and sustained weight loss after 2 years. The PD was more effective than the NNR diet regarding loss of weight and fat mass after 6 months, but not after 24 months. Serum triglyceride levels were significantly lower at 24 months in the PD group. Liver fat decreased throughout the study in both groups. Hepatic insulin sensitivity improved during the first 6 months of the study, while peripheral insulin sensitivity did not change. Hepatic insulin sensitivity was associated with liver fat at baseline, but not during the diet intervention. Energy expenditure did not change in any of the study groups.

Conclusion Ad libitum diets can have sustained beneficial effects on weight and body composition in obese postmenopausal women, a PD being more effective on short-term than a diet according to the NNR. This is associated with a reduction in liver fat that may reduce the risk of future diabetes and cardiovascular disease. Further studies are needed in order to explore the association between liver fat and metabolic dysfunction, including insulin sensitivity.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2014. s. 45
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1682
Nyckelord
obesity, diet intervention, postmenopausal, ectopic fat
Nationell ämneskategori
Klinisk medicin
Forskningsämne
medicin
Identifikatorer
urn:nbn:se:umu:diva-95161 (URN)978-91-7601-159-1 (ISBN)
Disputation
2014-11-14, Hörsal B, byggnad 1D, Umeå universitet, Umeå, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2014-10-24 Skapad: 2014-10-23 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

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Mellberg, CarolineSandberg, SusanneRyberg, MatsEriksson, MarieLarsson, ChristelOlsson, TommyLindahl, Bernt

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Mellberg, CarolineSandberg, SusanneRyberg, MatsEriksson, MarieLarsson, ChristelOlsson, TommyLindahl, Bernt
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MedicinYrkes- och miljömedicinStatistikInstitutionen för kostvetenskap
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European Journal of Clinical Nutrition
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