Thursday, June 9, 2016

10 Days of 'Paleo Life in the Wilderness' Will Strip up to 18 cm off Your Waist and Boost Your Insulin Sensitivity by 53%

Even though it may have been funny, this is not exactly how the scientists simulated the "paleo lifestyle" in the study at hand. Eventually, however, it came down to eating healthier, being active and even being stressed (within the limits of natural "paleo stress", though).
No, this science website is not going to turn into a paleo blog, ... don't worry. It's mere coincidence that this is the 2nd "paleo" study in 2 weeks that is interesting enough to get its own SuppVersity article devoted to it (last one).

Moreover, said study, which was published in the peer-reviewed scientific journal BioMed Research International, recently (Pruimboom. 2016), doesn't even have the world "paleo" in title of full-text and could still be called "the true paleo" study. It does, after all, revolve around a 10-day mimic of a "hunter-gatherer lifestyle" and its favorable effects on anthropometrics and clinical chemical indices such as the reductions in insulin, triglycerides, HDL, elevated liver health markers and other indices that are usually far from being optimal in the average student, scientist, physician, and other health professionals who participated in the study at hand.
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As the researchers point all, all subjects (n=10, n=32 and n=11) "were interested to experience the impact of ancient lifestyle on their own health and well-being and therefore jointly decided to engage in this study" (Pruimboom). In that, the term "this study" refers to three separate 10-day trips through the Spanish Pyrenees during the summers of 2011 (𝑛 = 10), 2012 (𝑛 = 32), and 2013 (𝑛 = 11), on which ...
"[t]he participants lived outdoors and walked from one watersource to another. Food was provided by the organization and with help of forest-guards from official institutes of the Catalan county. Food intake was planned before the trip, based on the average daily food intake by the traditionally living Hadzabe people in Tanzania. The use of mobile phones or other electronic devices was not allowed" (Pruimboom. 2016)
It is obviously debatable, if "mayonnaise" is a paleo food (not sure if they made it themselves) and how "paleo" the rest of the subjects' diet which may have been designed to mimic the macros, but probably not the foods of the Hadzabe (see Figure 1, tabular overview on the left) actually was.
Figure 1: Exemplary food intake (left) and changes in anthroprometrics (right); stat. sign. w/ p < 0.001 was observed for the median changes, not the minimal and maximal changes, obviously (Pruimboom. 2016).
What is undebatable, though, is the statistical significance and health relevance of the reductions in weight and body fat you can deduce from the sign. reduction in the median subjects' waist circumference.
Mind the statistics: There's a reason why I plotted more than one value in Figure 1. While I cannot tell you the reason why, I can tell you that at least one subject did not see the expected improvements in waist circumference. Possibly, he or she ate too much mayonnaise ;-), ... Why's that relevant? Well, it obviously goes to show you that calories still count. While the median subjects (with the low number of participants the scientists didn't calculate averages) obviously was in a caloric deficit, this one person probably just wasn't caught feasting secretly on the supply.
It should be noted, though, that these changes were certainly not attributable solely to the diet. Rather than that it should be obvious that the significant reduction in body and most certainly belly fat was the consequence of (a) what and how much the subjects ate while (b) experiencing what the Dutch scientists call "ancient stress factors" they were facing during a 10-day trip that revolved around the following four principles:
  • Walking and limited manual work- providing the exercise / general physical activity stimulus modern humans lack: There were daily walking trips from waterhole to waterhole, with an average walking distance of about 14 km/day, including altitude differences up to approximately 1,000 m. The participants carried their own backpacks with an average weight of 8 kg. The trip took place in the part of the Pre-Pyrenees with a maximum altitude of 1,900 meters above sea level. In addition, some manual work was done to clean mountain trails as agreed upon with the Catalan Government.
  • Intermittent fasting - leaving room to actually experience hunger and all its beneficial hormonal correlates (e.g. AMPK increase => mitochondrial housekeeping, etc.): Participants consumed two meals daily. The first meal was provided by the organization halfway and the second meal prepared on arrival at the camping site. Animals, including ducks, chickens, turkeys, rabbits, and fish, were delivered alive and killed by the participants. Fish were caught with nets in the Noguera river. All foods were prepared on the spot by the participants.
  • 100% exposure to the elements - resynchronizing the internal clock: The participants slept outside in sleeping bags on small inflatable mattresses. Outside temperatures varied from 22 to 42∘C during daylight, whereas night temperatures varied from 12 to 21∘C. One group experienced a day of snow in the middle of July, which prompted the organization to provide hotel accommodations for a single night.
  • Cyclic water intake - experiencing thirst to benefit from the anti-inflammatory release of oxytocin (Krause. 2011): Bulk (intermittent) drinking behavior was recommended by drinking as much as possible (up to satiety) after reaching a waterhole. The waterholes contained nonchloritized drinking water (Note: I would not suggest using "dehydration" as a means to improve your health; while it may have done this in the study at hand, it's simply stupid - and that's in the literal sense, as you've read in my article "Hydrated or Dumb").
Only in conjunction, with these "stress factors" did the diet do its body fat reducing and, as the data in Figure 2 shows, glucose and blood lipid reducing effects:
Figure 2: Changes in glucose and lipid metabolism over (I repeat) only 10 days; worth mentioning: all but the effect on HDL were statistically highly sign. with p < 0.001 (Pruimboom. 2016).
Effects of which the scientists say that they were the result of acute stress, which promotes release of stress hormones, including adrenaline, noradrenaline, and cortisol, all of which are bad in excess, but will "give rise to recovery from the reigning state of chronic low-grade inflammation and the return to homeostasis" (Pruimboom. 2016), when the stressors are hit the sweet spot of hormesis as it occurred in response to / corollary with the elevation in AST, ALT and hs-CRP of which I've explained previously that all of them can be natural reactions to (especially unaccustomed) physical activity (learn more about ALT, AST and exercise induced inflammation that may be misunderstood as a health problem).

In the study at hand, said "recovery from the reigning state of chronic low-grade inflammation" was characterized by "profound metabolic and immunologic adaptations", of which the scientists highlight that they relate to three classic features of the metabolic syndrome, i.e. body mass, glucose homeostasis, and circulating lipids. The fourth, i.e. blood pressure was - unfortunately - not recorded.
Ad-Libitum Paleo Diet W/ a Handful of Simple Rules Cuts 5-7 kg of Body Fat in 12 Weeks - Plus: Paleo Research Overview | more.
Bottom line: With the metabolic syndrome, also named the insulin resistance syndrome, being "a well-established risk factor for various diseases of affluence, including type 2 diabetes, cardiovascular disease, essential hypertension, polycystic ovary syndrome, nonalcoholic fattyliver disease, certain types of cancer (colon, breast, and pancreas), sleep apnea, and pregnancy complications, such as preeclampsia and gestational diabetes", the scientists are right to highlight in their conclusion that the subjects didn't just feel better subjectively (according to questionnaire), but returned from the "wilderness" in an objectively healthier state.

A state of which the scientists say that it has been promoted by the previously discussed consequences of the four pillars (see list) and related effects, such as the reduction of the postprandial inflammatory response (Holmer-Jensen. 2011; Klop. 2011; Peairs. 2011) and increased protection against pathogens (Fielding. 2000; MacEneaney. 2009) that occurs, when you are physically active before a meal. Even the presence of "cutaneous- and other body surface-directed danger signals" could, as Pruimboom et al. point out have been "hormetic triggers" | Comment!
  • Fielding, Roger A., et al. "Effects of prior exercise on eccentric exercise-induced neutrophilia and enzyme release." Medicine and science in sports and exercise 32.2 (2000): 359-364.
  • Holmer-Jensen, Jens, et al. "Differential effects of dietary protein sources on postprandial low-grade inflammation after a single high fat meal in obese non-diabetic subjects." Nutrition journal 10.1 (2011): 1.
  • Klop, Boudewijn, et al. "Understanding postprandial inflammation and its relationship to lifestyle behaviour and metabolic diseases." International journal of vascular medicine 2012 (2011).
  • Krause, Eric G., et al. "Hydration state controls stress responsiveness and social behavior." The Journal of Neuroscience 31.14 (2011): 5470-5476.
  • MacEneaney, Owen J., et al. "Effect of prior exercise on postprandial lipemia and markers of inflammation and endothelial activation in normal weight and overweight adolescent boys." European journal of applied physiology 106.5 (2009): 721-729.
  • Peairs, Abigail D., Janet W. Rankin, and Yong Woo Lee. "Effects of acute ingestion of different fats on oxidative stress and inflammation in overweight and obese adults." Nutrition journal 10.1 (2011): 1.
  • Pruimboom, Leo, et al. "Influence of a 10 days mimic of our ancient lifestyle on anthropometrics and parameters of metabolism and inflammation. The ‘Study of Origin’."