Thursday, June 8, 2017

Paleo Diet + Kitchen-Sink Micronutrient Supp Sends Type II Diabetes into Remission | 14/17 Subjects Normalize HbA1c

I guess that would qualify as a "variation of the paleo diet", as well. 
No, this is not an advertisement for a diet book. In fact, the "variation" of the paleo diet the Canadian + US researchers used doesn't even require a cookbook, because it's as simple as "consisting of meat and vegetables, three times per day for three to five months" and "whole low glycemic fruit and nuts or seeds" as snacks between the meals  (Christensen 2017).

That I still expect some people to call the study "shady", though, is the use of Apex dietary supplements in those of the subjects with a predetermined micronutrient deficiency (I wouldn't mind that - what I do mind, though, is that the scientists do not explicitly declare if they received funding by Apex and 'forget' to report 36 of 38 lab values they claim to have tested).
As you would expect it from a "paleo diet", dairy was not on the menu

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Before you get overly mad at the researchers, let me say that I personally believe that the kitchen sink supplement combination (with vitamins and minerals no one really needs and minuscule amounts of everything that has a single rodent study to support its usefulness in T2DM | see Table 1) probably didn't contribute significantly to the success of the intervention.
Table 1: The Apex supplements used in the study at hand follow the highly popular (and at least as questionable) kitchen sink approach to micronutrient supplementation (ingredients according to Christensen 2017).
I mean, 40mg of taurine per serving? Studies show effects in T2DM with 6000mg per day. Or 20mg of NAC? Well, at least that's enough not to blunt your gains ;-)... Enough of the sarcasm, though, let's take a look at some tables/lists that actually matter:
Figure 1: Overview of the food groups (and respective foods) the subjects were allowed to eat.
The list of foods the subjects (11 females, 6 males | average age 69.7 ± 1.8 years) were allowed to eat (illustrated in Figure 1) looks pretty much like classic paleo: no dairy, for example,... on the other hand beans and peas are not exactly what paleo fanatics would eat voluntarily (esp. not unsoaked and sprouted ;-) -- be that as it may, what is important is, after all, that the diet had significant beneficial effects on the two most important of the 38 tested laboratory values (albumin, alkaline phosphatase, ALT, AST, bilirubin, bun and creatine, calcium, carbon dioxide, total CBC, chloride, c-reactive protein (CRP), creatine, ferritin, fibrinogen activity, glucose, GGT, hemoglobin (HbG) a1c, homocysteine, iron/TIBC, LDH, lipid panel, magnesium, phosphorus, citrated blood potassium, protein, sodium, TSH, T4 (free and total), T3 (free and total), T3 uptake, thyroglobulin antibody, thyroid peroxidase antibody, uric acid, serum urinalysis, vitamin D), i.e. the subjects' average glucose levels and the long-term blood glucose gauge HbA1c:
Figure 2: Changes in mean glucose and HbA1c in T2DM subjects and untreated (healthy) controls (Christensen 2017).
As you can see, significant reductions were achieved in both, the average glucose and the HbA1c levels. In fact, in 14 out of 17 subjects, the reduction of the A1C brought them out of the 6.5% - impressive for something as simple as cleaning up your diet.

In all fairness, though, it has to be said that the diet didn't to all that on its own... and no, I am not referring to the stupid supplement again, but rather to the fact that all diabetic participants received
diabetic medications while blood sugar A1C levels were above 6.5%. It would thus be haphazard to simply drop your medication, because "dat SuppVersity study shows that paleo cures T2DM, anyway". You understand?
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What are the implications? While we cannot be sure if and to which extent the multi-ingredient supplement contributed to the subjects' dieting success, the assumption that it had more than a minor additive effect to the diet (even the authors don't claim that) would be nothing but an unsustainable marketing claim.

Accordingly, the take-home message of the study at hand is not that an overpriced kitchen sink multi-micronutrient product, but a few months on a paleo diet, consisting of meat protein and vegetables, low glycemic fruit and nuts, can reduce the Hb1Ac of older male and female type II diabetics so significantly that, by definition, they would no longer be considered "diabetic" (<6.5%).

Next to the dubious supplementation regimen, the study does yet have another weakness: using healthy individuals who were not even changing their diet as control is like using no control at all. Furthermore, the authors fail to report the rest of the results (see the long list of blood markers they assessed) and do not disclose/negate a potential conflict or interest. A valuable control group would have been forced to adhere to another diet that has been associated with successful T2DM reversal like a high protein Mediterranean diet or (warning sarcasm inbound) the useless high carb + low-fat diet doctors will still prescribe to ensure that their patients are coming back for another prescription of their diabetes drugs | Comment!
References:
  • Christensen, Kim D., and Karen Vieira. "A variation on the ‘Paleo’diet and its potential role in type 2 diabetes control."Sky Journal of Medicine and Medical Sciences Vol. 5(2), pp. 008 - 014, March, 2017