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Interventions and public health nutrition

Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial




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).


Seventy obese postmenopausal women (mean age 60 years, body mass index 33 kg/m2) 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.


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.


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.

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We thank all of the women who participated in this study for their invaluable patience and cooperation. Erik Hägg, Jonas Andersson, Lars-Göran Sjöström, Göran Ericsson, Inger Arnesjö, Katarina Iselid and Monica Holmgren made important contributions to screening the health of study subjects and technical assistance. Johanna Larsson helped process food records. Kate Westgate and Stefanie Mayle (MRC Epidemiology Unit, University of Cambridge, Cambridge, UK) assisted with processing physical activity data. Paul Franks contributed important views on planning the study. This study was supported by grants from The Swedish Council for Working Life and Social Research (2006-0699 and 2010-0398), the Swedish Research Council (K2011-12237-15-6), the Swedish Heart and Lung Foundation, the County Council of Västerbotten and Umeå University, Sweden.

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Correspondence to C Mellberg.

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Contributors: Study concept and design; acquisition of data; and drafting the manuscript: CM, SS, MR, CL, TO, and BL. Analysis and interpretation of data and critical revision of the manuscript for important intellectual content: all the authors. Statistical analysis: CM, SS. ME, and BL. Obtained funding: TO, BL, and MR. Administrative, technical or material support: SB, CL, TO, and BL. Study supervision: MR, CL, TO, and BL.

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Mellberg, C., Sandberg, S., Ryberg, M. et al. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr 68, 350–357 (2014).

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