Scoping Review of Paleolithic Dietary Patterns: A Definition Proposal

Nutr Res Rev. 2020 Jun 2;1-45. doi: 10.1017/S0954422420000153. Online ahead of print.

Abstract

Paleolithic Diet (PaleoDiet) is an allegedly healthy dietary pattern inspired on the consumption of wild foods and animals assumed to be consumed in the Paleolithic era. Despite gaining popularity in the media, different operational definitions of this Paleolithic nutritional intake have been used in research. Our hypothesis is that specific components used to define the PaleoDiet may modulate the association of this diet with several health outcomes. We comprehensively reviewed currently applied PaleoDiet scores and suggested a new score based on the food composition of current PaleoDiet definitions and the theoretical food content of a staple dietary pattern in the Paleolithic age. In a PubMed searched up to December 2019, 14 different PaleoDiet definitions were found. We observed some common components of the PaleoDiet among these definitions although we also found high heterogeneity in the list of specific foods that should be encouraged or banned within the PaleoDiet. Most studies suggest that the PaleoDiet may have beneficial effects in the prevention of cardiometabolic diseases (type 2 diabetes, overweight/obesity, cardiovascular diseases and hyperlipidemias) but the level of evidence is still weak because of the limited number of studies with large sample size, hard outcomes instead of surrogate outcomes and long-term follow-up. Finally, we propose a new PaleoDiet score composed of 11 food items, based on a high consumption of fruits, nuts, vegetables, fish, eggs and meats; and a minimum content of dairy products, grains and cereals, and legumes and practical absence of processed (or ultra-processed) foods or culinary ingredients.

Keywords: Paleolithic Diet; cardiometabolic diseases; comprehensive review; dietary score; interventional studies; observational studies..