Reverse Metabolic Syndrome With a Paleo Diet | Chris Kresser
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How a Paleo Diet Can Reverse Metabolic Syndrome

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Metabolic syndrome usually precedes type 2 diabetes and heart disease, two conditions that seem nearly inevitable in our modern society. However, recent research shows that switching to a Paleo diet may reverse metabolic dysfunction. Read on to find how the Paleo diet can improve body weight, lipid panels, and insulin resistance, with positive results in as little as two weeks.

Use the paleo diet to treat metabolic syndrome.
A balance of healthy fat and carbs are key to treating metabolic syndrome. istock.com/Elena_Danileiko

Metabolic syndrome is widespread, affecting 34 percent of all U.S. adults and half of those over 60. (1) Instead of a distinct disease, metabolic syndrome is a cluster of symptoms. One is diagnosed if at least three of the following five markers are present: (2)

  • large waist circumference
  • high blood pressure
  • elevated fasting glucose
  • elevated triglycerides
  • low HDL (“good”) cholesterol

Metabolic syndrome is a red flag, warning you that your body isn’t healthy. In fact, each of the symptoms listed above is a separate risk factor for diabetes and/or cardiovascular disease, two leading causes of death in the United States. (3, 4, 5) Fortunately, adopting a Paleo diet can reverse the markers of diabesity and metabolic syndrome and even help those who have already developed insulin resistance, as I will discuss in this article.

Metabolic Syndrome, Insulin Resistance, and Heart Disease – What Do They All Have in Common?

Metabolic syndrome, insulin resistance, and heart disease are all considered “modern” diseases because they weren’t prevalent until the 1900s after the Industrial Revolution. Drastic changes in U.S. dietary habits have occurred only in the last century or so, including increased consumption of hydrogenated oils (trans fats), vegetable oils, processed foods, and refined sugars. Even grain consumption wasn’t common until the Agricultural Revolution around 10,000 years ago, which is actually only around 5 percent of the human species’s existence.

Many tribal cultures today that maintain traditional hunter–gatherer diets are virtually free from metabolic syndrome, heart disease, and type 2 diabetes. For example, the Kitavan, Masai, Machiguenga, and !Kung tribes consume very little, if any, refined grains or processed sugars, though the specific contents of their diets vary widely. (6, 7, 8, 9)

Insulin resistance and inflammation together are believed to be the underlying causes of metabolic syndrome. (10, 11) Our modern diets contain huge contributors to both: (12, 13)

  • Industrial seed oils have been shown to have a pro-inflammatory effect in some studies. (14)
  • Processed grains and refined carbs cause both inflammation and metabolic dysfunction in mice, perhaps by disrupting the gut microbiota. (15)
  • Excessive refined sugar intake, particularly high-fructose corn syrup, is correlated with insulin resistance and inflammation. (16, 17, 18)

Our modern diets are so detrimental to our health that when tribal cultures “Westernize” their diets, they quickly develop modern metabolic diseases. (19, 20, 21) They might be even more susceptible to modern diseases than those of European descent, who have thousands of years more evolutionary adaptation under their belts to accommodate grain consumption. Now, on the flip side, let’s see what happens when Western dieters revert to a Paleo, traditional diet.

Paleo Diets Outperform Other “Healthy” Diets

Paleo diets are finally appearing in randomized, controlled trials, to be compared to what are considered “healthy” or “heart-healthy” modern diets. Instead of focusing on macronutrients as most contemporary diet studies do, (22, 23, 24) these studies focused on avoiding or consuming different groups of foods all together, and the results are extremely promising. In the studies reviewed below, a Paleo diet was devoid of refined sugar, processed foods, vegetable oils, and grains, while also usually avoiding dairy and legumes. Favored foods included lean meats, vegetables, fish, eggs, fruit, and nuts.

Emerging research shows the Paleo diet outperforms “heart-healthy” diets.

Paleo diet is beneficial for people with type 2 diabetes

In a short, 14-day diet study, the Paleo diet was compared to the diet recommended by the American Diabetes Association in people with type 2 diabetes. (25) While both groups showed equivalent positive changes in weight and insulin sensitivity, only the Paleo group had beneficial changes in fasting glucose, total cholesterol, and LDL (“bad”) cholesterol.

In a longer, six-month crossover trial, the Paleo diet also outperformed the recommended diabetic diet. (26) In this sort of trial, half the participants started with the Paleo diet, and then switched to the Diabetic diet halfway through the study. The remaining participants did the the opposite. The Paleo diet showed greater improvements in triglycerides, HDL (“good”) cholesterol, diastolic blood pressure, body weight, and waist circumference.

In people with both insulin resistance and heart disease, a 12-week study showed that the Paleo diet resulted in more advantageous effects on both waist circumference and two-hour glucose measures than the popular Mediterranean diet. (27)

Paleo diet is beneficial for people with metabolic syndrome

In people who already had metabolic syndrome, the Paleo diet after only 14 days lowered blood pressure, cholesterol, and triglycerides, and raised HDL cholesterol better than the diet recommended by the Dutch Health Council. (28) In fact, the number of metabolic syndrome symptoms experienced by the Paleo group actually decreased over this short pilot study.

Over four months, people with hypercholesterolemia first followed the diet recommended by the American Heart Association and then followed with a Paleo diet. (29) The Paleo diet resulted in greater benefits for total cholesterol, LDL and HDL cholesterol, and triglycerides.

Two longer studies lasting two years compared the Paleo diet to modern “healthy” diets. In both cases, the Paleo diet outperformed the control diet at six months, but at the two-year mark, the diets showed mostly similar benefits. (30, 31)

Paleo diet is beneficial for healthy people

In otherwise healthy individuals, a Paleo diet improved body weight, waist circumference, and systolic blood pressure in three weeks. (32) Likewise, in non-obese yet sedentary people, a Paleo diet showed benefits for blood pressure, plasma insulin, total cholesterol, LDL cholesterol, and triglycerides. (33)

This growing collection of literature shows that reverting to a Paleo diet, even for as few as 14 days, can start to improve lipid markers and measures of metabolic syndrome. Research is finally catching up with what many people, myself included, have been advocating for a while: eat real, nutrient-dense foods, and you get healthier!

Why Does the Paleo Diet Get Such a Bad Rep?

U.S. News and World Report again ranked the Paleo diet near last, at 36 out of 38 diets in their “Best Diets Overall” rankings. Why might this be, especially since recent evidence highlights its health benefits?

Paleo dieters in controlled studies often consumed fewer calories ad libitum than dieters in the control groups, sometimes up to 35 percent fewer. (32) When Paleo groups show better health outcomes, critics ask, “Is it the Paleo diet itself or the fewer calories that is advantageous?” First, I fail to see how this can be considered a “negative” attribute of the Paleo diet. Spontaneous calorie restriction while feeling fuller calorie for calorie (34) sounds like the long-awaited solution to the current overeating epidemic. Second, many studies accounted for this extra weight loss. Boers et al., 2014, offered approved snacks to Paleo dieters. (28) At the end of the study, they still managed to lose more weight than the control group, but the researchers accounted for this in their statistical model and found the advantageous results remained, despite weight differences. Two other studies confirmed that the Paleo diet benefits remained after adjusting for weight loss or decreased waist circumference in the Paleo group. (27, 29)

Dieticians and nutritionists are also concerned with reduced calcium intake present in most Paleo diets. (26, 28, 32, 35) However, two studies reviewed above showed that while calcium intake was lower, calcium excretion was also lower, indicating that calcium absorption may be increased in Paleo dieters and/or that calcium/magnesium balance is probably not disrupted. (25, 28)

Last, the Paleo diet is ranked so low because it is considered hard to follow, with too many food restrictions. Yes, a Paleo diet is a commitment, but it is more than just a diet. Going Paleo is a lifestyle that should focus on many other aspects of health, including stress management, exercise, sleep, and reducing toxin exposure.

Adopt a Paleo Lifestyle, Transform Your Health

The Paleo diet has a lot to offer, whether you already have metabolic syndrome or if you are a healthy weight and have normal blood work. The research is finally in support of going Paleo, and hopefully more studies will follow with larger group sizes and longer follow-ups. If you are ready to transform your health, consider trying my 14Four program, which emphasizes four pillars of the Paleo lifestyle: movement, diet, stress, and sleep.

The 14Four program is perfect for beginners and for those who are already Paleo and just want a reset. With you every step of the way, this program eases you into the Paleo lifestyle with tailored meal plans and exercise routines, while tracking your results and offering community support.

Now I’d like to hear from you. What do you think of the recent research on the Paleo diet? How has the Paleo diet improved your health? Let us know in the comments!

  1. I’m an avid reader of your posts and have just undertaken the 30-day reset. I haven’t been able to find definitive answers online, so I was wondering if you could take a moment to let me know: can I have homemade Kombucha (no excess sugar added) and/or Nutritional Yeast on the 30 day reset? Also, if I soak all my nuts overnight before consuming or cooking with them, do I still have to limit my intake to ‘a handful per day’? Finally, does yogurt or kefir made from homemade nut milks factor into the daily nut limit?
    Thank you in advance for your time! I’m very dedicated to doing this right so I can experience the health improvements of the PPC!!!

  2. Our early ancestors didn’t brush… didn’t floss… didn’t get cavities.

    In the modern world, peoples are riddled with cavities, gum disease, and in general, overall decay of oral health.

    We once had the ability to remineralize our teeth from the inside out… through nutrtition. This is well evidenced by Weston A Price & May Mellanby work with vitamins A, D & K.

    How many people reading this comment actually consume real, preformed vitamin A (retinol)?

    • Is that the kind in Cow’s liver ? or do you mean retinyl palmitate capsules? I do both but I am a little afraid of the retinyl palmitate but more afraid of taking Vit D3 without it (and vit K2)

    • — “…knowing we should be eating offal and actually eating these foods are two very different things.” — Dr. Chris Kresser

      Don’t forget to eat nose-to-tail, just as our early ancestors did. In the modern world, we love our meat… we love it so much that we neglect the most nutrient dense parts of the animal… the organs, the glands, the bones.

      Too many people that are following paleo principles are too restrictive in what they consume… restrictive diets often restrict nutrients (most commonly, preformed vitamin A (aka retinol)) that we need for optimal health. As I stated earlier, don’t forget to eat nose-to-tail.

  3. “Industrial seed oils have been shown to have a pro-inflammatory effect in some studies. (14)”

    I have to disagree with this statement. The reference cited here doesn’t even support this. It’s a population study trying to determine optimal omega-3 intake in order to prevent disease.

    They say in the conclusion: “To our knowledge, inadequate information is available to determine whether it is safe or unsafe to consume 9% of all calories as LA, a precursor to the proinflammatory arachidonic acid.”

    LA produces anti-inflammatory fatty acids as well as arachindonic acid. Omega-6 has been unfairly maligned imo. It’s still absolutely essential – it’s just that people tend to get too much of it and not enough omega-3.

    • Rob, the problem is more about oxidation. Seeds oils are made with industrial processes and when they are on the shelf they are already oxidized.

      • That’s why you buy cold-pressed, refrigerated, unrefined versions when possible. Ask the manufacturer if they do stability/quality tests for oxidation.

          • Unstable is a relative term though – PUFAs do fine when refrigerated in a nitrogen flushed bottle. By “fine” I mean stay fresh/unoxidized for the shelf life from a reputable company that follows proper quality control and stability studies.

              • Yes, exactly, the Good Oils section at the end of that article is what I am talking about and I specifically had Udo’s Oil in mind.

                The line “one photon of daylight will trigger a chain reaction of free radical damage that creates trans fats” is ridiculous though. The author doesn’t seem to understand how trans fats are made. A sliver of daylight is not suddenly going to turn any oil rancid, let alone create trans fats…

                • Yes the trans fat transormation is bogus, anyway the point is that how can you rely that the oil is not oxidated? Unless you’re going to buy a cold press and make it at home…
                  We had a really bad scam about italian extra virgin olive oil that is touted as the best quality in the world…

            • Sure, and PUFAs needn’t be the demon that some assert them to be but why not limit them in favor of the more superior, ‘mono’ and regular, ‘saturated’ versions?

              • What do you mean by superior though? I don’t see it as either/or. PUFAs provide essential omega 3/6, mono and saturated don’t provide those, although they have their place and benefits too.

                • Well, most people who eat well, if not Paleo, get plenty of O3s and O6s, anyhow I think. Regardless, it is about the ‘balance’ of the two omegas, is it not? So, by that token, you won’t be missing out if you eschew the Polys for the monos and sat fats.

                  I consider them superior because both are much more stable than PUFA. Typically, they aren’t prone to uber-processing either.

  4. I’ve never found Paleo hard to stick with, probably because I’ve never been much of a junk food or sweets eater. Eliminating good artisan bread was the hardest for me, and even then, it only took a few days to get over wanting it. The Mediterranean diet allows wheat, which IMO (and contrary to popular belief) is unhealthy for most people, whether gluten-sensitive or not.

    • Totally agree. First of all the so called “Mediterranean” diet has nothing to do with the real ancient version full of fish, some meat, olives and extra virgin olive oil and plenty of veggies and delicious spices.
      It has nothing to do with bread, pasta and pizza as touted by the mainstream big food business that has all the interest to blame the species appropriate diet for humans as a fad diet. Isn’t it crazy? It’s like eliminating meat from tigers menu and turning them vegans.

  5. Good read. Is an industrial seed oil any seed oil you buy in a bottle? Does it matter if it’s cold pressed or released with hexane? What about avocado oil? If flax seeds have more omega 3 than omega 6, do you still consider flax oil detrimental — or is it just over certain amounts? I thought the term ‘industrial seed oil’ was a pretty wide brush. I thought I had read that all oil is inflammatory so I am wondering why seed oils are singled out unless it’s because somewhere there is a list of how inflammatory each oil is.

  6. Hey Chris,

    Long-time reader and follower of your work. While I generally agree with much of this, I’m curious how you personally define a “Paleo diet.” I know people these days probably tend to think low carb, liberal fat (lots of saturated fat), veggies and meat, but in otherwise healthy people like me, that can have negative effects, including skyrocketing TC and LDL-P, which I know you correlate to best risk of future CHD.

    Thanks
    -Chris

  7. Humans were never meant to eat meat at all..we have entirely different dentition, jaw muscles, stomach, intestines and processing systems from carnivores… you ignore these scientific facts at your peril….and it is false to claim we started eating grains 10,000 yrs ago when we only have 5,900 accurately recorded years of habitation, the rest is postulation….the animals have not been brainwashed like humans have, so we can look to them and observe that the longest living and strongest animals are all herbivores, the elephant is the strongest, the giraffe has the largest most powerful heart, the hippo the most aggressive fighter etc. the gorilla has incredible strength…..the giant cats on the other hand, go for the weakest, slowest and quickly give up the chase after a few minutes, because meat makes you slow and sluggish…these facts are undeniable but you wont take any notice and will therefore die early in your 70s when as a herbivore you could live into your 90s and beyond. Oh dear – the money that can be made from quackery…Sad.
    (84 and full of vege energy)

    • I strongly disagree, and will point out that the “dentition, jaw muscles, stomach, intestines and processing systems from carnivores” is very much closer to those of humans, than those of herbivores is to humans. And there is clear archaeological evidence of when humans took up agriculture as the main source of food.

      • Agreed, never mind the fact we don’t have the huge stomach arrangements that herbivores make use of to digest vegetation efficiently. No one I know in the paleo world says we are carnivores, we are omnivores. Some humans can do well as vegetarians, many more do not thrive.

    • Dr. Graham Sayer,
      I totally disagree with you that we were not intended to eat meat. God clearly gives the go ahead in the bible. I do agree that the earth is only about 6000 years old and recorded history shows this.
      My husband’s grandmother lived to be 102 1/2 years old, in good health, still doing light housework such as dishes and laundry up till she was around 100 years old. She ate whatever she wanted, including meats, and she was not on any kind of medication until the last 6 months of life.
      My great grandmother and her 4 sisters all lived to be in late 80’s, one in the 90’s, and another to 103, and they all ate meats and other foods. They were very active people.
      I agree eating plenty of fresh fruits and veggies is part of a healthy lifestyle, but so are healthy meats and fats.
      Perhaps you should read Weston A. Price’s book “Nutrition and Physical Degeneration, written in the 1930’s after the author visited and studied 18 cultures that mostly ate a traditional high fat, meat, and/or fish diet.
      We have incisors for tearing meat. We have molars for chewing meat. Meat helps build muscle. Grass-fed meats are some of the healthiest food on the planet. There are very few cultures past or present who do not consume meat and fat.

      • I agree. Some meat in the diet is necessary for many people. I am one of those people. As much as I might prefer to adhere to a vegetarian diet, I just don’t feel good without at least a little meat each day. I also do better on fatty meat rather than lean. This is not to say that my diet consists solely of meat. It does not. I also eat a lot of vegetables and some fruit. I think we all need to experiment and tweak the Paleo concept until the proportions are right for each of us.

    • I am hypoglycemic and animal protein is the only type of protein that stabilizes my blood sugar levels – all the plant proteins I’ve tried have caused my sugar levels to crash. Why is my body telling me that it needs animal protein to survive?

  8. While I am not strictly paleo I am a firm believer in its health benefits. I’m currently about 60/40 paleo and healthy but lets say the more paleo I have gone at different times in my lifego the more healthy I got….and fast! A lot of it is common sense. Whatever about grains and legumes surely no one would argue that processed food deserves a place at the table.
    I would think that a big reason that Paleo gets a hard rap is becomes it goes up against some of the major food production industries and lobbyists. They are in it to make money and they dont care at what cost. Never underestimate the will and the power of the large grain producers/sugar producers/processed food/fizzy drinks/ and even dairy producers. They will not take it lightly if someone tries to screw with their profits and they’ll fund any and all “research” to prove theyre not the bad guys and present the results in a way thats favourable to them.
    Each person has to use their head. Stop eating processed food for a month and see how you feel. If you feel good then you can probably ignore the Coke funded research that says processed food is part of a healthy diet or whatever nonsense…

  9. Paleo diets can run the gamut from A to Z, so the term “paleo” is ambiguous and therefore confusing. Paleo can be ketogenic with high fat, moderate to higher protein, and low fat, with more (or less) animal foods, and more (or less) cooked foods. Paleo can be low fat, modest but adequate protein, high carb raw vegan, with fruits, vegetables, nuts and seeds. And anything in between, such as some Mediterranean diets, as long as ancestral foods are the core. There are myriad possibilities in the design of paleo diets.

    I’d like to see the paleo people doing high fat, moderate to higher protein, and low carb share their glucose, lipid, and thyroid related testing more often, along with their age, height and weight, Omega 6:3 ratio, arachidonic acid levels, and APOE genotype — just a few things I’d like to see to put their dietary claims into perspective. Unfortunately, these are almost never shared, so needed perspective is absent and the conversation cannot proceed.

    Diets that are plant-based or mostly plant-based, high carb in terms of vegetables and fruits, no grains or minimal grains, high percentage of raw foods eaten at room temperature (according to season or climate), adequate but not excessive protein (10-20% protein, 0.39 grams of protein per pound of body weight), and lower fat around 10-20%, minimal or no oils, no heated oils. Doctors Barnard, Esselstyn, Cousens, et. al., have done very well with diets roughly along these lines. This is the sort of diet that I favor, and I’m happy to share any test results. I’ve never had all of the criteria of metabolic syndrome, just insulin resistance and higher BMI post-menopause, now corrected since age 61 with a shift in diet. Such a diet can be, and often is, paleo, but isn’t what one normally thinks of when “paleo diet” is mentioned today. The stereotypical paleo diet is higher protein, higher fat, low carb, no grain, no legumes, ancestral foods with animal and plant sources. So I’m back to ambiguity of the term “paleo” in regard to actual diet composition, as well as the need to track and share biomarkers for perspective.

    • You must be reading my mind. Great post. The people who eat only plants and the If you don’t eat Paleo you’re gonna die people rarely share lab results or genotypes. I think a lot of the benefits in health comes from losing weight. I only wish I had been eating twinkies and white bread with my koolaid so I would have something to give up. What I wouldn’t give for real data.

      • What lab results? People who are healthy, energetic, and feel terrific seldom have the desire to run to the doctor for lab tests. The only “real” data worth bothering with is how one feels.

        • I would like to agree with you but unfortunately, I feel fine when my liver enzymes are elevated from too much fat. My cholesterol can be off the charts and I have no idea. I think the answer is to measure trends so you know when you’re on the wrong path before you have to be rushed to the ER.

  10. I eat Paleo and am much better and healing from Chronic Lyme disease. Thank you for all your posts! They are so very helpful! 🙂

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