**5. The Paleolithic diet**

The Paleolithic diet is another regimen, which has been recently discussed as a means of obtaining weight loss and control of glycemic levels. This diet, in particular, has been shown to be more satiating per calorie compared to the diabetes diet [24, 25].

General information provided on the diabetes diet aims at providing meals with even distributions of increased portions of vegetables, root vegetables, dietary fiber, wholegrain bread, and other whole grain cereal products, fruits and berries, and less total fat—in particular, unsaturated fats [25]. The salt intake was recommended to be kept below 6 g/day [26]. In this respect, the Paleolithic diet was described to be based on lean meat, fish, fruit, leafy and cruciferous vegetables, root vegetables, eggs and nuts, with reduced intakes of dairy products, cereal grains, beans, refined fats, sugar, candy, soft drinks, beer, and added salt [26]. The following items were recommended in limited amounts for the Paleolithic diet: eggs (≤2 per day), nuts (preferentially walnuts), dried fruit, potatoes (≤1 medium-sized per day), rapeseed or olive oil (≤1 tablespoon per day), and wine (≤1 glass per day) [26, 27]. The recommended intake of the other types of food products did not carry any restrictions and no advice was given with regard to the proportions of food categories [26, 27]. The evolutionary preference and rationale for the Paleolithic diet has been highlighted in Eaton et al. [27].

The Paleolithic diet is known to result in significantly lower fasting plasma leptin, nonsignificantly lower fasting plasma glucagon concentrations as well as gain weight loss, compared with a standard diabetes diet [28–30]. However, the small sample size in studies such as those by Eaton et al. [27] makes it impossible to perform adjusted multivariate analysis. Overall, long-term and adequately powered trials investigating the effects of Paleolithic diet are warranted.
