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A dieta do paleolítico : uma revisão da evidência dos seus riscos e benefícios
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Introdução: A dieta paleolítica teve origem na teoria da discordância evolutiva entre a herança genética e a evolução do ambiente externo do homem, sendo uma adaptação contemporânea do padrão alimentar da Era Paleolítica, que os defensores da dieta afirmam ser protetora contra as doenças da idade moderna. Tendo em conta o elevado teor de proteína, gorduras não saturadas, baixo índice glicémico e exclusão de alimentos com glúten, lactose e alimentos processados, o presente trabalho procurou perceber a evidência existente relativamente aos benefícios para a síndrome metabólica, bem como os riscos relacionados com a doença renal crónica, osteoporose e défice de iodo, comparativamente com outras dietas saudáveis. Metodologia: Foi realizada pesquisa bibliográfica utilizando os termos MeSH: dieta do paleolítico, dieta do caçador-recolector, insuficiência renal, doença renal crónica, osteoporose, hipocalcémia, deficiência de iodo e síndrome metabólica. Foram selecionados artigos considerando os limites: temporal de cinco anos (01/01/2012 a 31/12/2017) e linguístico de Português e Inglês, e avaliada a sua qualidade da evidência segundo os critérios do GRADE. Resultados: Da pesquisa resultou uma seleção de dez artigos com amostras superiores a vinte participantes e duração de intervenção entre duas e noventa e seis semanas, bem como uma qualidade de evidência baixa a moderada. As dietas controlo eram baseadas na dieta mediterrânica e em guidelines nutricionais da Organização Mundial de Saúde e de associações de saúde de outros países. Conclusão: O trabalho de revisão efetuado permitiu concluir que existem moderados benefícios a curto prazo da dieta paleolítica na síndrome metabólica, nomeadamente no peso, circunferência abdominal, pressão arterial, perfil lipídico e saciedade, apesar destes serem pouco significativos. No entanto, a escassez de estudos e a baixa qualidade dos mesmos não permitiu concluir relativamente aos riscos da mesma, permanecendo incerto o risco de hipercaliémia, deterioração da função renal, diminuição da densidade óssea e défice de iodo.
Introduction: The Paleolithic diet was originated in the evolutionary mismatch theory between the human genetic heritage and the human’s external environment, being a contemporary adaptation of the Paleolithic Era’s food pattern, which the diet’s defenders claim to be protective against diseases of the modern age. Taking into account the high content in protein, unsaturated fats and low glycemic index food and exclusion of foods that contain gluten, lactose and processed foods, the present work sought to understand the existing evidence regarding its benefits to the metabolic syndrome and also the risks related to chronic kidney disease, osteoporosis and iodine deficiency compared to other healthy diets. Methodology: It was done a bibliographic research using the MeSH terms: paleolithic diet, hunter-gatherer diet, renal insufficiency, chronic kidney disease, osteoporosis, hypocalcemia, iodine deficiency and metabolic syndrome. It were considered the temporal limit of five years (01/01/2012 to 31/12/2017) and the linguist limit of Portuguese and English. After the selection, quality of evidence was evaluated according to the GRADE criteria. Results: The research resulted in a selection of ten articles, which had more than twenty participants and duration of intervention between two to ninety-six weeks, and also a low to moderate quality of evidence. The control diets were based on the Mediterranean diet and nutritional guidelines of the World Health Organization, and from other countries’ health associations. Conclusion: This review allowed to conclude that there are moderate short-term benefits of the Paleolithic diet in the metabolic syndrome, such as weight, waist circumference, blood pressure, lipid profile and satiety, although these were not significant. However, the scarcity and low quality of the studies did not allow to conclude about the risks of this diet, there for there is a remaining the uncertainty about the risk of hyperkalaemia, renal function deterioration, bone density decrease and iodine deficiency.
Introduction: The Paleolithic diet was originated in the evolutionary mismatch theory between the human genetic heritage and the human’s external environment, being a contemporary adaptation of the Paleolithic Era’s food pattern, which the diet’s defenders claim to be protective against diseases of the modern age. Taking into account the high content in protein, unsaturated fats and low glycemic index food and exclusion of foods that contain gluten, lactose and processed foods, the present work sought to understand the existing evidence regarding its benefits to the metabolic syndrome and also the risks related to chronic kidney disease, osteoporosis and iodine deficiency compared to other healthy diets. Methodology: It was done a bibliographic research using the MeSH terms: paleolithic diet, hunter-gatherer diet, renal insufficiency, chronic kidney disease, osteoporosis, hypocalcemia, iodine deficiency and metabolic syndrome. It were considered the temporal limit of five years (01/01/2012 to 31/12/2017) and the linguist limit of Portuguese and English. After the selection, quality of evidence was evaluated according to the GRADE criteria. Results: The research resulted in a selection of ten articles, which had more than twenty participants and duration of intervention between two to ninety-six weeks, and also a low to moderate quality of evidence. The control diets were based on the Mediterranean diet and nutritional guidelines of the World Health Organization, and from other countries’ health associations. Conclusion: This review allowed to conclude that there are moderate short-term benefits of the Paleolithic diet in the metabolic syndrome, such as weight, waist circumference, blood pressure, lipid profile and satiety, although these were not significant. However, the scarcity and low quality of the studies did not allow to conclude about the risks of this diet, there for there is a remaining the uncertainty about the risk of hyperkalaemia, renal function deterioration, bone density decrease and iodine deficiency.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Dieta do paleolítico Síndrome metabólico Doença renal crónica Osteoporose Défice de iodo