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Paleolithic diet fraction and score in post hoc data analysis of a randomized controlled trial with lifestyle interventions for abdominal obesity

Rydhög, Björn LU ; Carrera-Bastos, Pedro LU ; Granfeldt, Yvonne LU ; Sundquist, Kristina LU and Jönsson, Tommy LU (2025) In BMC Nutrition 11(1).
Abstract

Background: Paleolithic Diet Fraction (PDF) and Paleolithic Diet Score (PDS) are both measures of how closely a food intake conforms to a Paleolithic dietary pattern. PDF is calculated directly from an individual’s absolute food intake and PDS is an aggregated score based on an individual’s food intake relative to a population. Both are inversely associated with all-cause and cause-specific mortality, coronary events and cancer. Here, for the first time, both measures are calculated in the same population and compared in a post hoc data analysis of a two-year-long randomized controlled trial (RCT) examining effects of lifestyle changes on waist circumference. Methods: Seventy-three participants with increased waist circumference and at... (More)

Background: Paleolithic Diet Fraction (PDF) and Paleolithic Diet Score (PDS) are both measures of how closely a food intake conforms to a Paleolithic dietary pattern. PDF is calculated directly from an individual’s absolute food intake and PDS is an aggregated score based on an individual’s food intake relative to a population. Both are inversely associated with all-cause and cause-specific mortality, coronary events and cancer. Here, for the first time, both measures are calculated in the same population and compared in a post hoc data analysis of a two-year-long randomized controlled trial (RCT) examining effects of lifestyle changes on waist circumference. Methods: Seventy-three participants with increased waist circumference and at least one additional risk factor for cardiovascular disease were randomized to a diet based on current dietary guidelines with or without grains and with or without physical exercise or controls. Of these, this post hoc analysis included the 57 participants (36 women and 21 men, aged 31–79 years) who completed the study per protocol with dietary data. Mean daily PDF and PDS were calculated using four-day weighed food records at baseline, 12 months, and 24 months. Correlations between PDF and PDS, and their respective associations with cardiometabolic outcomes were examined. Results: The mean daily PDF for energy at baseline, 12, and 24 months was 36%, 44%, and 42%, respectively. The absolute values of PDF and PDS, and their relative changes, demonstrated moderate to strong correlations during the study (rs​(55) = 0.38-0.75, p <.001-0.004). No significant associations were found between changes in absolute or relative measures of PDF or PDS and changes in cardiometabolic outcomes. Conclusions: There were moderate to strong correlations between PDF and PDS and no associations between PDF or PDS and cardiometabolic outcome measures, with the latter result possibly due to only modest changes in diet and an absence of outcome effects. Registry: ClinicalTrials.gov, TRN: NCT01208558, Registration date: 24 September 2010. Retrospectively registered.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Lifestyle change, Paleolithic diet, Paleolithic diet fraction, Paleolithic diet score, Type 2 diabetes, Waist circumference
in
BMC Nutrition
volume
11
issue
1
article number
180
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41039470
  • scopus:105017825125
ISSN
2055-0928
DOI
10.1186/s40795-025-01165-4
language
English
LU publication?
yes
id
4fe5202d-ec49-4978-928b-3d6c7284c004
date added to LUP
2025-11-20 15:47:53
date last changed
2025-11-21 03:00:06
@article{4fe5202d-ec49-4978-928b-3d6c7284c004,
  abstract     = {{<p>Background: Paleolithic Diet Fraction (PDF) and Paleolithic Diet Score (PDS) are both measures of how closely a food intake conforms to a Paleolithic dietary pattern. PDF is calculated directly from an individual’s absolute food intake and PDS is an aggregated score based on an individual’s food intake relative to a population. Both are inversely associated with all-cause and cause-specific mortality, coronary events and cancer. Here, for the first time, both measures are calculated in the same population and compared in a post hoc data analysis of a two-year-long randomized controlled trial (RCT) examining effects of lifestyle changes on waist circumference. Methods: Seventy-three participants with increased waist circumference and at least one additional risk factor for cardiovascular disease were randomized to a diet based on current dietary guidelines with or without grains and with or without physical exercise or controls. Of these, this post hoc analysis included the 57 participants (36 women and 21 men, aged 31–79 years) who completed the study per protocol with dietary data. Mean daily PDF and PDS were calculated using four-day weighed food records at baseline, 12 months, and 24 months. Correlations between PDF and PDS, and their respective associations with cardiometabolic outcomes were examined. Results: The mean daily PDF for energy at baseline, 12, and 24 months was 36%, 44%, and 42%, respectively. The absolute values of PDF and PDS, and their relative changes, demonstrated moderate to strong correlations during the study (r<sub>s</sub>​(55) = 0.38-0.75, p &lt;.001-0.004). No significant associations were found between changes in absolute or relative measures of PDF or PDS and changes in cardiometabolic outcomes. Conclusions: There were moderate to strong correlations between PDF and PDS and no associations between PDF or PDS and cardiometabolic outcome measures, with the latter result possibly due to only modest changes in diet and an absence of outcome effects. Registry: ClinicalTrials.gov, TRN: NCT01208558, Registration date: 24 September 2010. Retrospectively registered.</p>}},
  author       = {{Rydhög, Björn and Carrera-Bastos, Pedro and Granfeldt, Yvonne and Sundquist, Kristina and Jönsson, Tommy}},
  issn         = {{2055-0928}},
  keywords     = {{Lifestyle change; Paleolithic diet; Paleolithic diet fraction; Paleolithic diet score; Type 2 diabetes; Waist circumference}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Nutrition}},
  title        = {{Paleolithic diet fraction and score in post hoc data analysis of a randomized controlled trial with lifestyle interventions for abdominal obesity}},
  url          = {{http://dx.doi.org/10.1186/s40795-025-01165-4}},
  doi          = {{10.1186/s40795-025-01165-4}},
  volume       = {{11}},
  year         = {{2025}},
}