The Paleolithic ("paleo") diet is built on foods presumed available before agriculture: lean meat, fish, vegetables, fruit, nuts and eggs. It excludes grains, legumes, dairy, refined sugar, salt and processed foods.
A systematic review and meta-analysis by Manheimer and colleagues, published in the American Journal of Clinical Nutrition in 2015, pooled four randomised controlled trials with 159 participants who had components of metabolic syndrome. It reported that Paleolithic-style diets produced greater short-term improvements in waist circumference, triglycerides, blood pressure, HDL cholesterol and fasting blood sugar than control diets based on standard national guidelines. The authors describe the evidence base as limited — few trials, small samples, short durations — and state that larger and longer trials are needed before stronger conclusions can be drawn. A 2022 commentary in the same journal maintained that the evidence base remains limited.