HLSC122 Evidence Based Nursing: Paleo Diet and Weight Loss Report

This report addresses the clinical question of whether the Paleo diet leads to weight loss for overweight adults with a BMI of 29. It utilizes the PICO framework, identifying the patient/problem (overweight with a BMI of 29), intervention (Paleo diet), comparison (normal diet), and outcome (weight loss). The search strategy involved using CINAHL database, employing Boolean operators and truncation to refine results. Initial searches were broad, then narrowed using 'AND' operator and limiters like publication date and peer-review. The refined search yielded relevant articles, including studies comparing metabolic and physiological improvements in participants on the Paleo diet. These articles suggest that the Paleo diet can lead to significant reductions in body weight and fat mass. The report concludes by highlighting the effectiveness of the chosen search strategy and the relevance of the selected articles in answering the clinical question. Desklib offers solved assignments and past papers for students.

Evidence Based Nursing
Research
Name of the student
Name of the university
Author note
Evidence Based Nursing
Research

• PICO model is used to frame a question based on the provided evidences. It helps to
locate, assess and evaluate the case in a broader aspect, addressing all the points in
detail. The elements of the PICO structure includes Patient or Problem, Intervention,
Comparison and Outcome (Darmasseelane et al., 2014).
• While framing the PICO question it is important to find out the type of the question is
needed to be formed, since the PICO elements vary according to the type the question.
The PICO questions can be of following types, such as Treatment or therapy, prognosis
or forecast, prevention, diagnosis and etiology or causation (Mastellos et al., 2014).
• Once the individual elements of the PICO question are identified, it helps in writing the
question statement. The PICO format also helps to filter the search strategy. It identifies
the major concepts related to the question that needs to be answered.
PICO Framework

The clinical question aims to address the possibilities whether Paleo diet can be helpful for
overweight individuals who wants to lose weight (Tóth & Clemens, 2015).
Type of clinical question:
The clinical question follows the type of Prevention. It explores the preventive measures of
Paleo diet in generation of a healthy Body Mass Index.
Importance and Rationale:
The importance of generating a clinical question is that it helps to address all the required
issues in one simple statement while solving a case (Manheimer et al., 2015).
Significance of Clinical Question

Clinical Scenario
The patient Hau is a 35 year old young adult male. His BMI is 29, which is
considered as overweight. Hau has joined a new kick since he started a new job. He has
tried many different diets to lose weight, but none of them have been helpful for him. He now
wants to try Paleo diet, which may help him lose weight and stay healthy. Although, he is
doubtful of its effectiveness. Therefore he wants to explore the proven facts and quality
evidences about the effectiveness of Paleo diet regarding weight loss.
Therefore, the clinical question is, for adults with a BMI of 29, does the Paleo
diet lead to weight loss?

Introduction to PICO
From the scenario, the following PICO question has been formed:
Problem (P): The patient Hau has a BMI of 29 and is overweight
Intervention (I): He wants to try the Paleo diet
Comparison (C): Hau wants to try Paleo diet instead of having a normal diet
Outcome (O): Hau wants to lose weight with the help of Paleo diet
The patient, Hau, wants to try Paleo diet to overcome his problem of being overweight.
He has tried Soup diet, cabbage diet and high protein diet: but in vein. He wants to lose weight by
using the Paleo diet plan.

Key Health Databases
The following databases are most commonly used for health related searches:
• CINAHL
• Medline or PubMed
• PsycInfo
• SPORTDiscus
• UpToDate
Out of these, CINAHL and Pubmed are the most widely acknowledged databases.
We have used the search database CINAHL for our study (Boers et al., 2014).

The database in the ACU Library Website

Chosen Database: CINAHL

Initial Search Process
Search ID# Search terms Search options Actions
S1 Overweight* OR High* BMI Find all my search terms 39,388
Expanded with * for
truncation
Boolean operator OR
S2 Paleo* diet* Find all my search terms 154
Expanded with * for
truncation
S3 Normal* diet* OR Ordinary
diet*
Find all my search terms 8001
Expanded with * for
truncation
Boolean operator OR
S4 Weight los* OR Los* weight Find all my search terms 36,982
Expanded with * for
truncation
Boolean operator OR

Search Refinement
• For search refinement, all the key search terms are needed to put
together with Boolean Operator AND.
• Although, it was not possible to find results using all the search
terms
• Therefore only the most important key words were used to assess
the results
• This is the reason we used only S2 and S4 terms for further
refinement of search

Search Refinement
Search ID# Search terms Search options Actions
S5 S2 AND S4 Find all my search terms 19
Limited with Boolean
Operator AND
S6 S2 AND S4 Find all my search terms 17
Limited to Published date
2013-2017
Language- English
S7 S2 AND S4 Find all my search terms 9
Limited with Peer
reviewed

Best Articles Found

This article compares the metabolic and physiological improvements of participants
who were on Paleo Diet (PD). Twenty participants with BMI 26±1kg/m2 and aged 43±3
years were studied on the basis of their insulin sensitivity, body composition and
weight, blood pressure and lipid profiles. The study proved that people who were on
Paleo Diet for 5-weeks resulted in significant reductions in their body weight, fat mass
and percent body fat.
Best Articles Found

This article assesses both the beneficial and the controversial aspects of the Paleolithic
diet plan. It talks about the benefits of Paleo diet in weight loss and its proven
improvements in metabolic dysfunction. On the contrary, the study also provides
information about individuals who consume Paleo diet, tend to become deficient in
calcium. This study suggests, that the General Practitioners (GP) should advice people to
intake adequate calcium in order to avoid further complications such as osteoporosis.
Best Articles Found

 For better results, the CINAHL database was selected.
 Initially the key terms were used with OR Boolean Operator and with truncation, to gain
as much results as possible.
 Later, for refining the searches, AND Boolean Operator and several limiters were used.
 This resulted in 9 Articles, out of which 2 were chosen.
 These two addressed all the PICO questions and answered the clinical question as well.
Summary

References
Binnie, M. A., Barlow, K., Johnson, V., & Harrison, C. (2014). Red meats: Time for a paradigm shift
in dietary advice. Meat science, 98(3), 445-451.
Boers, I., Muskiet, F. A., Berkelaar, E., Schut, E., Penders, R., Hoenderdos, K., ... & Jong, M. C.
(2014). Favourable effects of consuming a Palaeolithic-type diet on characteristics of the
metabolic syndrome: a randomized controlled pilot-study. Lipids in health and disease, 13(1),
160.
Darmasseelane, K., Hyde, M. J., Santhakumaran, S., Gale, C., & Modi, N. (2014). Mode of
delivery and offspring body mass index, overweight and obesity in adult life: a systematic
review and meta-analysis. PloS one, 9(2), e87896.

References
Davidson, J. (2013). Paleo Diet For Weight Loss (Vol. 2). JD-Biz Corp Publishing.
Greenhalgh, T., Bidewell, J., Crisp, E., Lambros, A., & Warland, J. (2016). Understanding Research
Methods for Evidence-Based Practice in Health 1e.
Manheimer, E. W., van Zuuren, E. J., Fedorowicz, Z., & Pijl, H. (2015). Paleolithic nutrition for metabolic
syndrome: systematic review and meta-analysis, 2. The American journal of clinical
nutrition, 102(4), 922-932.
Martin, C. A., & Akers, J. (2013). Paleo Diet Versus Modified Paleo Diet: A Randomized Control Trial of
Weight Loss and Biochemical Benefit. Journal of the Academy of Nutrition and Dietetics, 113(9),
A35.

Mastellos, N., Gunn, L. H., Felix, L. M., Car, J., & Majeed, A. (2014). Transtheoretical model stages of change
for dietary and physical exercise modification in weight loss management for overweight and obese
adults. Cochrane Database Syst Rev, 2(2), CD008066.
Otten, J., Mellberg, C., Ryberg, M., Sandberg, S., Kullberg, J., Lindahl, B., ... & Olsson, T. (2016). Strong and
persistent effect on liver fat with a Paleolithic diet during a two-year intervention. International Journal of
Obesity.
Otten, J., Stomby, A., Waling, M., Isaksson, A., Tellström, A., Lundin‐Olsson, L., ... & Olsson, T. (2017). Benefits
of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic
control: a randomized controlled trial in individuals with type 2 diabetes. Diabetes/metabolism research
and reviews, 33(1), e2828.
References

Pitt, C. E. (2016). Cutting through the Paleo hype: The evidence for the Palaeolithic
diet. Australian family physician, 45(1/2), 35.
Quick, V., Wall, M., Larson, N., Haines, J., & Neumark-Sztainer, D. (2013). Personal,
behavioral and socio-environmental predictors of overweight incidence in young
adults: 10-yr longitudinal findings. International Journal of Behavioral Nutrition and
Physical Activity, 10(1), 37.
References

Sonneville, K. R., Horton, N. J., Micali, N., Crosby, R. D., Swanson, S. A., Solmi, F., & Field,
A. E. (2013). Longitudinal associations between binge eating and overeating and
adverse outcomes among adolescents and young adults: does loss of control
matter?. JAMA pediatrics, 167(2), 149-155.
Tóth, C., & Clemens, Z. (2015). Successful treatment of a patient with obesity, type 2
diabetes and hypertension with the paleolithic ketogenic diet. Int J Case Rep
Images, 6(3), 161-7.
References