Study comparing low carb, mediterranean and low fat diet

by **Dtlv74** on Wed Mar 03, 2010 11:59 pm

This study was in the news today so I thought I'd hunt it down and check it out:

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

ABSTRACT

Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates.

Methods
In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non–restricted-calorie.

Results
The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels).

Conclusions
Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108 [ClinicalTrials.gov] .)

link to full study

All in all impressive results for the low carb diet, as would be expected in a weight loss study also looking at blood profiles. The interesting thing is that it's actually the mediterranean diet that showed the best improvement in glucose management and not the low carb diet. The reduced levels of glycated hemoglobin were also best in the med diet, which put together with everything makes the med diet possibly the best for those with diabetic or pre diabetic issues looking for a weight loss diet.

by **Pain** on Thu Mar 04, 2010 12:08 am

Dun dun dun!

Expand the findings for the med diet to a modified healthy diet and you're pretty well at the peak of nutrition.
Remove the wheat breads and replace with buckwheat and root crops etc, plenty of good protein all those lovely phytochemicals.

Simple healthy eating.

by **Dtlv74** on Thu Mar 04, 2010 1:24 am

Pain wrote:Dun dun dun!

Expand the findings for the med diet to a modified healthy diet and you're pretty well at the peak of nutrition.
Remove the wheat breads and replace with buckwheat and root crops etc, plenty of good protein all those lovely phytochemicals.

Simple healthy eating.

Agree one hundred percent

tbh the med diet is not far off what I am aim for... although without the calorie restriction and more lean bulk style.

by **Will** on Thu Mar 04, 2010 7:55 am

It's probably why my body composition is always so much better after I come back from my part of the world. I always always look like I'm carrying less water, a bit tighter. Furthermore, the food just actually tastes so much better, fruits and veg in particular are just to die for.

by **Rab** on Thu Mar 04, 2010 8:08 am

Dont yous think that when the bread you are eatng is much cleaner - ie 0 not a loaf fullof crap so it can be sat somewhere for a week after being made then also be ok lying in the cupboard for a further 4 days?

I dont think fresh decent bread is anywhere near as bad and hence a part of the Med diet i assume?

by **Will** on Thu Mar 04, 2010 10:09 am

I agree, I eat a lot of bread in the Med, and it's freshly baked that morning using literally 4-5 ingredients. Yet I still drop bodyfat or at least improve my composition. Furthermore the flour is not refined/processed either. Not acidity regulators, preservatives, flour treatment agents etc... I love bread back home in Cyprus or France - I don't like it here.

by **Alex** on Thu Mar 04, 2010 10:27 am

I'm with Will on this as well and this goes for any unprocessed food simply using natural, raw ingredients. Follow this, eat sensibly and you can't go wrong.

by **Will** on Thu Mar 04, 2010 10:56 am

Alex wrote:I'm with Will on this as well and this goes for any unprocessed food simply using natural, raw ingredients. Follow this, eat sensibly and you can't go wrong.

I remember you and I chatting about it last time I came back from Cyprus. It's so easy to find fresh unrefined/unprocessed foods in the Med, it's very hard to get that here, as we have a propensity to shop in supermarkets or live in areas where fresh foods aren't practicable.

by **Ader** on Thu Mar 04, 2010 11:03 am

Home made bread (which I very occassionally make) is quite cool - Incredibly filling compared to off the shelf stuff, but goes off very quickly - Luckily the rest of teh house chip in and eat it before it does 8-)

Wholemal is the best, plus have some fun adding nuts & seeds if you want - Or a shed load of garlic for ready made garlic bread :mrgreen:

by **Karlos** on Thu Mar 04, 2010 11:46 am

I never thought giving up bread would make that much difference if you choose the good WG/granary varieties, but it's one of the best thing i've done for body fat levels in the past few weeks. I didn't even eat it regularly before, just pwo. Instead i have porridge,oat bran, beans or WG rice and it's made a noticeable difference.

Is the med diet basically fruit, veg, healthy oil and bread?

by **Alex** on Thu Mar 04, 2010 11:58 am

Will wrote:
Alex wrote:I'm with Will on this as well and this goes for any unprocessed food simply using natural, raw ingredients. Follow this, eat sensibly and you can't go wrong.

I remember you and I chatting about it last time I came back from Cyprus. It's so easy to find fresh unrefined/unprocessed foods in the Med, it's very hard to get that here, as we have a propensity to shop in supermarkets or live in areas where fresh foods aren't practicable.

It's down to culture with an abundance of markets selling fresh produce while meal time itself is considered the most important part of the day for social interaction from the purchasing ingredients, preparing them and finally the eating. Life then revolves around this but then you have the climate to make this possible.

You have Supermarkets but they are largely empty unlike here where you cannot move for people. When I go down to Spain everyone hits the market early and while there are Supermarkets, they are mainly the non-natives using them or they're used for household items. They're also expensive, more so than over here overall.

by **Alex** on Thu Mar 04, 2010 12:01 pm

Karlos wrote:Is the med diet basically fruit, veg, healthy oil and bread?

Pretty much with fresh local fish thrown in. Other meats are used but this will vary between regions. If you don't go crazy on the bread then it's not a bad diet.

by **Ader** on Thu Mar 04, 2010 12:03 pm

Karlos wrote:Instead i have porridge,oat bran...

That would certainly make me lose fat - It took me a while to realise what the problem was but basically I just don't seem to digest them and they go right through me - Very quickly sometime!!! A side issue is I get dehydrated so if I tried to live on oats I'd start loooking cut pdq :lol:

by **Dtlv74** on Thu Mar 04, 2010 12:15 pm

Yeah it's basically a 'clean' diet with a few little twists. The thing that makes it unique is the dominant fat is monunsaturated (oleic acid from olives), and protein is mostly from poultry and sea food with only occasional red meat. Also, moderate wine drinking is also considered an acceptable part of the diet.

Dairy is considered ok, more cheese and yoghurt is consumed than milk though, and unprocessed wholegrains are fine - simple 'home made' style breads make a moderate contribution to the list of energy foods. Fruit is a typical dessert and there's quite a heavy use of beans and lentils in the main courses but a wide range of veggies as a whole. Root veg is used but not much. There's also inclusion of alliums like garlic and onions.

Emphasis is on fresh and seasonal food.

Purely from a compliance point of view I think it's the best kind of weight loss diet as it allows variety. It may not result in as much weight loss as low carb, which is very effective, but the restriction of so many foods on low carb diets can make it a really difficult and boring diet for some.

I do like this study though - two years is a decent amount of time and they looked at health markers that are meaningful. The only other thing I'd like to have seen looked at is the effect of the diets on LDL particle size, and which diet best reduced Pattern B LDL.

by **Alex** on Thu Mar 04, 2010 12:20 pm

One thing that may have made this study really interesting would have been to split the groups up further and include Vit D3 supplementation to simulate the climate along with the diet see what effects this had over diet alone.

Study comparing low carb, mediterranean and low fat diet

Study comparing low carb, mediterranean and low fat diet

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