A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-over Trial

Abstract

Objective: Evidence suggests that both Mediterranean and vegan diets improve body weight and cardiometabolic risk factors, but their relative efficacy has not been compared in a randomized trial. Methods: In a randomized crossover trial, 62 overweight adults were randomly assigned to a Mediterranean or vegan diet for a 16-week period. Body weight, plasma lipids, blood pressure, and body composition (dual X-ray absorptiometry) were measured. Secondary measures included insulin resistance (Homeostasis Model Assessment, HOMA-IR), oral glucose insulin sensitivity (OGIS), and predicted insulin sensitivity (PREDIM) indices. Thereafter, participants were asked to return to their baseline diets for 4 weeks, after which they began the opposite diet for 16 weeks. The same parameters were measured before and after this 2 nd 16-week period. Results: Overall net weight changes were 0.0 (Mediterranean) and À6.0 kg (vegan), (treatment effect À6.0 kg [95% CI À7.5 to À4.5]; p < 0.001). HOMA-IR decreased and OGIS increased on the vegan diet with no significant change on the Mediterranean diet (treatment effect À0.7 [95% CI, À1.8 to þ0.4]; p ¼ 0.21; and þ35.8 mL/min/m 2 [95% CI, þ13.2 to þ58.3]; p ¼ 0.003, respectively). PREDIM did not change significantly in either group. Among participants with no medication changes, total and LDL-cholesterol decreased 18.7 mg/dL (0.5 mmol/L) and 15.3 mg/dL (0.4 mmol/ L), respectively, on the vegan diet, compared with no significant change on the Mediterranean diet (treatment effect À15.6 [-24.6 to À6.6]; p ¼ 0.001 and À14.8 [-23.5 to À6.2]; p ¼ 0.001, respectively); systolic and diastolic blood pressure decreased 9.3 and 7.3 mmHg on the Mediterranean diet, compared with 3.4 and 4.1 mmHg on the vegan diet (treatment effect þ5.9 [95% CI þ1.0 to þ10.9]; p ¼ 0.02; and þ1.8 [95% CI À4.6 to þ8.1]; p ¼ 0.58, respectively). Conclusions: A low-fat vegan diet improved body weight, lipid concentrations, and insulin sensitivity, both from baseline and compared with a Mediterranean diet. Blood pressure decreased on both diets, more on the Mediterranean diet. Clinical trial registration: ClinicalTrials.gov number, NCT03698955 https://clinicaltrials.gov/ct2/show/NCT03698955?term=NCT03698955&draw=2&rank=1

Nutritional, Cardiovascular Health and Lifestyle Status of ‘Health Conscious’ Adult Vegans and Non-Vegans from Slovenia: A Cross-Sectional Self-Reported Survey

“…There is a lack of a standardized definition of what well-designed vegan and non-vegan diets actually mean in terms of macronutrient composition. The authors of the present paper therefore suggest that well-designed vegan (as used by research that has shown noteworthy results [ 23 , 24 , 25 , 26 ]) and non-vegan diets (as proposed in government guidelines on healthy eating by the Ministry of Health of Slovenia [ 27 ]) should limit total fat intake to up to 20% and 30% of energy, respectively (i.e., saturated fat intake ≤10% of energy for both), fiber intake should be above 60 and 30 g/d, and both diets should limit free sugar intake to ≤5% of energy. The effects of dietary cholesterol on blood lipids remains a matter of debate [ 28 , 29 , 30 ].…”

Weight Loss is Associated with Changes in Gut Microbiome: A Randomized, Cross-Over Trial Comparing a Mediterranean and a Low-Fat Vegan Diet in Overweight Adults.

“…Dietary intake has been described in detail previously (13). Brie y: Based on the self-reported diet records, energy intake slightly decreased on the vegan diet (p < 0.001) compared with no change on the Mediterranean diet.…”

“…The methods have been described in detail previously (13). Brie y: This randomized, cross-over trial took place between February and October 2019 in Washington, DC.…”

“…In this secondary analysis of a randomized crossover trial, which compared a Mediterranean and low-fat vegan diet head to head in overweight adults (13), we predicted that a 16-week dietary intervention would result in 1) a greater abundance of Bacteroidetes relative to Firmcutes on both diets, 2) a greater abundance of Prevotella on the Mediterranean diet, and 3) a greater abundance of Faecalibacterium Prausnitzii on the vegan diet. Furthermore, we anticipated that 4) these changes would be associated with changes in body weight.…”

Nutritional Supplements and Neuroprotective Diets and Their Potential Clinical Significance in Post-Stroke Rehabilitation

“…The beneficial effect of the MD is probably related to synergistic interactions between the various ingredients as a whole of the nutritional regimen [ 47 ]. A potential mechanism underlying the effect of the MD on the vascular system may be associated with a beneficial impact on endothelium-dependent vasoreactivity and insulin resistance [ 48 , 49 , 50 ], as well as with antioxidant and anti-inflammatory activity [ 51 , 52 , 53 ].…”