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

Journal of the American Nutrition Association
February 1, 2022
Neal D Barnard et al. (12 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the relative efficacy of a vegan diet versus a Mediterranean diet in improving body weight and cardiometabolic risk factors in overweight adults.

Results Summary

The vegan diet resulted in significant weight loss (-6.0 kg), improved insulin sensitivity, and reduced LDL and total cholesterol compared to the Mediterranean diet. Blood pressure decreased on both diets, but more so on the Mediterranean diet.

Population

62 overweight adults

Effective Dosage

Not specified

Duration

16 weeks per diet, with a 4-week washout period

Interactions

None mentioned

Extracted Claims (16)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Mediterranean diet
no change
body weight
overweight adults
0.0 kg
no significant change
#1
vegan diet
decrease
body weight
overweight adults
-6.0 kg
decreased
#2
vegan diet
decrease
HOMA-IR
overweight adults
-
decreased
#3
Mediterranean diet
no change
HOMA-IR
overweight adults
-
no significant change
#4
vegan diet
increase
OGIS
overweight adults
+35.8 mL/min/m2
increased
#5
Mediterranean diet
no change
OGIS
overweight adults
-
no significant change
#6
vegan diet
no change
PREDIM
overweight adults
-
did not change significantly
#7
Mediterranean diet
no change
PREDIM
overweight adults
-
did not change significantly
#8
vegan diet
decrease
total cholesterol
participants with no medication changes
18.7 mg/dL (0.5 mmol/L)
decreased
#9
Mediterranean diet
no change
total cholesterol
participants with no medication changes
-
no significant change
#10
vegan diet
decrease
LDL-cholesterol
participants with no medication changes
15.3 mg/dL (0.4 mmol/L)
decreased
#11
Mediterranean diet
no change
LDL-cholesterol
participants with no medication changes
-
no significant change
#12
Mediterranean diet
decrease
systolic blood pressure
participants with no medication changes
9.3 mmHg
decreased
#13
vegan diet
decrease
systolic blood pressure
participants with no medication changes
3.4 mmHg
decreased
#14
Mediterranean diet
decrease
diastolic blood pressure
participants with no medication changes
7.3 mmHg
decreased
#15
vegan diet
decrease
diastolic blood pressure
participants with no medication changes
4.1 mmHg
decreased
#16
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 2nd 16-week period.Results: Overall net weight changes were 0.0 (Mediterranean) and -6.0 kg (vegan), (treatment effect -6.0 kg [95% CI -7.5 to -4.5]; p < 0.001). HOMA-IR decreased and OGIS increased on the vegan diet with no significant change on the Mediterranean diet (treatment effect -0.7 [95% CI, -1.8 to +0.4]; p = 0.21; and +35.8 mL/min/m2 [95% CI, +13.2 to +58.3]; p = 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 -15.6 [-24.6 to -6.6]; p = 0.001 and -14.8 [-23.5 to -6.2]; p = 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 +5.9 [95% CI +1.0 to +10.9]; p = 0.02; and +1.8 [95% CI -4.6 to +8.1]; p = 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.

Medical Subject Headings (MeSH)
AdultBody WeightCardiovascular DiseasesCross-Over StudiesDiet, MediterraneanDiet, VeganHumansInsulin ResistanceVegans
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations76
Citations/Year25.3
Relative Citation Ratio11.49
NIH Percentile98.3%
Research Impact Scores
APT Score0.95
Weight Score3.29
Normalized Score0.72
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