Mediterranean Diet vs. Keto: Which is Faster for 5% Weight Loss?
Struggling to shed pounds? This study compares the Mediterranean Diet and Very Low-Calorie Ketogenic Diet for achieving a 5% weight loss. Discover their effectiveness, timeframes, and impact on body composition to find the best fit for your health goals.
DRR S DIDWAL MD
2/13/20245 min read
A study published in the International Journal of Environmental Research and Public Health (1) compared the Mediterranean diet (MD) and the Very Low-Calorie Ketogenic Diet (VLCKD) for weight loss. Both groups lost 5% of body weight, but VLCKD took 1 month vs. 3 months for MD. MD led to a greater reduction in waist circumference, ,fat mass, and an increase in muscle mass and water. Both diets are effective, but MD might be better for long-term health and body composition, and individual needs should be considered when choosing a diet.
Key Points
Obesity:
Growing pandemic affecting 1.9 billion adults globally.
Increases the risk of various health problems like diabetes, heart disease, and cancer.
Losing 5% of body weight improves health significantly.
Mediterranean Diet (MD):
UNESCO-recognized sustainable diet rich in fruits, vegetables, whole grains, fish, and olive oil.
Lowers the glycemic load and promotes healthy eating habits.
Effective for weight loss, maintaining weight, and improving heart health, cognitive function, and mood.
Very Low-Calorie Ketogenic Diet (VLCKD):
Restricts carbs to 30–50 grams per day, forcing the body to use ketones for energy.
Only recommended for short periods (8–16 weeks) under medical supervision.
Effective for rapid weight loss and reducing fat mass, particularly visceral fat.
Not suitable for people with certain health conditions like diabetes, kidney disease, or pregnant women.
Study:
Compared MD and VLCKD for weight loss in people with overweight/obesity.
Goal: Achieve at least 5% body weight loss.
Results:
Both diets achieved the 5% weight loss goal, but:
VLCKD: 1 month.
MD: 3 months.
MD led to greater reductions in:
Waist circumference.
Fat mass.
Increased muscle mass and water content.
Both diets were effective, but MD might be better for:
Long-term health and body composition.
Individual needs and preferences.
Key Points:
Consider individual health and preferences when choosing a diet.
Both MD and VLCKD can be effective for weight loss, but their effects differ.
MD may be more sustainable and beneficial for long-term health.
VLCKD should only be used under medical supervision for short periods of time.
1.Obesity is a growing health concern, linked to various chronic diseases and reduced quality of life. Losing even 5% of body weight can significantly improve health outcomes. This study compares the Mediterranean Diet (MD) and the Very Low-Calorie Ketogenic Diet (VLCKD) for their effectiveness in achieving this goal.
Mediterranean Diet:
Promotes high consumption of fruits, vegetables, whole grains, legumes, nuts, healthy fats, and a moderate intake of dairy and fish.
Encourages portion control, home-cooked meals, and social eating with physical activity.
Offers long-term sustainability and benefits for cardiovascular health, cognitive function, and mood.
Studies show its effectiveness in weight loss compared to other diets, like low-fat diets.
Very Low-Calorie Ketogenic Diet (VLCKD):
Restricts carbohydrates to 30–50 g/day, inducing ketosis for energy production.
Provides 700–800 kcal/day with moderate protein and healthy fats.
It requires supplementation and is recommended for short periods (8–16 weeks) under medical supervision.
Shows significant weight loss, improved fat metabolism, and potentially better food control compared to other diets.
Effective for specific populations with severe obesity and comorbidities needing rapid weight loss.
Contraindicated for certain conditions like T1DM, recent cardiovascular events, and kidney issues.
Study Aim:
This study compared the time taken by both diets to achieve a 5% body weight loss in overweight and obese individuals. It also assessed their impact on body composition and anthropometric measures.
2.1. Study Population
A total of 374 male and female subjects with overweight or obesity were consecutively enrolled at the Endocrinology and Metabolic Diseases unit of the University Hospital Campus Bio-Medico of Rome from December 2021 to May 2022, based on inclusion and exclusion criteria. Inclusion criteria were adults aged 18–70 years and BMI ≥ 25 kg/m2, while exclusion criteria included various medical conditions and factors. The subjects were divided into two groups: the Mediterranean diet (MD) and the Very Low-Calorie Ketogenic Diet (VLCKD), with 191 and 183 subjects, respectively. The two groups were homogeneous for age, height, and weight. The population was further stratified based on gender, age (≤50 years old or ≥50 years old), and BMI.
2.2. Study Protocol
Subjects underwent an initial endocrinological visit for inclusion, followed by allocation to either MD or VLCKD. Nutritional counseling and dietary protocols were provided, and follow-up visits were conducted monthly until a 5% body weight loss was achieved. Regular phone calls monitored dietary adherence and motivation. After reaching the weight loss goal, participants transitioned to a maintenance diet (MD) or a reintroduction diet (VLCKD).
2.3. Anthropometric Parameters
Body weight, height, and waist circumference were recorded at baseline and monthly until the 5% weight loss goal. BMI was calculated, and body composition analysis was conducted using bioelectrical impedance analysis (BIA).
2.4. Body Composition Analysis
BIA measurements were taken monthly to assess parameters including phase angle, total body water, extracellular water, intracellular water, fat-free mass, fat mass, and body cellular mass.
2.5. Nutritional Protocols
The MD involved individualized hypocaloric Mediterranean dietary plans, while the VLCKD provided <800 kcal and <30–50 g of carbohydrate/day. Both diets included specific meal compositions and recommendations.
2.6. Statistical Analysis
Statistical analysis was performed using GraphPad Prism version 9.4.0, including Pearson tests and t-tests for intragroup and intergroup comparisons. The significance level was set at p < 0.05.
A sample size of 128 subjects (64 per group) was calculated, considering a power of 80% and a significance level of 0.05, accounting for possible dropouts.
3. Results
3.1. Study Population
Out of 374 subjects, 268 completed the study. The MD group comprised 133 subjects, and the VLCKD group comprised 135 subjects. Dropouts primarily occurred before achieving the 5% weight loss goal.
3.2. Results on Anthropometric Parameters and Body Composition
Both MD and VLCKD groups achieved at least 5% body weight loss, with VLCKD subjects achieving it after one month and MD subjects after three months. No significant differences were observed in body weight loss between the two groups. MD showed greater reductions in waist circumference and fat mass percentage, as well as higher increases in total body water percentage and fat-free mass percentage compared to VLCKD.
3.3. Subgroups Evaluation: Age and BMI
When stratified by age (≤50 years old or ≥50 years old), MD was more effective in reducing waist circumference, fat mass percentage, and increasing fat-free mass percentage and total body water percentage in subjects ≤50 years old. No significant differences were observed in subjects ≥50 years old. Similar trends were observed when stratified by BMI.
4. Discussion
The study demonstrated that both MD and VLCKD were effective in achieving 5% body weight loss in subjects with overweight or obesity. MD showed advantages in certain anthropometric and body composition parameters compared to VLCKD. Stratification by age and BMI revealed differential effectiveness between the two diets in subgroups.
5. Conclusions
The study suggests that both MD and VLCKD are viable strategies for weight management in subjects with overweight or obesity. Understanding individual needs and characteristics can help tailor nutritional interventions for optimal outcomes.
Reference Article
1.Di Rosa, C., Lattanzi, G., Spiezia, C., Imperia, E., Piccirilli, S., Beato, I., Gaspa, G., Micheli, V., De Joannon, F., Vallecorsa, N., Ciccozzi, M., Defeudis, G., Manfrini, S., & Khazrai, Y. M. (2022). Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity-A Cohort Study. International journal of environmental research and public health, 19(20), 13040. https://doi.org/10.3390/ijerph192013040
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