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Weight loss with a Mediterranean diet

Mancini JG, Filion KB, Atallah R, et al. Systematic Review of the Mediterranean Diet for Long-term Weight Loss. Am J Med. 2016;129:407-15.

Review question

In people who are overweight or obese, what is the effect of the Mediterranean diet on weight loss after 1 year?


A Mediterranean diet includes mostly fruits and vegetables, whole grains, legumes (e.g., peas, beans, lentils), nuts, and olive oil; some chicken or turkey, fish, and dairy products; and very little red meat. People who eat a Mediterranean diet tend to have lower risk for cardiovascular disease. This review focused on the long-term effects of a Mediterranean diet on weight loss compared with other diets.

How the review was done

5 studies (randomized controlled trials) were published up to January 2015.

The studies included 998 adults, who were about 44 to 58 years of age.

People in the studies were overweight or obese and were trying to lose weight. Most had coronary heart disease or diabetes.

The studies compared the effects of a Mediterranean diet with a low-fat diet, low-carbohydrate diet, or the American Diabetes Association diet over at least 1 year.

What the researchers found

People eating a Mediterranean diet lost more weight than people eating a low-fat diet (see Table).

People eating a Mediterranean diet lost a similar amount of weight as people eating a low-carbohydrate diet or the American Diabetes Association diet.

A Mediterranean diet was generally similar to other diets at improving cardiovascular risk factor levels, including blood pressure and lipid levels.


In people who are overweight or obese, eating a Mediterranean diet for at least 1 year resulted in more weight loss than a low-fat diet and similar weight loss to a low-carbohydrate diet or the American Diabetes Association diet.

Mediterranean diet vs other diets for weight loss in people who were overweight or obese


Number of trials

Range of average weight change over at least 1 year

Effect of Mediterranean diet



Mediterranean diet

Comparison diet


Mediterranean diet vs low-fat diet

3 trials

4.7 kg to 6.2 kg (10 to 14 pounds) weight loss

5.0 kg (11 pounds) weight loss to 2.9 kg (6 pounds) weight gain

People lost more weight with a Mediterranean diet than a low-fat diet.

Mediterranean diet vs low-carbohydrate diet

2 trials

4.7 kg to 7.4 kg (10 to 16 pounds) weight loss

5.3 kg to 10.1 kg (12 to 22 pounds) weight loss

Weight loss was similar for a Mediterranean diet and a low-carbohydrate diet.

Mediterranean diet vs American Diabetes Association diet

1 trial

7.4 kg (16 pounds) weight loss

7.7 kg (17 pounds) weight loss

Weight loss was similar for a Mediterranean diet and American Diabetes Association diet.


Related Topics


Coronary heart disease
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

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